I was diagnosed hypo back in 1997 ish! I was mostly on 50mcg of levothyroxine for many years then onto 75mcg at some point. Later even alternating 50/75 alternate days.
In July 2020 my GP testing numbers were: TSH 2.83, T4 21 (range 12-22) I wasn't feeling too good so opted to do the alternate days of 50/75.
I think I was retested Dec 2020 (?) TSH3.88, T4 18. I carried on with 50/75 because I felt well.
Next testing was Dec 2021. TSH 5.11 and I was told to take 75 every day. To be tested in 2 months.
Feb 2022. TSH 6.94 (range 0.27-4.20) T4 15 (range 11-22)
My GP wants me on 100cmg of levo but I'm anti because I've been given that dose before and remember feeling 'unwell'.
My totally unqualified thoughts on the subject of the upward trend is: a) am I absorbing the levo? b) is the brand 'Teva' not suiting me? Two days ago I switched to taking MercuryPharma.
I shall discuss with my GP on Monday but not over confident that he will have the answer.
Any clues please why the TSH is climbing? Thanks for any help.
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janet65
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Welcome back janet65, I am sorry you've not been feeling well. The following
Feb 2022. TSH 6.94 (range 0.27-4.20) T4 15 (range 11-22).
Your TSH is too high - the aim being a TSH of 1 or lower. Your T4 is low,
Your GP should increase your dose in order to bring TSH down to around 1 or lower and request he checks your Free T3 and Free T4 too. The aim for the latter two is to be in the upper part of the ranges.
When we're hypo the aim is to get sufficient thyroid hormone replacements to bring TSH to around 1 or lower. We should also get the Frees tested (i.e. FT4 and FT3). The aim is that both Frees are in the upper part of the ranges.
You might find it worthwhile to raise your dose as the pharma company may have made small changes to levo.
Do you take levothyroxine on an empty stomach (usually when we awake but some prefer a 'middle of the night dose). Levo should be taken with one glass of water and wait an hour before you eat as food can interfere with its uptake.
I am not medically qualified but you can read my 'history' by clicking on my name and it will take you to a new page.
Also request doctor to test Free T3 and Free T4. If you've also not had B12, Vit D, iron, ferritin and folate tested recently request these too.
Put your results on a new post with the ranges for more comments.
Thank you for all your advice. Yes, when I speak to the GP I shall ask for a TSH, T4 & T3 to be done. The only person who ever did that for me was a gastroenterologist.
No, I didn't know that others weren't doing well on Teva....I've been taking it for a very long time so is probably the reason I'm in this predicament!
Thanks for you help and advice. I didn't understand that T4 needs to be near the top of the range and TSH very low number.
When our thyroid gland is failing, we probably never have heard the word
hypothyroidism. I hadn't but neither did any of the doctors I paid. There was more than 2 or 3.
Always make your blood test appointment for thyroid hormones at the very earliest - even if made weeks ahead - and it is a fasting test (you can drink water) but don't take thyroid hormones before the blood draw but afterwards. Always take thyroid hormones with one glass of water as sometimes it could stick in throat. . Wait about an hour after taking thyroid hormones before you eat. Food can interfere with its uptake.
I thought this was happening all the time and as a matter of course. Maybe it’s my misunderstanding. It’s often also presented on here as though it’s T4’s only function. Obviously that’s wrong but the point about it converting to T3 only when necessary perhaps needs clarifying. Does anyone have knowledge or articles to the contrary?
Hi Noelnoel ,just had a look at a quote from that link from shaws
"These hormones are: T3 (triiodothyronine), which contributes to the body’s muscle control, digestion, heart function, and bone health; and T4 (thyroxine), which helps maintain metabolism, mood, and body temperature. Your body can convert T4 to T3 if necessary."
it's not correct.
That makes it sound like T3 does one job and T4 does others.
this is NOT the case.
I have no idea were they got the idea that T4 'does' those things . It is the action of T3 that does ALL those things.
T4 is a storage and transport form of T3 , with a long life.
T3 is the ONLY one that has direct effects inside cells.
T4 always has to be converted into T3 inside the cells before it can 'do' anything.
T4 itself can't 'do' anything as it simply doesn't fit into our T3 receptors until it's had one of it's Iodine atoms removed ... then it fits and it can trigger whatever action that particular cell does.
It is also somewhat misleading in that it gives 'normal ' ranges for fT4 and fT3 . But different labs use different ranges , and we can't compare a result done on one lab machine to another result from a different lab who's machine has different ranges.
This illustrates beautifully why we should always apply due diligence, particularly concerning health matters. There are a lot of well-meaning people on this fantastic forum but there is also a lot of misinformation
Thank you for clarifying T4’s role, it’s as I knew but people often think that its sole function is to convert to T3
"Thank you for clarifying T4’s role, it’s as I knew but people often think that it’s sole function is to convert to T3"
Do you mean you think it does have other functions ? or have i just read that wrong .
If there are any functions of T4 other than to hang around and wait to be converted to T3 , i don't think anybody has discovered with any certainty what they are yet.
Some people on here with NO thyroid seem to manage just fine of T3 only, despite having no T4 at all .
There IS recent research showing that T4 has an effect on some receptors on the outside of cell walls that seems to have some relation to cancer proliferation .. higher rT4 levels = more proliferation .. but it's a bit complicated . not all cancers are the same Jimh111 has done a recent post looking at what is known about this so far
Do you mean you think it does have other functions ? or have i just read that wrong
No, it’s as you say, it triggers, transports and stores and this I knew but it will have other functions to which we remain ignorant, for now. What I meant was, there’ll be functions yet to be discovered and even if not, it will most certainly have knock-on effects that we’re unaware of. After all, every action/reaction creates another and another and to say (not you) that its sole function is conversion, is simply misleading
All a bit philosophical I know but if you can’t be philosophical on a Sunday, when can you
Luckily for us science has progressed enormously these last 50 years and we know so much (even us lay-people) enabling self-treatment but interestingly/paradoxically the treatment of thyroid dysfunction has regressed. Medicine is a marvellous tool but some medics, not so much
Thanks Shaws ....my responses are likely to go downhill from here on in .. i've just decided i'm having a glass of Cider .... after which i won't be able to spell 'philosophical' on a sunday Noelnoel
Tattybogle (or anyone really), you may have had one too many ciders by now and if that’s the case, good luck to you but this comment further down the post, any thoughts on it?
TSH is naturally higher in winter and lower in summer…
Hi. Yes exactly.Worrying about T4 is useless as in my case if I need to tae more thyroxin to lower TSH I have to.
Without a thyroid I keep to a TSH of 2.0 - 3.0. Not too high or low.
I am free of cancer after 2 clear neck scans.
I take my Synthroid under tongue so it goes into the blood stream like my B12 nuggets Solgar range. A recent B12 test shows 465. Should be high for older like me.
73 years young!
I also have AF but the rapid persistent irregular kind. Developed when undiagnosed papillary cancer was happening.
I am going to print this out and take it to my GP. She does not appear to know the difference between Total T3 (mine's at the bottom of normal range) and Free T3, which she reckons they're not allowed to order.
Thanks for that clarification. That description of T4 as a storage and transport form is a great way of describing it. I read so many articles and sometimes end up more confused than when I started....just as I think I’ve grasped something it all seems like sand slipping through my fingers. At the moment I’m considering giving up on T3 (I’m a poor converter). because of palpitations and would like to try going back to the 150 mcg T4 which I was happily taking before a doctor picked up on my really low TSH. TSH has been really low for 20 years (praise for NHS records online!). but FT4 and FT3 always well within range. My own regular doc knew this but was not guided by TSH alone and more but how I felt and symptoms. I’m going to post this in another new strand but you seem to have a good grasp of everything and I understand your replies!
I was on Mercury pharma for years and was well on this brand the pharmacy switched me to Teva I became very unwell having to attend AandE kept going back to my GP she kept saying it was my age my daughter had the same problem it looked as if we weren’t absorbing this Teva for some reason I ended up taking a heart attack the doctor now writes our brand on prescription now.
I'm so sorry to hear that worse case scenario!!!! I hope your heart made a full recovery. That really is my thought that I'm not absorbing the Teva. I shall be having MP written on my repeat prescriptions too. Thanks for sharing that.
HiI take Synthyroid under the tongue so it goes straight into blood stream.
Take piece of banana at 1/2 hr.
Due to thyroid Papillary I have had my thyroid removed.
With 2 clear neck scans my surgeon suggests that I keep my TSH at between 2.0 and 3.0. Not too high and not too low. Forget T4 The thyroxin will move that up or down.
I never had radio active iodine nor did I get into suppression of TSH.
I showed 2.0 when I was diagnosed with the cancer.
I'd see if the GP will do more tests next time. In July 2020 your TSH was still higher than most of us want - but free T4 was near the top of the lab range. Since then, thing have gone down hill. Please see if s/he will do all the tests recommended by Thyroid UK - TSH, free T4, free T3 and key nutrients - ferritin, folate, vit D and B12 [early morning fasting blood test, no later than 9am and 24 hours from previous dose of levo].
Two other things you should try (Imho) - (a) see how you do on the Mercury Pharma - you're probably aware that lots of people don't get on with Teva; and (b) try the new dose split into 2 - say half in the morning and half at night, and see if that works better, as you didn't feel well with 100 mcg in one go before.
You are ENTITLED to feel properly, fully well - but for some of us, that just doesn't happen if all they test is TH and free T4. Good luck x
Thank you for that suggestion of dividing the 100mcg dose! I'm on that one for sure. Yes I've been tested (for other reasons) for Vit D - Optimal and the others. I had colon cancer in April 2020 and my haemoglobin went down to 102....thankfully back up to my normal 135. now.
This is a genuine damaged thumb....I strained the first joint trying to open a bottle of hoisin sauce....it will be a quick release procedure. I don't do well on steroid injections so have refused those. At the moment it's stiff, not bent and unmoveable. The private hospital is Benenden. I've been referred as a member but also through the NHS system, that's why I can only have one case open at a time.
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.
About 90% of all primary hypothyroidism in Uk is due to Hashimoto’s. Low vitamin levels are particularly common with Hashimoto’s.
Gluten intolerance is often a hidden issue with autoimmune thyroid disease. Request coeliac blood test BEFORE considering trial on strictly gluten free diet
Thank you. I had considered Hashimoto and wondered if it applied to me. I'm being treated (long term) for severe eosinophilic asthma with biologic injections so already have autoimmune issues. Thank you for all the links too.
Thyroid hormones regulate body temperature, among other things. It's common that You need more hormones in winter (to warm up your body) than in summer. The same happens with your lifestyle, diet, and so on. Energy demands fluctuate.
I suppose you could take 75mcg Mercury for a couple of months, so you can tell if you feel any different with a different brand... then get retested . If your TSH hasn't started to come down by then , i think you should definitely increase the dose .
Just because you previously felt unwell on 100mcg doesn't mean you will now .. perhaps the last time you didn't need that much, but TSH 6 is a clear indication you do need some more.
You don't have to go from 75 to 100 . You could try a smaller increase first ... 87.5mcg ( 100mcg /75mcg on alternate days )
Thank you. I'm already on MP, 1st day 75mcg, 2nd day 75mcg (am) 25mcg (pm) 3rd day 50mcg (am) and later the other 50mcg. So far no headache like yesterday. If it was the Teva brand stalling me I may have the dose lowered when retested in April.
Is your GP a specialist endocrinologist or better still a trained postgraduate medic in thyroid gland endocrinology otherwise it will end up being unsatisfactory?!😥
I'm never even met the GP (lockdown) but looking at a pic he doesn't look old enough to be out of school yet!! That's me being funny because he's young. He doesn't show any specialism after his name. I've thought about asking to see an Endocrinologist. The NHS waiting list is about 15weeks, I have a private hospital but can't ask them yet because they're dealing with a trigger thumb.... I'm a mess!! And the thyroid saga has been a continual stab in the dark at medicating me!
I lived in Spain for 14 yrs and they did scans on my thyroid every 2 yrs. On my return to England I was soon told that the NHS doesn't have money for such luxuries like Spain.... I've just had my heart checked on a B/T last Nov and the results were normal. I've also had quite a few doppler scans because of meds that can damage the heart. Thanks Chreri.
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