I took another blood test to preempt my next request for a dose increase with the GP. According to NICE 1.6mcg/kg I should be titrating up to 115mcg. Currently on 50mcg.
THYROID STIMULATING HORMONE03/08/2022
2.55 mu/LTSH levels normal (normal range 0.27 - 4.2 mU/L)
THYROXINE03/08/2022
16.7 pmol/LFT4 levels normal (normal range 12 - 22 pmol/L)
TRIODOTHYRONINE03/08/2022
4.3 pmol/LFT3 levels normal (normal range 3.1 - 6.8 pmol/L)
Bloods taken at 9am fasting, last Levo 26 hours earlier.
Thorne B complex stopped 7 days earlier.
Taking 3000iu D3/K2 better you loading dose for 6 more weeks.
Eating liver at least once a week.
Taking L-Glutamine morning and night. (An hour after Levo).
Thorne B complex after breakfast (when not blood testing the following week)
Taking Selenium mid afternoon, Zinc with copper at bed time and topical magnesium .
Have been gluten, dairy, soy free for 6 weeks.
I do feel better than I did, more energy/capacity for normal life, baby hairs growing back in my hairline, done my first solid poos in years, sleeping a bit better (but that isn’t saying much it was dire before) need to wee about 4 times a night, but I’m still 10kg overweight, aches, nightsweats, forgetful, low libido, overthinking, irregular periods, super heavy bleeding (transexamic acid 2 hours after Levo), weaker bladder than usual, tingling fingers, internal vibration feeling. Need naps after busy/ stressful days to get me through the week. Have to plan in rest days, to be able to cope. Oh and permanently sore throat.
So, what is my strategy?
How will I convince my GP that ‘normal’ isn’t ’well’ ?
What info shouldn’t I share with the GP and what should I share?
Am I being naïve to hope for a 115mcg prescription and the option to titrate to 75 then 100 etc myself over 2-3 months?
All and any advice and reassurance would be gratefully received. 🦋💚🦋
Thanks 🙏
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Thanks so much, this is reassuring, yes I just put the % through range in the amazing clever spreadsheet and that really helps show up the detail. OK will ask for 25mcg increase based on this evidence. Much appreciated.
Many of us never need as much as 1.6 micrograms per kilo! I'd be grossly over-dosed.
You just have to see how it goes. These formulas have the potential to be very misleading. Don't treat them as defining a target.
Yes - I agree your dose of levothyroxine should be increased. And, no, I don't think you stand any chance of getting any sort of open ended prescription. Sadly.
Why are you taking Teva…..are you lactose intolerant?
Teva upsets many people
Have you ever had different brand levothyroxine?
Many people find Levothyroxine brands are not interchangeable.
Many patients do NOT get on well with Teva brand of Levothyroxine.
Teva contains mannitol as a filler, which seems to be possible cause of problems. Teva is the only brand that makes 75mcg tablet. So if avoiding Teva for 75mcg dose ask for 25mcg to add to 50mcg or just extra 50mcg tablets to cut in half
But for some people (usually if lactose intolerant, Teva is by far the best option)
Glenmark or Aristo (100mcg only) are lactose free and mannitol free. May be difficult to track down Glenmark, not been available very long
Most easily available (and often most easily tolerated) are Mercury Pharma or Accord
Mercury Pharma make 25mcg, 50mcg and 100mcg tablets
Accord only make 50mcg and 100mcg tablets
Accord is also boxed as Almus via Boots, and Northstar 50mcg and 100mcg via Lloyds ....but Accord doesn’t make 25mcg tablets
If a patient reports persistent symptoms when switching between different levothyroxine tablet formulations, consider consistently prescribing a specific product known to be well tolerated by the patient. If symptoms or poor control of thyroid function persist (despite adhering to a specific product), consider prescribing levothyroxine in an oral solution formulation.
Physicians should: 1) alert patients that preparations may be switched at the pharmacy; 2) encourage patients to ask to remain on the same preparation at every pharmacy refill; and 3) make sure patients understand the need to have their TSH retested and the potential for dosing readjusted every time their LT4 preparation is switched (18).
Thanks, I’m taking Teva because that was what I was first given by my chemist, at the time I didn’t know there were alternatives and I have no reason to believe it isn’t suiting me, I don’t source my meds privately just via usual NHS system. Thanks for the info I’ll have a read and bare this in mind. I don’t know if I’m lactose or mannitol intolerant.
I chose the Thorne Basic B as I was recommended it on this forum after the previous June blood tests with vits. The biotin element is also recommended by Isabella Wentz Hashimoto’s protocol, I’ve found her books helpful too. Why do you ask? Am I missing something or taking something you don’t think I need? My plan was to try all the vits advice for 12 weeks (I’ve been introducing one every 2 weeks as recommended) then re-test and see what that shows. Ideally dropping any or switching to maintenance doses after that.
You said she needs a separate high dose B12 supplement which she doesn't as she has a decent level of Active B12, and I wondered where you got the idea that she did.
Thorne Basic B is a B Complex not a multi vitamin.
When I was given Teva it made me feel like my B12 injection hadn't worked. I now have no Teva printed on my prescriptions, which worked well until the new young chemist gave North Star he said it was not Teva and I pointed out that in small print it had Teva written on it, and on the information insert it had Teva right at the end of the second page......... and the tablet packet had it boldly printed on it. He eventually managed to get me some Mercury Pharma 25mcg so hopefully he will remember next time.......................................
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