Medichecks results taken 8/6/22 venous draw by nurse, last dose of Levo (25mcg) taken 25 hours before, blood drawn at 7.45am.
Vit D is a surprise, I am very outdoorsy. Have been a carb dodger most of my life, have gone properly gluten free since joining the forum 2 weeks ago, eat masses of eggs and grow my own veg. Not much of a drinker, have stopped alcohol too in last fortnight.
Any recommendations would be much appreciated, especially ones that involve NHS prescriptions and not spending a fortune!
Thank you
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Regenallotment
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Yes, that's perfectly normal. But we can see your antibody results in the main picture. You have Hashi's. Did you know that?
Welcome to the forum, Regenallotment.
25 mcg is a very low dose - only half a normal starter dose unless over 60 or have a heart condition. So, not surprising your TSH is still much too high and your FT4 and FT3 are still low. You need an increase in dose of 25 mcg. And will probably need a further increase six weeks after.
Your vit D is very low, yes, and you should talk to your doctor about that. You need loading doses or something. Being an outdoorsy person has nothing to do with anything when you're hypo. We have hypos from Australia on here who have low vit D. Your body just doesn't absorb it.
Your ferritin is also pretty low. Your doctor should probably investigate that, too.
And your folate is too low - although your B12 is good. Don't bother your doctor with that, though. If he gives you anything it will only be folic acid, which is not well absorbed. You'd be much better off buying your own B complex. Just taking one B vit is not a good idea because they all work together and need to be kept balanced. But no way will your doctor prescribe a B complex! Thorne Basic B is a good one, which isn't very expensive.
Thanks so much for the encouragement and reassurance. I just need to persist getting a doctors appointment, by 8.30 this morning the phone lines said no more calls - try the website - its a blooming nightmare. I do feel better prepared though and reading the forum has given me much needed reassurance.
Sorry, I know I've been super annoying by experimenting.
This latest test was after reducing back down again as I am running out of Levo and doctor refused to repeat my prescription as I'd been playing around with the dose, here is the timeline.
Nov 21 to end March 22 - 25mcg a day
April to end May 22 - 37.5mcg a day (50mcg alternate days with 25mcg on others)
mid May 22 - 2 weeks on 50mcg a day - felt like a new woman but terrible medical anxiety as appointments impossible to get at practice, had that previous blood test, not fasting, at 1.30pm after 50mcg at 6.15am - contacted you guys.
Start of June (jubilee bank holiday) dropped to 25mcg to preserve stocks and ordered this medichecks test as recommended.
I realise I haven't helped myself messing around with my dose so much in a short space of time, I'm actually feeling better than I was, still awful but not sofa bound. I think my anxiety and PMS had a lot to do with how I felt when I first messaged.
So TSH would have been much higher had you not increased dose
Still ….you are where you are
Make an appointment with (different?) GP …..if face to face take these results in with you
If it’s on phone email or print results and get to GP 3-4 days before phone consultation
Recommend taking printed copies of guidelines below in with you too …..or include with test results if email
If GP still won’t increase dose
Ask for referral to endocrinologist of your choice (probably at least 6 months waiting time) or book private consultation
Roughly where in U.K. are you
Email Thyroid U.K. for list of recommended thyroid specialist endocrinologist and doctors
tukadmin@thyroiduk.org
Even if we frequently don’t start on full replacement dose, most people need to increase levothyroxine dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until eventually on, or near full replacement dose
Consider starting levothyroxine at a dosage of 1.6 micrograms per kilogram of body weight per day (rounded to the nearest 25 micrograms) for adults under 65 with primary hypothyroidism and no history of cardiovascular disease.
In the majority of patients 50-100 μg thyroxine can be used as the starting dose. Alterations in dose are achieved by using 25-50 μg increments and adequacy of the new dose can be confirmed by repeat measurement of TSH after 2-3 months.
The majority of patients will be clinically euthyroid with a ‘normal’ TSH and having thyroxine replacement in the range 75-150 μg/day (1.6ug/Kg on average).
The recommended approach is to titrate thyroxine therapy against the TSH concentration whilst assessing clinical well-being. The target is a serum TSH within the reference range.
……The primary target of thyroxine replacement therapy is to make the patient feel well and to achieve a serum TSH that is within the reference range. The corresponding FT4 will be within or slightly above its reference range.
The minimum period to achieve stable concentrations after a change in dose of thyroxine is two months and thyroid function tests should not normally be requested before this period has elapsed.
Your Ft4 is far too low….because you are under medicated
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
In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate methyl folate supplement and separate B12 (eg Jarrow brand)
Ferritin isn’t bad but you don’t want it to drop any further
Look at increasing iron rich foods in diet
Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption
This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.
Thyroid disease is as much about optimising vitamins as thyroid hormones
Thanks so much for all this info.I have the list of specialists from TUK, live in Hereford so nearest would be Birmingham/Bristol for me.
GP - yeah our practice covers the whole city, all the small practices merged and you take pot luck.At the moment it’s zero appointments. I’ll print and drop the results in addressed to the GP that initially spotted 3 years of HRT wasn’t working and use all the online forms.
Thanks again, this forum is such a help. Much appreciated.
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