hello, im new to this forum. Just wondering if anyone can help with my results and help advise on what i should do.
Over the last 4 years my TSH levels have been gradually increasing until i was started on Levothyroxine last october, however GP has only given me 25mcg. Just had repeat bloods and its still over range.
the past bloods results i have:
TSH and T4
sep 2019- 4.8 mu/l Range (0.30-6.0)
Feb 2020- 6.3 mu/l- Range (0.30-6.0)
March 2021- 6.2- Range (0.3-6.0) T4 12.0 range (10.4-24.5). TPO 150iu/ml range (0-35).
July 2021- 5.29- Range (0.35-5.0) This was an afternoon test
October 2022- 13.3- Range 0.30-6.0)- Started on 25 mcg Teva -T4 12.8 range (10.4-24.5)
Jan 2023- 8.2 - Range 0.30-6.0). T4- 13.7- Range (10.4-24.5)
I did the advanced thyroid test on medichecks this week and results are:
CRP- 0.7 (range 0-5).
Ferritin - 40.5ug/l- (Range 13-150ug/l)
Folate- serum- 5.28 ug/l- (Range >3.89
Active B12- 112 pmol/L- (Range 37.5-150)
Vit D- 72nmol/l- (Rnage 50-200)
TSH- 8.26mu/l- (Range 0.27-4.2)
Free T3- 4.37 pmol/l- (Range 3.1-6.8)
Free Thyroxine- 16 pmol/l- (Range 12-22)
TGA- 70iu/ml- (Range <115)
TPO antibodies- 85iu/ml- (Range <34).
i didnt take any vitamin supplements in the week before and i didnt take my Levothyroxine for over 24 hours before these tests. Ive also had issues with B12 in the past with my bloods coming back from the GP as 219 ng/l (range 160-1000) in sep 2019 however an active test at this time came back as deficient about 35 i think but the GP refused to accept those results. so i do supplement that now.
Should my GP now be increasing my Dose of Levothyroxine? im currently on 25mcg. i sent a message to the GP to ask but they have ignored me. Im going to ring tomorrow morning as ive still got numbness in my hands, and ive got really bad anxiety at the moment. Other things i noticed are: tremors in my muscles, palpitations at night, i have bald patches in my head, im always cold, regular constipation, dry skin.
I currently weigh 80kg. Also i have been doing a degree the last 2 years so am under a lot of stress.
They were really reluctant to start me on it in the first place as im 36.
Many thanks for any advice.
Written by
Apesxx
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Firstly, your GP has failed you. Just too shocking they have left you with a TSH above range on 25mcgs Levo. You need an immediate increase and you are going to have to become your own best advocate. Make an appointment with your GP and insist on an immediate increase.
Your folate is low, buy some Thorne Basic B complex which will also boost your other B vitamins.
Your ferritin is too low, should be around 90-100. Start eating chicken livers or pate a few times a week.
Vit D should be higher. I'm sure someone will advise how much you need to take.
yes your dose needs increasing now . and the NHS guidelines for treating hypothyroidism very clearly tell GP's to do this ... so make sure they follow them . ( i'll link to the right bit below )
as you are 36 you should have been started on 50mcg levo, NOT 25mcg (25mcg is advised as a more gentle start for people who are over 65 or who have heart conditions)
Starting you on 25mcg has just made the process of getting you up to the right dose ( and feeling better ) take 3 months longer than it needed to . cks.nice.org.uk/topics/hypo...
"The NICE clinical guideline recommends:
Consider starting LT4 at a dosage of 1.6 micrograms per kilogram of bodyweight per day (rounded to the nearest 25 micrograms) for adults under 65 years of age with primary hypothyroidism and no history of cardiovascular disease.
Consider starting LT4 at a dosage of 25–50 micrograms per day with titration for adults aged 65 years and over, and adults with a history of cardiovascular disease.
The British National Formulary (BNF) recommends:
For adults aged 18–49 years — initially 50–100 micrograms once daily; adjusted in steps of 25–50 micrograms every 3–4 weeks, adjusted according to response; maintenance 100–200 micrograms once daily.
For adults aged 50 years and over, with cardiovascular disease, or severe hypothyroidism — initially 25 micrograms once daily; adjusted in steps of 25 micrograms every 4 weeks, adjusted according to response; maintenance 50–200 micrograms once daily.
Advise the person to take LT4 medication on an empty stomach in the morning before other food or medication."
nice.org.uk/guidance/ng145/... (*note 'subclinical hypothyroidism' means 'TSH over range ,while fT4 is still within range' )
"Treating subclinical hypothyroidism
1.5.2When discussing whether or not to start treatment for subclinical hypothyroidism, take into account features that might suggest underlying thyroid disease, such as symptoms of hypothyroidism, previous radioactive iodine treatment or thyroid surgery, or raised levels of thyroid autoantibodies.
Adults
1.5.3Consider levothyroxine for adults with subclinical hypothyroidism who have a TSH of 10 mlU/litre or higher on 2 separate occasions 3 months apart. Follow the recommendations in section 1.4 on follow-up and monitoring of hypothyroidism.
1.5.4Consider a 6-month trial of levothyroxine for adults under 65 with subclinical hypothyroidism who have:
~ a TSH above the reference range but lower than 10 mlU/litre on 2 separate occasions 3 months apart, and
~ symptoms of hypothyroidism.
If symptoms do not improve after starting levothyroxine, re-measure TSH and if the level remains raised, adjust the dose. If symptoms persist when serum TSH is within the reference range, consider stopping levothyroxine and follow the recommendations on monitoring untreated subclinical hypothyroidism and monitoring after stopping treatment."
So get it increased to 50mcg now (because TSH is still over range)
Then get retested after 6-8 weeks on 50mcg (don't let them make you wait 3 months ..they have already wasted enough time) .
If TSH is 'in range' on 50mcg but GP says "well it's in-range now so i don't need to increase dose ant further", use this list of references recommending GP's keep TSH between about 0.5 to 2/2.5 in patients on Levo . healthunlocked.com/thyroidu.... ( my-list-of-references-recommending-gps-keep-tsh-lower-)
Vitamin D at least over 80nmol and between 100-125nmol maybe better
Ferritin at least half way through range
Folate nearer 20
As your Active B12 is now over 70 you can replace separate B12 with supplementing a good quality daily vitamin B complex, one with folate in (not folic acid)
This can help keep all B vitamins in balance and will help maintain B12 levels too
Thorne Basic B recommended vitamin B complex that contains folate, but they are large capsules. (You can tip powder out if can’t swallow capsule)
Thorne currently difficult to find at reasonable price, should be around £20
If you want to try a different brand in the meantime, one with virtually identical doses of the ingredients, and bioavailable too, then take a look at Vitablossom Liposomal B Complex. Amazon sometimes has it branded Vitablossom but it's also available there branded as Yipmai, it's the same supplement
IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results
Feel for you. I have same problem with my GP surgery. I dared to question my high TSH levels and am now seen as "difficult". Hopefully you will have better luck.
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