Thyroid Advice

[xxjojxx]

Hi folks, been lurking here for a few weeks after being diagnosed with autoimmune thyroid disease and sub clinical hypothyroidism.

This diagnosis was made due to undergoing investigations as a result of recurrent miscarriage.

My first TSH was 5.4 so I was treated with 25mcg of levothyroxine and retested after 6 weeks and it has only come down to 4.9.

Before the first test I was taking prenatal vitamins which contain biotin and I took these within 24 hours of my thyroid test as I didn’t know about this until joining this forum. I stopped taking these 48 hours before the most recent test.

I am desperate to get the TSH below 2.5 as per fertility advice as we have been on hold from trying for months now as we underwent tests but I cannot keep waiting.

My question is can I push my doctor to increase my dosage by more than 25mcg at a time? I can’t face the thought of every 6 weeks finding out it has barely changed. I know that optimal dosage is often 1.6mcg per kg so I would expect a dosage of about 125mcg — the thought of waiting 24 weeks is intolerable.

Advice would be appreciated.

[SlowDragon Administrator]

Welcome to the forum

Standard starter dose of levothyroxine is 50mcg and typically dose levothyroxine is increased slowly upwards in 25mcg steps over several months

Many people can’t tolerate increasing any faster

ALWAYS test thyroid levels early morning and last dose levothyroxine 24 hours before test

Which brand of levothyroxine are you now taking on 50mcg

You need thyroid antibodies, vitamin D, folate, B12 and full iron panel test including ferritin done

Have any of these been tested yet?

Low iron/ferritin are implicated in miscarriage too

[Buddy195 Administrator]

Welcome to the forum xxjojxx,

25mcg Levothyroxine is only a starter dose (usually for the very young or elderly), the usual starter dose being 50mcg, so no doubt you’ll need an increase to get TSH under 2. I would push for an increase and retest in 6-8 weeks on a higher dose. Many with auto immune thyroid conditions feel best with TSH ‘significantly under 1’.

Do you have results for FT4 and FT3, plus any antibody tests?

Have you tested key thyroid vitamins (ferritin, folate, B12 and vit D) , as having these optimal supports thyroid health.

[Lalatoot]

Your body needs time to adapt to thyroid hormone levels which is why 25mcg increments are advised every 6 weeks. If you did increase quicker you would still have to wait for your body to adapt to the changes and you run the risk of throwing it further off kilter with too big a change at once.

[Aquatennis22]

Hi. Yes, I’d def push for an increase. But as others said May be safest to only go up 25 mcg every 6 weeks. Even though that takes longer, it is safer from what I’ve heard.

You might not need to go up all the way to 125 in the end, even though that is the weight formula, so it may go a little faster than anticipated.

[xxjojxx]

Thanks everyone for your replies. I finally managed to get through to a doctor who has now prescribed 50mcg and will retest levels in four weeks.

I have had antibody tests done but have not been given the numerical results for these as the clinic refused to post them out to me and will only give me them when I am in again in November.

The last FT4 result was 14 (ref 9-28pmol/L), FT3 was not tested. My ferritin was 27 (ref 15-200ug/L) and 200h Vit D was 66 (ref 50-139nmol/L). I am not sure if these were retested the second time as I haven't been in to collect full results yet.

I do not think they tested B12 or folate but I am on a 5mg folate supplement.

I think the brand of levo is TEVN.