Help with Thyroid bloods..

[Void1234]

Just following on from previous post my Thyroid bloods came back and any help interpreting would be great, My TSH is now sitting at 1.81 mu/L - range 0.27-4.2mU/L

My FT4 is 14.6 pmo1/L range 12-22 pmol/L and my FT3 is 4.7 pmoI / L range 3.1- 6.8pmoI/L ,

i still feel not great and now waiting on CT , Im 76Kg in weight and on 75mcg Levothyroxine. Any steer appreciated

[SeasideSusie Remembering]

Hi Void1234

Did you do your test as we advise:

* No later than 9am

* Nothing but water before test

* Last dose of Levo 24 hours before test

* No biotin, B Complex or any supplement containing biotin for 3-7 days before the test

If so then your results show that you are currenty undermedicated. The aim of a treated Hypo patient on Levo only, generally, is for TSH to be 1 or below with FT4 and FT3 in the upper part of their reference ranges, if that is where you feel well.

Your FT4 is only 26% through range and your FT3 is 43.24% through range. You could do with a dose increase - 25mcg now, retest in 6-8 weeks to check levels and also see how you feel to see if you need a further increase.

If your GP is reluctant to increase then use the following information:

Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine (the professional magazine 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, 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(Not working as expected?)

You can obtain a copy of the article by emailing ThyroidUK:

[e-mail]

print it and highlight question 6 to show your doctor.

[Void1234 in reply to SeasideSusie]

hi , yes test done at 8.30am empty stomach. No vitamins etc taken. My GP refuses to raise my levo, i do have some extra 25mcg here i can try to use to increase until i see Endo. Can i just check will i have lots of side effects raising? Such as palpitations etc? Thanks

[SeasideSusie Remembering in reply to Void1234]

Can i just check will i have lots of side effects raising? Such as palpitations etc?

I can't predict but you certainly wont be overmedicated and wont get symptoms of overmedication considering how undermedicated you are. But if you're worried take it more slowly, just add an extra 12.5mcg now, retest in 6-8 weeks.

[Void1234 in reply to SeasideSusie]

thank you will try

[SlowDragon Administrator]

My GP refuses to raise my levo

Well GP is wrong….of course you need dose increase in levothyroxine

As Seasidesusie says ….perhaps initially increase by 12.5mcg daily

When were vitamin D, folate, ferritin and B12 last tested

[Void1234 in reply to SlowDragon]

hi there , thanks for response. August all were tested and in range. Ive had to request copies of my medical records as numbers not given.

[waveylines]

so shocking your GP wont increase your dose - you clearly need it! I dont know why hypothyroidism mangement is left to GPs to manage so many dont have a clue and leave patients under medicated.

I doubt you will have side effects from increasing but like seaside-suzie said increase by 12.5 intially for a few days then the nexts 12.5mcg (total 25mcg increase). I definately would challenge your GP. Many GPs are so worried by overtreatmenr tbey forget the consequences of undertreatment long termly.

[Void1234 in reply to waveylines]

hi thanks there , so further update… GP receptionist called me this morning as I sent letter in Monday detailing symptoms, dates and showing photos of progressive swelling of thyroid and also queried dosage. Told me- GP has advised you take medication in morning. Reiterating Endo advice note that no change in meds and thyroid levels are good. No further bloods needed to check Iron etc or blood panels. I have asked for full copy of my medical records with all results. The Endo isnt seeing me in person until Oct and thyroid feels more swollen day by day.? Told to take my beta blockers and potentially a label of anxiety now placed on my file! What happens when i have no thyroid !! And they remove it just told to keep quiet then 🙄

[waveylines in reply to Void1234]

Have you tried contacting the Endos secreatary to explain how poorly you are feeling. To contact just ring the main hospital number where he is based and ask to speak to the secretary of Endos name. Ive found the secretaries very helpful in the past.

[Void1234]

hi yes, it was going straight to voicemail and also sent letter asking for a call.