TSH elevated T4 in bloods normal range

[Roquynn23]

Wondering if anyone has experienced having a high TSH level yet levothyroxine T4 uptake is safely within range?

Over the last 5 years my levels have fluctuated from hypothyroid normal parametets to elevated T4 low TSH to exact opposite. Food, other meds, general bloods all managed well to ensure no conflict. Annual check Nov 2022 and TSH elevated in 30,s yet T4 happily within mid range. I have increased or decreased from baseline 150mcg in 2017 to last week reaching 250mcg daily. I take 6 a.m. with water. Nothing else until 8 a.m. I take omeprazole at 5 p.m. and famotidine at 10 p.m. along with other pain releif and anti sickness meds... am baffled...obvs hair fallout, dry skin etc, sleeping from about midnight to 6 am, then napping on and off couple hrs at a time until around 4pm.

Would like some feedback or knowledge or personal experience as I have a g.p. who is thinking i dont take my meds regularly. I do and have done since 1999

[Jaydee1507 Administrator]

Even though you're taking the PPI & Famotidine apart from the Levo they may well be affecting your absorption. Approx what weight are you?

Your FT4 middle of the normal range is just not good enough. Most people on Levo need it right near the top, so you're clearly under replaced.

[Roquynn23 in reply to Jaydee1507]

Thanks for replying Jaydee...I am overweight for sure. No matter what I do I cannot shift it. Have been on ppi for a long time as a control for bile overproduction. Famotidine a fairly new intro since Oct 2022 due to Barretts Oesophagitis. Maybe a slow metabolism is creating an issue despite many hours apart in routine? Hmmm...thank you...appreciate your comments...M

[Jaydee1507 Administrator in reply to Roquynn23]

I didn't realise thats your first post here so welcome to the group.

It looks to me like your GP is happy to treat your symptoms of hypothyroidism with other meds but hasn't actually got your thyroid treated properly. This is very common as they are only interested in blood results in the normal range, when what we really need are OPTIMAL results.

As hypo people we suffer from low stomach acid and so dont absorb vitamins properly. If we have low vitamin levels then our thyroid hormone doesn't work well. At your next blood test get GP to check ferritin, folate, B12 and D3 levels. Post the results here when you get them. You are legally entitled to copies of your blood tests.

If you really want to lose weight and get well then hang around here and learn about your condition and what can help. Your GP is probably the last person who knows what to do.

[Roquynn23]

Thank you, Jaydee1507 for that advice. All else was tested in Nov but I do not have the actual numbers. I will be hanging around for a while for sure. It's only taken me a few years to get here!!! I certainly need to expand my knowledge base. G.P. referred query straight to endo consultant after these tests came back. Consultant made decision to increase doseage again. I will be tested again in 4 weeks. I will post results then.

[McPammy]

have you had your T3 checked at the same time as TSH and T4. T4 levothyroxine converts to the most important hormone T3. Without enough T3 your TSH will go high even if your T4 is at a good level. That’s what happened to me. I found out I was hardly converting my levo T4 to T3 through blood test results. I was only converting 8% to T3. Get your T3 checked also. You can also do the DIO2 gene test through Regenerous Laboratories privately for about £165. If positive this confirms you are a poor converter to T3. When my T3 was very low I put on over 4st! Once we added T3 along with levothyroxine I dropped all that weight in no time. But most importantly I now had energy. I was severely lacking in energy and could barely walk. Now I’m going the gym and doing brisk walks daily. It’s been a complete game changer. Also check your vitamins D, B12, ferritin and folate they all need to be good in the ranges.

[Roquynn23]

Thanks McPammy. I am not even sure if T3 is checked but I do remember gp said T4 in bloods was doing its job. But I will enquire further next week. Thank you.

[SlowDragon Administrator]

Being hypothyroid results in low vitamin levels

PPI will lower vitamin levels even further

ESSENTIAL to test B12, folate, ferritin, vitamin D and magnesium levels at least once a year

On levothyroxine we MUST have good vitamin levels for levothyroxine to work

What vitamin supplements are you currently taking

Links re PPI and vitamin deficiencies

gov.uk/drug-safety-update/p...

webmd.com/heartburn-gerd/ne...

pharmacytimes.com/publicati...

PPI and increased risk T2 diabetes 

gut.bmj.com/content/early/2...

Iron Deficiency and PPI 

medpagetoday.com/resource-c...

futurity.org/anemia-proton-...

onlinelibrary.wiley.com/doi...

sciencedirect.com/science/a...

Essential to test thyroid levels early morning and last dose levothyroxine 24 hours before test

Do you always get same brand levothyroxine at each prescription

Approx how much do you weigh in kilo

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

Essential to test TSH, Ft4 and Ft3

Plus test BOTH thyroid antibodies at least once

Have you had thyroid antibodies tested by GP?

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 and thyroid antibodies 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/

Monitor My Health also now offer thyroid and vitamin testing, plus cholesterol and HBA1C for £65 

(Doesn’t include thyroid antibodies) 

monitormyhealth.org.uk/full...

10% off code here 

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

Only do private testing early Monday or Tuesday morning. 

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

[Roquynn23]

Slowdragon, thank you so much for the invaluable info. I know vit b12 and D and hbca1 as am in and out of parameters for Diabetes type 2. I have a malabsorption problem as well as fatty liver. My cholesterol remains higher than it should ⅞i to the malabsorption issues. I jĵ take multivitamins but I do take vitD daily...I will take up those you have signposted me to. Thank you so much