We need reference ranges for your results please, we can't interpret them without as ranges vary from lab to lab.
We do know that your TSH is probably too high, generally hypo patients feel best when TSH is arond 1 or below but we have no idea whether your FT4 is low in range, below range, mid range or whatever. From most ranges we see on the forum it's either low in range or below range but you need to confirm the range for us to be sure. However, just looking at your TSH and your symptoms tells us you are likely to be undermedicated and in need of a dose increase. 25mcg is a starter dose and if 50mcg is too much then increase gradually in small increments, eg 6.25mcg or 12.5mcg at a time.
I suggest you ask for ferritin to be tested, or an iron panel, low levels bring their own symptoms which can be similar to hypo symptoms, and we need a good level of ferritin for any thyroid hormone to work properly.
So FT4 is only 12.14% through range which is extremely low. This result, along with your TSH plus fatigue and brain fog all point to undermedication so you need an increase. As I said, because you experienced palpitations on 50mcg you could take it slowly with your increases. However, palpitations can be a symptom of hypothyroidism so maybe your were undermedicated on 50mcg and would have eventually settled given time and the right dose of Levo.
Ferritin is good providing that there is no inflammation. CRP is always helpful when tested at the same time as ferritin as CRP is an inflammation marker and ferritin rises with inflammation.
No problem as long as it's one hour before or two hours after food and water only for an hour before taking your dose, 4 hours away from Vit D, calcium, magnesium, iron, HRT, PPIs, and 2 hours away from any other medication, so that nothing interfere's with Levo's absorption.
Highly unlikely to find 25mcg dose levothyroxine high enough
How old are you approx and roughly how much do you weigh in kilo
Standard starter dose of levothyroxine is 50mcg and dose is typically increased slowly upwards in 25mcg steps over 6-12 months until on full replacement dose
Levothyroxine doesn’t top up failing thyroid it replaces it
Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine
Do you always get same brand levothyroxine at each prescription
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)usually diagnosed by high thyroid antibodies
Have you had thyroid antibodies tested
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 hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)
Recommended on here that all thyroid blood tests early morning, ideally before 9am 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
List of private testing options and money off codes
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