TSH 0.12 , this was 5.44 6 weeks ago, help understanding

[Sand01]

Hi

I need some advice, my TSH was 5.44 6 weeks ago which seemed odd as been on Levothyroxine for around 8 years without problems, so doctor increased from 100 micrograms to 125.

I had bloods done after6 weeks , now TSH is 0.12. (T4 19.4, this was 14.2)

I think I know why so high originally as after researching I was taken prescribed iron tables at the same time which I beleive stop the assorption or something like that.

So now do you you think I should go back to my usual 100 micrograms?

I rang the doctors and receptionist said the doctor has seen my latest results and said all normal.

In the last 2 weeks my concentration has gone, hot flushes increased and I feel quite awful so assuming because of my levels.

Any help & advice very much appreciated

[Jaydee1507 Administrator]

When you quote blood result numbers we do need to see the ranges for each of them (numbers in brackets) as they vary from lab to lab.

Have you recently had key vitamin levels checked - feritin, folate, B12 & d3? Hypo people suffer from low stomach acid and poor vitamin absorption.

[Sand01]

Hi

When I had them done 6 weeks ago, the ranges were

TSH 0.55-4.78mu/L

T4 9.50-22.70pmol/L

My other results back in Dec 22 were

Serum ferritin 38 ug/L (Range 10.00-291.00ug/L)

Serum follate 12.3 ug/L (Range 3.40-12.20ug/L)

Serum vitamin B12 524 ng/L (Range 211.00-911.00 ng/L)

I am afraid I have no knowledge what this all means 😀

[Jaydee1507 Administrator in reply to Sand01]

I would suggest going inbetween your current dose and where you were before, so 112.5mcgs. You can cut a 25mcgs tablet or take the 25mcg tablet every other day to get that dose.

Your ferritin is on the low side. We need OPTIMAL vitamin levels for our thyroid hormone to work well. Try eating chicken livers twice a week or pate.

Your vit D needs testing.

[tattybogle]

it would perhaps be more sensible to let GP know you'd like to try a dose in between the two first for 6 weeks, rather than going back to 100mcg .(or just try it yourself ) as 100mcg did not appear to be quite enough before . and TSH is now a little bit below range on 125mcg .

Do allow at least 6 weeks after a dose change to allow symptoms and bloods to settle down .

GP could prescribe 100/ 125 alternate days , or you could cut a 25mcg in half to get 112.5mcg / day if you prefer to take the same each day ( some people feel a bit odd if they take alternate doses , some don't notice)

When you went up to 125mcg , was the brand of Levo the same as you usually use for the 100mcg ? different brands can sometimes make people feel naff.

When you were taking the iron tablets, were you leaving a 4 hour gap from the Levo ?

I don't know enough about iron/ ferritin etc but others do eg SlowDragon , so hang about and there may be more questions/ advice about getting/ keeping iron levels good.

[Sand01 in reply to tattybogle]

Hi, I think that was the problem initially, I was taking the iron at the same time as taking 100, which is probably why my TSH was high at 5.44, I just feel if I say take 112.5 my TSH will drop further as that is the way it is going now, I was maybe thinking drop to my usual 100 and take the iron 4 hours later.

I think the brands were different.

[tattybogle in reply to Sand01]

if nothing else was changed , then reducing levo to 112.5 from 125 should raise TSH a little ...

However if you also start taking the iron well away from levo now , then that will effectively be a dose increase ( you will absorb more of the Levo again ).. so you may be right........ yes you could try going back to 100mcg and taking iron at least 4 hrs apart .

What was TSH / fT4 'usually' ....before you added the iron ?

[Sand01 in reply to tattybogle]

I have had iron for a couple of years now, but I think I only started taking it in the morning with my Levo a few months ago.

As mentioned, in Dec 22 my TSH was 5.44, now it is 0.12, that I feel is not only with the increase from 100 to 125, but also due to me not taking iron at the same time.

I dont have my previous results, I really wish I could see all my doctors notes online.

[SlowDragon Administrator]

iron supplements should be at least 4 hours away from levothyroxine and yes would have significantly affected absorption taking at same time

Which brand is your 100mcg tablets. Do you always get same brand 100mcg tablets

Which brand is 25mcg tablets

Suggest you go back to 100mcg and retest in 8-12 weeks

It takes much longer to settle reducing dose

You need vitamin D tested too

Optimal level is at least over 80nmol and between 100-125nmol might be better

vitamindtest.org.uk

Test twice yearly via NHS private testing service when supplementing 

[Sand01 in reply to SlowDragon]

I really appreciate everyone's replies.

The 100 & 25 are different brands, I always seem to get different brands (I cannot check now as at work)

It is the concentrating that is really getting me , I work with figures so a little frustrating at the moment as it is taking me a lot longer to get anything done .

[tattybogle]

p.s the GP who prescribed the increase to 125mcg when TSH had gone up to 5 should have asked about your timing of taking the Iron tablets ...

and the GP who prescribed the iron should have made it clear that a 4 hr gap was required ...

were either of them awake/ conscious when you spoke to them ? lol

[Sand01 in reply to tattybogle]

I totally agree, they did not mention any of this, it is only since doing my own research I found this out.