What’s the range on Ft4 (figures in brackets after result)
The aim of levothyroxine is to increase the dose slowly upwards in 25mcg steps until Ft4 is in top 1/3 of range
Just testing TSH and Ft4 is inadequate
Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine
For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested.
Very important to test vitamin D, folate, ferritin and B12 at least once year minimum
Low vitamin levels are extremely common, especially with autoimmune thyroid disease (Hashimoto’s or Ord’s thyroiditis) diagnosed by high thyroid antibodies
About 90% of primary hypothyroidism is autoimmune thyroid disease
Autoimmune thyroid disease with goitre is Hashimoto’s
Autoimmune thyroid disease without goitre is Ord’s thyroiditis. Both are autoimmune and generally called Hashimoto’s.
In U.K. medics never call it Hashimoto’s, just autoimmune thyroid disease (and they usually ignore the autoimmune aspect)
Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water and last dose levothyroxine 24 hours before test
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)
Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins
If TPO or TG thyroid antibodies are high this is usually due to Hashimoto’s (commonly known in UK as autoimmune thyroid disease). Ord’s is autoimmune without goitre.
Thank you! TSH is now 1.49 range 0.2-4.5.T4 is 11.4 range 7.0-17.0.
I’d like to aim for TSH 0.5-1 and T4 top third of range as per Nice guidelines but am anticipating difficultly getting a dose increase now I and ‘within range’.
My vit D was low so now supplementing accordingly with recommendations from TIP.
My B12 long term low so on EOD IM hydroxocobalamin.
So you think an increase to 50mcg levothyroxine should be the best option?
I did get private T3, TPOAb and TgAb and think I’ve just posted them in this thread?All normal I think?
Vit D was 55. I’m taking 10,000IU per day with K2MK7 and magnesium malate and magnesium glycinate after a meal of 15mg healthy fat (Brazil nots as they also contain selenium)
My latest B12 was 211 but v symptomatic. I’m pescatarian do no meat but eat lots of salmon, prawns and tuna and green veggies. Was as low as 104.
Folate 4.9. Am taking 5mg folic acid a day.
Ferritin 48. Will be starting 150mg elemental iron twice a day with 1000mg vit c each dose.
Thorne Basic B or Jarrow B Right are recommended options that contains folate, but both are large capsules. (You can tip powder out if can’t swallow capsule)
IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results
With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a B12 supplement as well as a B Complex (to balance all the B vitamins) initially for first 2-4 months, then once your serum B12 is over 500 (or Active B12 level has reached 70), stop the B12 and just carry on with the B Complex.
Re your low B12 - before you supplement you should ensure you do not have a B12 deficiency (you could have pernicious anaemia). I have this condition and get a B12 injection monthly but it is usual to get an injection every 3 months.
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