help with Tsh

[Shona81]

hello lovely people, I need help…at the begging of November I done 2 private blood tests

Medicheck from finger at home :

Tsh 4.18 (0.27-4.2)

Ft3 4.7 (3.1-6.8)

Ft4 16.3 (12-22)

And private test with sample taken from vein :

Tsh 3.31 (0.35-4.94)

Ft3 2.85 (1.58-3.91)

Ft4 1.02 (0.7-1.48)

After speaking to my doctor she agreed to increased my dose from 50 mg to 50/75 mg alternate days . Blood test from surgery after 6 weeks showed

Tsh 3.44 (0.35-5.5)

Ft4 16.1 (10.5-21)

after speaking to reception and being told all ok no further action needed I did increase my dose to 75mg and booked appointment to see my doctor to discuss my medication which is next week, in preparation for this I did another blood test ( from vein ):

Tsh 3.31(0.35-4.94)

Ft3 2.73(1.58-3.91)

Ft4 0.96(0.7-1.48)

B12 403 (189-883)

Ferritin 29.22(4.63-204)

Vit D 29.6 (20-100)

Folate 17.5(4.6-18.7)

I know it’s only been 4 weeks since last dose increase but can someone tell me why isn’t my Tsh going down? I’m taking b complex, vitamin d3 + k2 , and iron daily , also for the last 4 months I have been given Teva Levothyroxine brand ( before it was mostly wockhardt)…could it be possible that it doesn’t work on me ? Thank you for any insight x

[SlowDragon Administrator]

TSH isn’t going down Because dose wasn’t increased enough

After November results you should have been increased to 75mcg daily

Which brand of levothyroxine are you currently taking

Do you always get same brand levothyroxine at each prescription

Were all tests done early morning and last dose levothyroxine 24 hours before test

Testing 4 weeks after increasing is too soon

Retest after 6-8 weeks on 75mcg

Approx how much do you weigh in kilo

Likely eventual daily dose levothyroxine is approx 1.6mcg per kilo of your weight per day

Meanwhile working on improving low vitamin D and very low ferritin

Increase iron rich foods in your diet

Red meat daily, liver or liver pate once week. Orange juice to increase iron absorption etc etc

[Shona81 in reply to SlowDragon]

Hi thank you for reply ...currently taking teva , test done at 8.30 am and yes the last dose taken 24 hours before ...I'm around 71 kg , unfortunately don't eat meat so can't increase iron that way ....what I can't really understand is why my tsh is exactly the same as it was in November with the dose increase shouldn't at least go down a bit ?

[SlowDragon Administrator in reply to Shona81]

71kg x 1.6mcg = 113mcg per day as likely eventual daily dose levothyroxine

113mcg x 7 days week = 795mcg per week

Currently you are only taking 75mcg per day

Teva brand levothyroxine upsets many people

Teva is only brand that makes 75mcg tablets

Perhaps try different brand at 100mcg dose

As vegetarian presumably you are supplementing B12 daily and separate vitamin B complex

You will need to organise your own full iron panel test for anaemia

As vegetarian likely to need to supplement iron

Essential to retest full iron panel 3-4 times a year

Iron is extremely toxic in excess