I have been Recently diagnosed as Hypothyroid TSH 11.5 and fT4 at 15.7. age 57 (almost). Started on Levothyroxine 25mg early April. Slightly concerned as I have not seen a GP all diagnosis and treatment conveyed by text and a quick 2 min phone call. Blood tests were because I reported breathlessness and lack of energy. Told to get another test in 3 months. (end June). Now 6 weeks into treatment with no noticeable improvement.
No T3 test has been offered, but fT4 is within normal range [11.0 - 23.0] and am not sure what this means.
Would like a full test done and to get some advice from an endocrinologist who at least shows some interest and is knowledgeable about all types of treatment not just Levo. Don't mind going private for an initial consultation. I am in Lincolnshire but don't mind travelling - any suggestions gratefully received.
Thank you
Written by
ChrisG1965
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You have been put on the lowest starting dose, (usually for over 60s, children & those with heart conditions) standard starter dose is 50mcg so this will not have sufficient impact.
Initially a dose tops up levels but then it replaced the level you need re testing and dose increases. Usually 6 - 8 weeks after dose change.
When to test ensure it’s 1st thing in morning. fasting (drink lots of water) and delay dose after draw.
Do you take levo away from other medications & foods?
Thank you PurpleNailsVery helpful, I have been taking Levo 1st thing in morning, I also take multivits & D and K2 an hour later. Will be placing an order for tests as per your suggestion. Thank you.
If you take your multi-vit and your D and K2 at the same time, and your multi contains iron, you won't be absorbing very much because the iron will block it all.
We do not recomment multis on here, for many reasons. Basically a waste of money, and may contian things you don't need/shouldn't take like calcium and iodine. Far better to get basic nutrients tested - vit D, vit B12, folate, ferritn - and supplement accordingly.
Hello Chris You’ve come to the right place for advice. You will need to educate yourself about the thyroid, how it works and how treatment can be the most effective.
Once your understand the basics
( which at first will be a lot of information) you will be able to advocate for yourself😬
Stick with clever clogs on this forum and you will get all the advice you need
most effective course of action for right now is to contact GP, ask for blood test now since it's been 6 weeks already and it will likely to be 8 weeks by the time you get a blood test appointment anyway. Say you have felt no improvement / and no problems as yet, and you feel it is time to try an increase in dose. Ask for clarification why you were started on such a small dose instead of the usual 50mcg.. (especially since your TSH at diagnosis was over 10.... 25mcg is very small dose indeed)
and assuming blood test results allow , ask for dose to be increased to 50 mcg .. making you wait 3 months on just 25mcg when your initial TSH was over 10 is ..... about as much use as a chocolate teapot... am not surprised you don't feel any effect yet .... 25mcg dose is only intended to be a very short term and gentle introduction to the usual 50mcg starting dose.. intended for the very frail .. or those with heart problems, so as not to risk over stressing the heart by speeding it up to fast with a larger dose all at once .
If you can afford the cost, I would test FT4 and FT3 plus antibodies (to show if you have an auto immune condition, aka Hashimotos) privately. Medichecks have an offer today (as they do most Thursdays), then post results on the forum for further advice. It’s so useful to know all thyroid hormone levels and most GPS (& even some endocrinologists) don’t test everything. Remember ‘normal’ does not mean ‘optimal’ when GPS are relating results. Always ask for a print out of your tests (ie your latest FT4 test); it’s useful to be able to accurately track your ‘thyroid journey’. I keep all my print outs and make a note of medication dosage/ symptoms etc.
Any supplements that contain iron or calcium or magnesium must be minimum 4 hours away from levothyroxine
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
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
REMEMBER.....very important....stop taking any supplements that contain biotin a week before ALL BLOOD TESTS as biotin can falsely affect test results - eg vitamin B complex
Thank you SlowDragon and others who have posted helpful replies. there's a lot to learn here and not a few adjustments to make. I am aiming to get tests and go back to GP for a revised dosage. I'll post further results here when I get them.
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