start levothyroxine or work on vitamin levels?

[clairel996]

Went to the doctor in September 2022 with symptoms of hair loss, fatigue and feeling cold. ( am a 36 year old female) Bloods were done and was told everything was OK. The hair loss was most concerning so I spoke with another doctor who reviewed my bloods who said thyroid levels were on the high side of normal so perhaps subclinical hypothyroid only TSH was tested) so he suggested to try levothyroxine. I had a private appointment booked with dermatology to investigate my hair so he said to check with them first and then get back to him so no treatment was started.

Since he mentioned levothyroxine and my levels being high I found myself here after some Googling so I then asked the receptionist for a printout of my bloods:

29/09/22 results as follows:

TSH 3.45 (0.27 - 4.2)

Serum B12 431 (197 - 771)

Serum folate 5.2 (3.9 - 26.8)

Serum ferritin 63 (13 - 150)

Serum iron level 16.6 (10 - 30)

Serum transferrin 2.2 (2 - 3.6)

Percentage iron saturation 30.8 (30 - 40)

Haemoglobin estimation 134 (120 - 150)

These bloods were done in the late afternoon while I was taking biotin supplement and using biotin shampoo and after reading on here that FT3 and FT4 were needed too, I decided to use monitor my health to recheck and they have just come back:

24/10/22

TSH 4.27 (0.27 - 4.2)

FT4 14.2 (12 - 22)

FT3 3.5 (3.1 - 6.8)

Vitamin D 33 (no range given just says deficient)

Should I start the levothyroxine or should I work on getting certain Vitamin levels up a bit first? Finding it a bit of a minefield and this forum has been ever so helpful! f you have made it to the end of my very long post, thank you for taking the time to read!

Claire

[Jaydee1507 Administrator]

I'll let someone else comment about vitamin levels, but tbh if a doctor is suggesting treatment and your levels, although hypo are relatively high these days for when treatment is suggested to start. I'd grab that prescription with both hands now before they change their mind.

[clairel996 in reply to Jaydee1507]

thank you for the reply. I didn't know much at the time when he suggested it but after some extensive reading on here it does seem rather rare to be offered up so quickly!

[Jaydee1507 Administrator in reply to clairel996]

People can wait years for treatment with results like yours. The recommendation now is not to start treatment until TSH reaches 10 which is terrible obviously, and leaves people unwell for far too long. It's not a good idea to start too many things at once, but it will be a fair few months before you get to an optimal dose so plenty of time to work on vitamins too. When you get your next bloods see if they will test your antibodies. Oh and get your GP surgery to complete the form for you to get free prescriptions.

[clairel996 in reply to Jaydee1507]

Thank you, I will do some more research on vitamins but I think I defiantly need vitamin D seeing as the levels were so low and will hopefully get an appointment with the doctor next week to start the levothyroxine. I am in Northern Ireland so we are very fortunate to have free prescriptions. Thanks again for the replies, really appreciate it

[rustyempire]

just a quick FYI to be aware that one should always test first thing before eating, and if taking thyroid leave off your last dose at least 12 hours prior. You can search the topic on here to find more info for next blood test to better prepared.

[clairel996 in reply to rustyempire]

thank you, yes that is why I wanted to restest myself and knowing about biotin having an impact so my TSH was a little suppressed on first blood test. There is so much knowledge here i really appreciate all the help and advice, thanks again!