Latest bloods following Levo increase

[Nelliebear]

After getting advice from this wonderful group 4 months back i spoke with my doctor and he increased my Levo dose from 50mg to 100mg. My FT4 level was low at 10. 1 & my TSH was on the lower side at 0.56 miu/L but within range

For a couple of months I actually felt great, energy was back, I felt less tired & happy in myself for once. However for the last month I’ve felt really groggy again and tired. So, I had my bloods done as advised by doctor and today I got my results requesting me to contact my surgery

Now my FT4 is within range at 15.5 but my TSH is now < 0.02 miu/L

What does this mean? I find it all very confusing. I’m waiting for a call from my doc but this now won’t be until early next week.

Thanks

Carla

[greygoose]

Could you give a range for the FT4, please? Results without ranges are meaningless because they vary from lab to lab.

[DippyDame]

Hello Carla

Please can you add ref ranges to your results....they vary from lab to lab.

The fact that you felt well for a while after the increase suggests that your body appreciated more levo

However, after some time the extra hormone proved to be inadequate and symptoms returned ....quite common, It happened to me a few years ago but at the time I had no idea what was going on.

As hormone levels in the blood rise TSH falls in response, so nothing unsurprising there to worry about.

Without results plus ref ranges it would be wrong to say for definite....but you may benefit from a further increase to 125mcg levo

Suggest you re read SeasideSusie's reply in your previous post

[SlowDragon Administrator]

Just testing TSH and Ft4 is completely inadequate especially as you have central hypothyroidism (pituitary or TSH not working correctly)

GP likely to want to reduce dose levothyroxine inappropriately because TSH is low

Refuse and request referral to endocrinologist

You need FULL Thyroid and vitamin testing

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested.

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

Folate was low in previous post

healthunlocked.com/thyroidu....

You also need thyroid antibodies tested

About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high thyroid antibodies 

Autoimmune thyroid disease with goitre is Hashimoto’s

Autoimmune thyroid disease without goitre is Ord’s thyroiditis. 

Both are autoimmune and generally called Hashimoto’s.

Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease (Hashimoto’s or Ord’s thyroiditis)

20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis 

In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)

Recommended on here that all thyroid blood tests early morning, ideally just before 9am and last dose levothyroxine 24 hours before test 

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

List of private testing options and money off codes

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

Only do private testing early Monday or Tuesday morning. Watch out for postal strikes, probably want to pay for guaranteed 24 hours delivery 

Link about thyroid blood tests

thyroiduk.org/getting-a-dia...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

Symptoms of hypothyroidism 

thyroiduk.org/wp-content/up...

[Nelliebear in reply to SlowDragon]

I’ve added the ref ranges below but it sounds like it may well help me to get private testing done if doctor refuses to refer me.

I find it all so confusing and still haven’t had anything explained to me from the doctors. I have had much more support & advice from this group. So thank you!

[Nelliebear]

Hi these are the reference ranges

Serum free T4 level 15.5 pmol/L [12.0 -

22.0]; FT4

Serum TSH level < 0.02 miu/L [0.27 - 4.2];

Hope this helps

Carla

[Gingernut44]

Your FT4 is only 35% through the range so do not allow your GP to reduce your dose - you actually need an increase. Without an FT3 result, you won’t know how well you convert T4 to T3.

Take SlowDragon’s advice and ask to be referred to an Endocrinologist.