TSH has crept up : When I was first diagnosed my... - Thyroid UK

Thyroid UK

141,243 members166,489 posts

TSH has crept up

nimble profile image
12 Replies

When I was first diagnosed my TSH was 14 ( 2 years ago)

With Levo the TSH has improved and this has gradually increased increased to 100mcg daily for a year now. Recently my TSH has increased to 3.3. My usual TSH range over the last 12 months has been 0.5 - 1.83.

This recent test that was done, alongside others incl. Vit D, Iron, B12 etc was because I felt my old symptoms returning - tiredness, fatigue, feeling low. I did not know what was causing this. All results have come back within their normal range. My TSH is 3.3, which although my GP keeps saying is in the normal reference range of 0.5 - 4.8, I still feel that it needs to be below 2 for me to feel ok.

I don't know how to get this across to the GP who was dismissive about it today. I know my body and I feel a generic normal range does not necessarily mean it is optimum for me. When it was below 2 previous 12 months i have felt fine.

I would welcome any advice. What should I do? Why can't the GP raise the dosage, even 25mcg and monitor me for a few weeks? I don't understand why it is such a big problem.

Written by
nimble profile image
nimble
To view profiles and participate in discussions please or .
Read more about...
12 Replies
Jaydee1507 profile image
Jaydee1507Administrator

Of course you are right, and your GP is wrong. I'm sure someone will be along with some quotes from NICE to show a GP but can you try a different GP within the same practice.

To feel well your TSH should be around, probably under 1.

nimble profile image
nimble in reply toJaydee1507

Thankyou Jaydee1507, I will try a get another GP to look into this. Fingers crossed they are a bit more responsive

shaws profile image
shawsAdministrator

GPs are the last person to rely upon as they seem to have had no training (due to my personal experience) as I was told I had no problems and my TSH was 100 at that time!

nimble profile image
nimble in reply toshaws

omg shaws. Unbelievable. I hope things have improved and you managed to get some help. How did you go about it, if you don't mind me asking?

shaws profile image
shawsAdministrator in reply tonimble

I am extremely happy now as I have no clinical symptoms as I was switched from levothyroxine (T4) to liothyronine (T3). I have been symptom-free for a number of years now.

Levothyroxine is T4 and is an inactive hormone, should convert to T3.

Liothyronine (T3) is the active hormone and we have millions of T3 cells in our bodies and brain and heart have the most.

I joined Thyroid Uk which has been set up by Lyn Mynott due to her personal experience.

This forum then permits many members to get advice/help from other members who've recovered their health and are now symptom-free.

We also have to ensure that our vitamins/minerals are optimum i.e. B12, Vit D, iron, ferritin and folate. If your B12 was low ask the GP to check that you do not have pernicious anaemia (I have this and so did my mother) as you'd need regular B12 injections. I used to get a quarterly injection but now I get a monthly one.

nimble profile image
nimble in reply toshaws

That's fantastic shaws. Hopefully my condition will improve when I get the right treatment/dosage.

I am so glad that I came across this forum today. I've been at my wits end tbh. Everyone on this forum, from reading other posts today, is so helpful.

Thankyou for sharing.

shaws profile image
shawsAdministrator in reply tonimble

This is the method to use when you are going to have a blood test:-

1. Always get the earliest possible appointment as TSH is highest early a.m.

2. It is a fasting test and do not take thyroid hormones on the morning of the blood test (you can drink water). Take it afterwards.

Also request a test for B12, Vit D, iron, ferritin and folate.

shaws profile image
shawsAdministrator

I have listened to nonsense by a GP and I told him he was wrong.

We are not engines but we need thyroid hormones to enable our body to function from head to toe.

I think the majority of GPs don't have much knowledge about how best to treat a patient who has hypothyroidism - from my own personal experience.

It was only by finding Thyroiduk which was set up by Lyn Mynott that I slowly began to understand how best to recover my health. We do need help/advice.

I have listened to nonsense by a few GPs and told them they were wrong.

The first was one who phoned to tell me that my blood test showed I had no problems. The pity is that he had no understanding of what a TSH of 100 indicated. I was feeling quite unwell - to say the least. I only found out it was 100 when I got a print-out of my results!

SlowDragon profile image
SlowDragonAdministrator

Approx how much do you weigh in kilo

Guidelines on dose levothyroxine by weight is approx 1.6mcg per kilo of your weight per day

Might help get increase

pathlabs.rlbuht.nhs.uk/tft_...

Guiding Treatment with Thyroxine: 

In the majority of patients 50-100 μg thyroxine can be used as the starting dose. Alterations in dose are achieved by using 25-50 μg increments and adequacy of the new dose can be confirmed by repeat measurement of TSH after 2-3 months. 

The majority of patients will be clinically euthyroid with a ‘normal’ TSH and having thyroxine replacement in the range 75-150 μg/day (1.6ug/Kg on average).

The recommended approach is to titrate thyroxine therapy against the TSH concentration whilst assessing clinical well-being. The target is a serum TSH within the reference range. 

……The primary target of thyroxine replacement therapy is to make the patient feel well and to achieve a serum TSH that is within the reference range. The corresponding FT4 will be within or slightly above its reference range.

The minimum period to achieve stable concentrations after a change in dose of thyroxine is two months and thyroid function tests should not normally be requested before this period has elapsed.

Comprehensive list of references for needing LOW TSH on levothyroxine 

healthunlocked.com/thyroidu....

TSH should be under 2 as an absolute maximum when on levothyroxine 

gponline.com/endocrinology-...

NHS England Liothyronine guidelines July 2019

 

sps.nhs.uk/wp-content/uploa...

Page 9 

Test for Deficiency of any of the following: Vitamin B12, Folate,  Vitamin D, Iron

See page 13 

1. Where symptoms of hypothyroidism persist despite optimal dosage with levothyroxine. (TSH 0.4-1.5mU/L)

Graph showing median TSH in healthy population is 1-1.5

web.archive.org/web/2004060...

Persevere - have all guidelines printed and be ready to quote them 

healthunlocked.com/thyroidu...

Suggest you request vitamin D, folate, ferritin and B12 levels are tested now (as your results suggest you are not on high enough dose levothyroxine)

What vitamin supplements are you currently taking?

Do you always get same brand levothyroxine at each prescription

If GP still refuses to increase dose

Get FULL thyroid and and vitamin testing done privately and see recommended thyroid specialist endocrinologist

Email Thyroid U.K. for list of recommended thyroid specialist endocrinologist and doctors 

tukadmin@thyroiduk.org

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...

If you can get GP to test vitamins then cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off down to £26.10 if go on thyroid uk for code

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

monitormyhealth.org.uk/

NHS easy postal kit vitamin D test £29 via

vitamindtest.org.uk

Only do private testing early Monday or Tuesday morning. 

Watch out for postal strikes, probably want to pay for guaranteed 24 hours delivery 

SlowDragon profile image
SlowDragonAdministrator

Also do you know if your hypothyroidism is autoimmune thyroid disease also called Hashimoto’s, usually diagnosed by high thyroid antibodies

Have you ever had thyroid antibodies tested in any previous test results

If not get tested via GP or privately

humanbean profile image
humanbean

I don't know how to get this across to the GP who was dismissive about it today.

Perhaps this might be of interest or use :

healthunlocked.com/thyroidu...

Jazzw profile image
Jazzw

This pinned post of Tattybogle’s has some good stuff in it too :)

healthunlocked.com/thyroidu...

Not what you're looking for?

You may also like...

Confused. Why is TSH low but T4/T3 also low?

Hi folks, Why would my TSH be below range and yet at same time my T4/T3 is also below mid-range? If...

Elevated TSH

My recent blood tests read: TSH 36.7 , freeT3 3.3 and T4 13.7. I was alarmed when I saw my TSH....
kalsang profile image

normal t4 but high tsh

Anyone know of any sensible reasons why t4 would be ok but tsh really high? It was normal for a...

TSH 82

Hi guys, looking for a decent endo as although I have zero symptoms of under active thyroid my...
Hypo73 profile image

TSH suddenly elevated.

hi I’ve had quite well managed Hashi’s -diagnosesd in 2020. After a rocky year at the start my...
ZoMa profile image

Moderation team

See all
SlowDragon profile image
SlowDragonAdministrator
Jaydee1507 profile image
Jaydee1507Administrator
RedApple profile image
RedAppleAdministrator

Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.

Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.