I was recently diagnosed with hypothyroidism (which from what I have read is actually subclinical).
My test results were as follows:
Test 1
Plasma TSH level 12.26 mU/ ( normal range 0.30 - 4.20
T4: 11.8 pmol/ L (normal range 9.0 - 19.0)
Test 2
Plasma TSH level 12.66 mU/ ( normal range 0.30 - 4.20
T4: 9.6 pmol/ L (normal range 9.0 - 19.0)
My T3 was not tested so I have no idea about what that might be.
My Dr prescribed 50mg Levothyroxine and I have been taking it for 2 weeks now. My worry is that my Dr told me to book a new blood test in 6 - 8 weeks (from starting treatment) and I am a bit concerned that this is quite a long time of potentially taking the wrong dosage.
My question is, should I be worried, and is this time frame normal?
I had some bad side effects the first week but they seem to have eased now, thankfully...
Written by
Nineby
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That is the correct time scale after starting T4 - Levothyroxine or after any dose increase or decrease in Levothyroxine thyroid hormone replacement.
T4 is a storage hormone and needs to be converted by your body into T3 the active hormone that runs the body and we generally feel at our best when our T4 is in the top quadrant of it's range as this should convert to a good level of T3 at at least 50% through it's range.
As you build up your dose of T4 your TSH will start to drop back down into it's range and we generally find we feel at our best when the TSH is under 2 and likely under 1 - in the range.
No thyroid hormone replacement works well until core strength vitamins and minerals, those of ferritin, folate, B12 and vitamin D are up and maintained at optimal levels.
It's advised to take T4 on an empty stomach with a full glass of water and wait around an hour before eating and drinking anything.
When you arrange your thyroid blood test you need as early a morning appointment as possible and take that days T4 after the blood draw.
If you go into Thyroid UK - thyroiduk.org - this is the charity who support this forum and where you will find all things ' thyroid ' should you wish to know more about your treatment options.
Subclinical is where TSH is over range but below 10 with FT4 in range.
Your TSH was over 10 both times, you have Primary Hypothyroidism.
Some GPs test after about 6-8 weeks, some say 3 months. So go with what your GP has said. You will need an increase in dose, 25mcg and retest again 6-8 weeks later. Repeat until your levels are where they need to be for you to feel well.
The aim of a treated hypo patient on Levo only, generally, is for TSH to be 1 or lower with FT4 and FT3 in the upper part of their ranges if that is where you feel well. Don't let your GP adjust dose on TSH alone, it is not a thyroid hormone, it's a pituitary hormone FT4 and FT3 are the thyroid hormones which tell us our thyroid status.
Always advised here when testing thyroid :
* Test no later than 9am because TSH is highest then and lowers throughout the day. To avoid a dose reduction or when looking for an increase we need the highest possible TSH.
* Nothing except water before the test, this is because some food and drinks can affect TSH.
* Last dose of Levo 24 hours before the test to avoid a false high or false low FT4.
* No biotin or B Complex or any supplement containing biotin for 3-7 days before the test. This is because biotin can give false results with any blood test.
These are patient to patient tips that we don't discuss with doctors, nurses or phlebotomists.
Always take your Levo one hour before or 2 hours after food, with water only and water only for one hour each side. Any other medication or supplements 2 hours away from thyroid meds, some need 4 hours.
If you are happy with your brand of Levo and have no adverse effects, stick to the same brand when dose is increased. If they don't make a 25mcg tablet ask for extra 50s and cut in half to give 25mcg or take extra 50 on alternate days.
Important to test key nutrients as optimal levels are needed for thyroid hormone to work properly. Ask for Vit D, B12, Folate and Ferritin to be tested.
6-8 weeks is normal for retesting until you are on the correct dose of Levo. When I first began taking Levo, I felt great until my 5th week. Then my symptoms became worse. I was undermedicated. My TSH went up higher. I upped my dose after my blood results were back. I felt great for 5 weeks and experienced more symptoms. My TSH began dropping with my higher dose of Levo. I am currently waiting for another increase in my dosage, but I actually feel GREAT now even though my last blood test had shown my TSH at 10 something. My vitamin d was very low as well. I started taking 5000iu of vitamin d3 and B Complex which seems to have seriously helped. My doctor put me on 75mcg at first, but it triggered bad heart palpitations and a fast heart rate. I cut my pills in half for 37.5mcg which stopped the palpitations. 6 weeks later, I took the full 75mcg without any issues related to my heart. Trust the people on this site. They are on top of their game.
Sorry for the delay, I just wanted to say thank you to everyone who took the time to respond, it is very much appreciated and helped me feel much more reassured about the situation.
I will definitely try to get my blood test booked for before 9am but I am not entirely sure my surgery does tests that early - both of the tests I had done were at 10.20am, so at least there was consistency there.
I've taken a look at my tests and can see that all of my vitamins & minerals were in the 'normal' range, but perhaps on the low side?
B12 was 395 ng/L (normal range 180 - 900)
Ferritin was 29.2 microg/L (normal range 10 - 200)
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Hypothyroidism - Newly diagnosed.
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