Questions questions

[Anewbie123]

Hi, I'm completely new to this. After full blood tests this week, TSH is 67 and T4 is 6.0. I have been prescribed levothyroxine 50mg starter. I'm 50, perimenopausal, take combined HRT oestrogen and progesterone. Ferritin 14 .4 (with iron supplements), ESR 25mm, cholesterol 7.5, eat healthily, increasing exercise, don't smoke, minimal alcohol, no caffeine. Any advice/moral support welcome. No family connections as far as I know. Feeling a bit overwhelmed and loads of questions!

[Buddy195 Administrator]

Welcome to the forum Anewbie123, you will get lots of great advice & support here, we are a very friendly bunch!

Please can you let us know the ranges for your thyroid & vitamin blood tests (in brackets after the reading) as laboratories can vary with these.

No one in my family has a thyroid issue either, but they do have other auto immune conditions. Have you had a blood check for antibodies to see if your hypothyroidism is auto immune (aka Hashimotos)?

What symptoms are you experiencing?

Are you due to be tested 6-8 weeks after starting on 50mcg Levothyroxine?

Very best wishes 🦋

[Anewbie123 in reply to Buddy195]

This are the test results I have:TSH Your Value 67.67 mU/L

Standard Range 0.35 - 5.50 mU/L

Free T4 Your Value 6.0 pmol/L

Standard Range 10.5 - 21.0 pmol/L

Ferritin Your Value 14.4 ug/L

Standard Range 10.0 - 291.0 ug/L

ESR Your Value 25 mm

Standard Range 1 - 12 mm

I don't have any other vitamin tests results. Something to ask for. Yes I've been asked to retest in 5 weeks.

[SlowDragon Administrator]

Welcome to the forum

50mcg is the standard starter dose levothyroxine

Thyroid levels should be retested 6-8 weeks after each dose increase

Which brand of levothyroxine have you been started on

Many people find different brands are not interchangeable and lots of people don’t get on with Teva brand (but for others, it’s by far the best brand)

Low vitamin levels are directly linked to being hypothyroid

How much iron are you currently taking

Have you had vitamin D, folate and B12 tested yet, if not request they are at next test

Similarly vast majority of primary hypothyroidism is autoimmune thyroid disease also called Hashimoto’s, usually diagnosed by high thyroid antibodies. If not had thyroid antibodies tested request they are at next test too

Levothyroxine is an extremely fussy hormone and should always be taken on an empty stomach and then nothing apart from water for at least an hour after

Many people take Levothyroxine soon after waking, but it may be more convenient and perhaps more effective taken at bedtime

verywellhealth.com/best-tim...

No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap.

Some like iron, calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away

(Time gap doesn't apply to Vitamin D mouth spray)

If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test

If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal

High cholesterol is linked to being hypothyroid and will reduce as dose of levothyroxine is slowly increased over coming months

[Anewbie123 in reply to SlowDragon]

Thanks for advice. I will ask for: Vit D

Foliate

B12

Thyroid antibodies

[SarahJane1471]

Welcome 🙏 It’s all a bit overwhelming at first I know I’ve only been diagnosed less than a year ( although I did lots of reading on here before) .

There will be a lot to take in but keep reading and it will all gradually start to make sense.

Sarah

[Anewbie123 in reply to SarahJane1471]

Thanks v much. I had NO idea how finely tuned it all is!

[greygoose]

Hi Anewbie123, welcome to the forum.

Ask as many questions as you like! It's the only way to learn, and we're all here to answer them if we can.

Just wanted to say not to worry about the cholesterol. It's got nothing to do with diet (despite what doctors think!) so, whatever you do, don't go on a lon/no-fat diet, as a lot of doctors recommend. Your cholesterol is high because your thyroid hormone (T3) is low - and it's going to be very low with that low T4 - and it won't do you any harm. And the last thing you want to do is take statins! 😊

[Anewbie123 in reply to greygoose]

That's really helpful thanks! I was wondering what else I could do to fix it, I'm pretty good on diet already so I feel relieved.

[SlowDragon Administrator in reply to Anewbie123]

nhs.uk/conditions/statins/c...If you have an underactive thyroid (hypothyroidism), treatment may be delayed until this problem is treated. This is because having an underactive thyroid can lead to an increased cholesterol level, and treating hypothyroidism may cause your cholesterol level to decrease, without the need for statins. Statins are also more likely to cause muscle damage in people with an underactive thyroid.

Come back with new post once you get results back after next test

Which brand of levothyroxine are you currently taking

[Anewbie123 in reply to SlowDragon]

Thank you

[greygoose in reply to Anewbie123]

You're welcome.

[humanbean]

Ferritin 14.4 ug/L Standard Range 10.0 - 291.0 ug/L Less than 2% of the way through the range

ESR 25 mm Standard Range 1 - 12 mm

.....................................

ESR (Erythrocyte Sedimentation Rate) is a measure of inflammation and/or infection and yours is obviously high. Unfortunately ESR doesn't tell you where the problem lies.

This link should be good for getting an explanation of what it is and what your result means :

labtestsonline.org.uk/tests...

The kind of things (apart from infection) that will raise ESR are low levels of nutrients, low levels of Free T4 and Free T3 (the thyroid hormones), anaemia, various forms of arthritis, sepsis, various lung diseases, and other things.

It isn't possible to lower ESR directly.

.....................................

Your ferritin is less than 2% of the way through the range which is massively under optimal. Optimal ferritin is roughly 50% - 65% of the way through the range i.e. approx 150 - 192 with the range you've been given for your test.

Are you being prescribed iron pills? If yes, what are they, and what dose are you taking? Raising anything to do with iron can be very difficult for many people, and can also take a very long time. I had very low ferritin (iron stores) and below range serum iron some years ago. It took me nearly two years to raise my ferritin to mid-range, but my serum iron was still low, although it had crept into the range. I ended up taking a maintenance dose of iron for a few more years after that.

I bought my own iron supplements - you can buy the ones that doctors prescribe without a prescription. It helped because I know that no doctor would have prescribed for nearly two years - I thought it was more likely that I would get cut off after 2 - 3 months.

For info on the iron supplements available in the UK, prescribed or over-the-counter :

healthunlocked.com/thyroidu...

and for warnings about what can go wrong :

healthunlocked.com/thyroidu...

Good luck.