Afternoon, I have just had a phone call from my doctor's asking me to rebook bloods. I refused to have my hba1c done as I only had one done 3 weeks ago. I have just been on my account and the results are there from my thyroid function.
TSH 3.08(0.35-5.5)
Free T4 14.2(10.5-21.0)
It's come back as normal, can anybody advice whether I should still be on 75mg as they said normal last time and then agreed to up levothyroxine
Thank you
Louisebannister
Your previous post told us your results on 50mcg Levo were
TSH: 5.76 (0.35-5.5)
FT4: 14.4 pmol/l (Range 10.5 - 21)
and now on 75mcg Levo they are
TSH 3.08(0.35-5.5)
Free T4 14.2(10.5-21.0)
So your TSH has gone down (which it should) but your FT4 has also gone down whereas it should have increased.
Did you do your test as we always advise:
* No later than 9am
* No food or drink other than water before the test
* Last dose of Levo 24 hours before
* No Biotin, B Complex or any supplement containing biotin for 3-7 days before the test
You were diagnosed and started Levo in March so you are still at the beginning of your thyroid journey and your GP should be testing/increasing Levo every 6-8 weeks until your levels are where they need to be for you to feel well. For most people that is likely to be TSH 1 or below with FT4 and FT3 in the upper part of their reference ranges.
So you are in need of your next 25mcg increase so please ask your GP for this. If GP says your results are within range so everything is fine then use the following information to support your request for an increase:
From GP online
gponline.com/endocrinology-...
Under the section
Cardiovascular changes in hypothyroidism
Replacement therapy with levothyroxine should be initiated in all patients to achieve a TSH level of 0.5-2.0pmol/L.
Also, Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine (the professional publication for doctors):
"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l. In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l. Most patients will feel well in that circumstance. But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l. This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l).*"
*He confirmed, during a talk he gave to The Thyroid Trust in November 2018 that this applies to Free T3 as well as Total T3 and this is when on Levo only. You can hear this at 1 hour 19 mins to 1 hour 21 minutes in this video of that talk youtu.be/HYhYAVyKzhw
You can obtain a copy of the article which contains this quote from ThyroidUK:
tukadmin@thyroiduk.org
print it and highlight Question 6 to show your GP.
Thank you. Blood test was at 7.40 on Monday morning and I didn't take my pills and just had water
OK, so results are accurate and you need an increase as mentioned above.
Has GP tested vitamin D, folate, ferritin and B12 levels yet
If not request testing after 6-8 weeks on 100mcg levothyroxine
What vitamin supplements are you currently taking
Have you had coeliac blood test done
Evening, no they haven't tested anything like that. I went on my record and it just said no follow up needed
Make an appointment with GP for next 25mcg dose increase in levothyroxine
Request thyroid antibodies and vitamin testing at next test
Or test privately
For full Thyroid evaluation you need TSH, FT4 and FT3
plus both TPO and TG thyroid antibodies tested at least once
Very important to test vitamin D, folate, ferritin and B12 at least once year minimum
About 90% of primary hypothyroidism is autoimmune thyroid disease
Low vitamin levels are extremely common, especially with autoimmune thyroid disease (Hashimoto’s or Ord’s thyroiditis) usually diagnosed by high thyroid antibodies
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
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
thyroiduk.org/getting-a-dia...
Medichecks Thyroid plus antibodies and vitamins
medichecks.com/products/adv...
Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins
Hi
Well done for refusing, wish I'd thought of that. Last weeks bloods came back as abnormal for me, low calcium, high ferritin, low folate. So in two weeks time they're going to test everything again.
Which is really stupid as everything else was normal. I handed a letter into my GP querying it and asking for vitamin D to be tested. I've not heard a thing. Never thought I could just refuse. Doctors are far too used to patients just passively agreeing with whatever they say.
I had my diabetic review in may and have had it drummed into me that test needs to be done every 3 months. I even got a voicemail from the receptionist telling me to book another blood test. I spent 15 minutes trying to get through to be told my bloods had been cancelled. Told her I cancelled them as they weren't required. The thyroid one went through okay which is what I was focused on x
Ask the nurse before she does them which ones she is doing and question it. I never used to be bolshy but have had a few issues. Hope you get sorted
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