Help with medication review

[Peaches33]

Hi everyone, I was diagnosed with under active thyroid late 2019. I’m on 50mg Levothyroxine but still have symptoms of tiredness, aches and pains and feeling cold all the time. GP has requested bloods - TSH but not T3 or T4. Is that normal?

My recent TSH blood result is 2.40 mu/L. I’m high in vitamin D, and high in cholesterol 6.00mmnl/L.

Should I ask for blood test for free T4? Am I receiving enough dosage of medication? Should I other blood tests for my condition?

Thanks in anticipation.

[Litatamon]

Hi Peaches33,

It is not helpful for you not to have a complete thyroid panel (FT4, FT3, TSH & antibody testing) but it unfortunately happens often for doctors, including endocrinologists, to omit T3. But it is needed.

Your dosage - 50 mcg - is a starter dose. And you probably need an increase.

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The vitamin d - are you supplementing it? What is your level?

[Buddy195 Administrator]

Welcome to the forum Peaches33,

If your GP is unable to complete all the tests (eg if TSH is within range, some surgeries may not be able to access FT4 and FT3 tests), you could look to do this privately, as many forum members do, for a better picture of your thyroid health:

 thyroiduk.org/help-and-supp...

I would also check key vitamin levels for ferritin, folate, B12 and vitamin D. Medichecks are often discounted on Thursdays, so it is worth checking offers then.

As others have said, 50mcg is a starter dose and most people feel best with TSH under one, so you will undoubtedly need an increase.

[Peaches33 in reply to Buddy195]

Thank you all for responding. I had a thyroid peroxide antibody test in 2019. This was abnormal at 255 ui/ml. GP would not give me thyroid medication until that was completed even though I suffered all the symptoms.

Serum folate is 8.6 Ug/l. Serum creatinine is 85umol/l abnormal. I supplement with vit D due to ethnic origin. It is just over 200 so will start reducing now but books say you can over med. Taking vit K2 with these. I have not got the serum iron reads yet but these have always been low - abnormal. GP said I could continue with the B12 injections, however I’ve never had these before! I suffer with digestive problems. Changing my diet now to suit.

Will probably get private tests completed for piece of mind. It would be good to come with evidence for the next GP appointment.

[Buddy195 Administrator in reply to Peaches33]

can you supply the ranges for your tests, as these vary between laboratories Peaches33

[Peaches33 in reply to Buddy195]

Hi again. Ref ranges are TSH 2.40 (0.27-4.20); Thyroid Peroxidase 255iu/ml (<109); serum iron 13umol (14-30); serum folate 8.6ug/L (no range given); serum 25-HO vit D 218nmo/L (50-174); serum free T4 15.1 pmol/L (10.8-25.5). T4 was taken in 2019.

[Cornwaller]

Sounds like you still have hypo symptoms, 50 is a pretty low dose of levo and your tsh is still moderately high. An increase in levo to 75 and review your symptoms and invest in a private thyroid panel n a couple of months would seem a sensible way forward.

Didn't get your b12 injections bit? If your b12 is low this may also give you symptoms not dissimilar to those of hypothyroidism. If you have both then a good practitioner will tease out and treat them both.

[klr31]

I would think that you need an increase in thyroxine. They left me on that dose too long too and I became very unwell. Check your T4 and T3, as well as D, B12, ferritin and folate. Karen