Back with blood results, need your advice again please!

[Umayya40]

Hi Hope youre all well. After my last post i took the advice to stop all Thyroid medication as I was overmedicating. I took a 3 day break and started 100 mcg Levo only..its been just over 8 weeks. I have had my bloods done recently with 24hour gap from levo, i would really appreciate your advice on what dose i should take now, my symptoms have returned... dry skin especially back of heels, hair loss, brain fog, some anxiety and depression episodes and stiff feet at the top, heavy eyes. Thank you in advance looking foward to your advice.

[SlowDragon Administrator]

previous post here

healthunlocked.com/thyroidu...

Have you tested vitamin D, folate, ferritin and B12

Are you currently taking any vitamin supplements

Are you male or female and approx age

Approx how much do you weigh in kilo

have you had thyroid antibodies tested for autoimmune thyroid disease also called Hashimoto’s

What brand levothyroxine are you currently taking

Suggest you increase levothyroxine by 25mcg per day …..ideally same brand as 100mcg

Retest in 6-8 weeks

[pennyannie]

Hey there :

OK - so on 100 mcg T4 daily your TSH is now 4.55 with a T3 at 4 and a T4 at 14.00 :

The TSH is high - when optimally mediated the TSH is usually down as the bottom of the range and likely around 1 and low in the range.

The TSH rises to indicate you need more thyroid hormone replacement.

We generally feel at our best when the T4 is in the top quadrant of the range as this should in theory convert to a decent level of T3 at around a 1/4 ratio T3/T4 :

Your T3 is around 25% and your T4 around 20% through the ranges and you need to increase your dose of T4 medication and start to build up your T4 dose by a 25mcg increment to 125mcg daily and retest again in 6-8 weeks.

I wonder if there is any reason why you can't absorb and utilize well the T4 medication ?

Are you dealing with anything else, and taking any other medications ?

Do you take the T4 on an empty stomach with just a glass of water and wait around an hour before you eat or drink anything ?

No thyroid hormone works well until ferritin, folate, B12 and vitamin D are up and maintained at optimal levels - do you have any current results of these ?

Have you found out the reason for your hypothyroidism ?

If you did have positive thyroid antibodies at diagnosis this is then likely Hashimoto's auto immune thyroid disease and there will be several other factors that need to be taken into account.

Just for interest and consideration : thyroidpharmacist.com

[Umayya40 in reply to pennyannie]

Thank you for replying! I take T4 in the morning on an empty stomach and all other supplements in the afternoon. After having the twins my health has generally been poor, im working on my B12, vitamin d and ferritin levels not had these tested in a while. Gp test my thyroid every 2 months & have prescribed 75mcg levo ( teva) again eventhough ive told them its not helping..driving me nuts! I brought 100mcg levo (Accord) online through a trusted pharmacy site as i was cutting up all the gp ones to make up 100mcg..no doubt i got the amount wrong.

I will take 125mcg as you have suggested but how do i convince the gp to prescibe these ?? Gp is not on my side at all. I dont know what has caused my hypothyroidism was never questioned. Do you recommend i test for this now or wait 8 weeks on 125mcg , also i will test all vitamin levels again & will post. Once again thank you so much for your time & help.

[pennyannie in reply to Umayya40]

I think retest after 6-8 weeks on 125mcg :

Can you see a different doctor as a TSH of 4.55 for someone already on T4 hormone replacement should be an alarm bell for your doctor to increase your dose and to a brand of T4 that suits you and not Teva if this upsets you.

Essential to test the ferritin, folate, B12 and vitamin D - many of us need to get these done privately - there is a list of companies offering such services on th Thyroid UK website who are the charity who support this forum - thyroiduk.org

When I ran mine, as my doctor refused, I found me ferritin was at 22 in a range of 15-300. so technically in the range and ' good to go ' - however researching my health issues I then read on very many well established websites that ferritin needs to be at least over 70 for any thyroid hormone replacement to work well !!

I now find I need to maintain my ferritin at around 100 : folate at around 20 : active B12 at around 75++ ( serum B12 500++ ) and vitamin D at around 100 :

Doctors are not taught about vitamins and minerals and some ranges that doctors work to are too wide to be sensible and we do need to become our own best advocates.

When hypothyroid and not optimally medicated your metabolism is slowed and you will find it difficult to extract your essential core strength vitamins and minerals through food, no matter how clean and healthy you eat :

When hypothyroid you can have low stomach acid which compounds the issue as your body isn't able to breakdown your food well enough to keep your well with food alone.

There are several clips of how to test for low stomach acid on YouTube -

I now need to take a little apple cider vinegar diluted in water before I eat my main meal containing protein to help my body break down my food rather than it sit in a lump and my getting further constipated - ring any bells ?

[Umayya40]

Yes your right need to get everything at optimal levels and get them tested regularly. I have an appointment with GP in December so we will see what they say 🙄. Im not constipated feel im regular with levo..well i think its the levo. Eventhough my results are at bottom range i feel so much better than before so i think im heading in the right direction, slowly but surely with your help will figure this out. Will post in 8 weeks with results inc antibodies test , also the Thyroid pharmacist link is so useful 👍