So I got my results back after being down at around level of 6 TSH in January. Im not back up to 22 TSH levels despite my dose staying the same. Is this normal? My dose is 50mg, should the dr up it to 100mg. I don’t know what to request. Just really upsetting that it’s gone back to that level again like last year. Just feeling really down and depressed at the moment, don’t know whether it’s to do with the level being high again.
TSH 22
T4 9.6
T3 wasn’t tested for some reason
B12 340
Folate 4
Vitamin D 100
Ferritin wasn’t tested either despite requesting it.
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Dshadzz07
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* Blood draw no later than 9am. This is because TSH is highest early morning and lowers throughout the day. If looking for a diagnosis of hypothyroidism, an increase in dose of Levo or to avoid a reduction then we need the highest possible TSH
* Nothing to eat or drink except water before the blood draw. This is because eating can lower TSH and coffee can affect TSH.
* If taking thyroid hormone replacement, last dose of Levo should be 24 hours before blood draw, if taking NDT or T3 then last dose should be 8-12 hours before blood draw. Adjust timing the day before if necessary. This avoids measuring hormone levels at their peak after ingestion of hormone replacement. Take your thyroid meds after the blood draw. Taking your dose too close to the blood draw will give false high results, leaving any longer gap will give false low results.
* If you take Biotin or a B Complex containing Biotin (B7), leave this off for 7 days before any blood test. This is because if Biotin is used in the testing procedure it can give false results (most labs use biotin).
These are patient to patient tips which we don't discuss with phlebotomists or doctors.
If you have been taking your Levo daily then your TSH shouldn't have risen again to that level.
Can you add the reference range for your FT4 result please, and what was it before when TSH was 6 in January.
Have you had thyroid antibodies tested, I'm wondering if you have autoimmune thyroid disease, aka Hashimoto's, because fluctuations in levels are common with Hashi's.
Folate level is very low, are you prescribed folic acid or taking methylfolate or a B Complex at all?
Yh I followed all you suggested. I’ve made sure to take my pills everyday maybe missed one or two. I can’t find my T4 levels from January but when I first got diagnosed back in October it was.
TSH 20
T4 6.5
So after 3 months of being on 50mg then it went to a TSH level of 5.5
Now 3 months later again sticking to it, it’s now gone up to.
TSH 22
T4 9.6
I’m just really confused where to go from here now.
Have you spoken to your GP? You need an increase in your dose of Levo, 25mcg now and retest in 6-8 weeks, further increases may be necessary and you should retest 6-8 weeks after each dose increase.
I would ask for thyroid antibodies to be tested to see if the cause of your hypothyroidism is autoimmune.
No, it’s really hard to contact them sometimes and can be stressful on me along with the depression. Just a difficult place currently because I was hoping the results would be good considering.
Well you need an increase so you need to get in touch somehow. If these are results from test done at GPs they should have contacted you to increase your prescription.
50mcg levothyroxine is only the standard starter dose
Initially TSH drops as you start/increase dose of levothyroxine…..but as your body gets use to improved metabolism it’s ready for the next 25mcg dose increase in levothyroxine
Make an appointment with your GP or send them a message saying TSH is 22 and that you need next dose increase in levothyroxine up to 75mcg
Which brand of levothyroxine are you currently taking
Many people find different brands are not interchangeable
Bloods should be retested 6-9 weeks after any dose change or brand change in levothyroxine
Always test thyroid levels early morning, and last dose levothyroxine 24 hours before test
Likely to need further increases in levothyroxine over coming months
Dose is increased slowly upwards in 25mcg steps until TSH is ALWAYS Below 2. Most people when adequately treated will have TSH around one and Ft4 and Ft3 at least 50-60% through range
Feeling down and depressed is extremely common hypothyroid symptom and will improve as dose levothyroxine increases slowly upwards
I feel for you, a TSH of 22 shows you really are under-medicated and you must be feeling the effects of that in all it's may guises, . I know I do and the exhaustion is so bad it is a struggle just to do the normal things required for everyday life and it is a temptation to just give up and stay in bed, however, if we don't fight our own corner with GP etc we won't get where we need to be. The sooner you get an increase the sooner you will start to pick up, it does take 6- 8 weeks to really alter blood levels but you should feel an improvement steadily. So they won't test your t3 , I know my doctor would only do it once, perhaps you could request it now seeing as your TSH has shot up so much , say you want to make sure you are in range on all aspects of thyroid hormone and converting it well from t4 to t3 because you feel so unwell. You need to arrange a phone consultation if you can't get face to face appnt., please do let us all know how you get on.
I’ve been put up to 75mg by my doctor so I’ll give it 2 months to see how I settle on that. I appreciate that very much that you understand how I’m feeling. I hope this will bring down my level.
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.
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.
Well the B12 range is 130-800 and they had to retest my folate as it was wrong or something idk. But it’s now 2.4 with range of 4-26. They’ve but me on folic acid 5mg a day for 3 months.
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