Help with latest blood results - big TSH increase

[SleepingDisco]

Hi lovely people,

Once again, please can I call on your brilliant minds to help me decipher my latest blood results 🙏

My TSH has made a huge jump - from 0.06mcg in my previous test (October 22) to 2.61mcg last week. Any thoughts on why this has happened? Up to now, my optimum levo dose has been 100mcg - it's always made me suppressed, but I feel so much better that way. I now have symptoms again - awful air hunger, weight gain, feeling cold - it's like going back a year to when I was first diagnosed.. I'm just confused about why my TSH has increased so much.. the only thing I can think of is I've cut back on drinking pink grapefruit high juice squash! Would this warrant such a change? I'm only talking about a few glasses a day and now only have 1 max, if any..

A quick outline about me;

Age 44

Meds; Levo - 100mcg (5 days pw, 75mcg 2 days pw, but often just take the 100mcg every day) I take my levo at night - 10pm ish

Supplements; Thorne Basic B daily (AM) Vit B12 (3000mcg drops), Vit D & K

I'll post the full results separately. I've also started monitoring my results using the excellent calculator on here. I'll post my spreadsheet comparisons too.

Thank you so much - I'm a bit worried about what's going on and need to feel armed before speaking to my GP. x

[SleepingDisco]

Here's my bloods comparison chart

Blood results comparison

[Jaydee1507 Administrator in reply to SleepingDisco]

My immediate thought about reason for your TSH to have risen would be the B12 you are taking so your thyroid hormone is working better. Your B12 still isn't optimal though so what are you taking for that?

Clearly you need a dose increase.

Your ferritin has dropped quite a bit so keep working on that. Optimal is 90-100.

[SleepingDisco in reply to Jaydee1507]

Thanks Jaydee1507 I'm taling Natures Aid Bioactive B12 drops. I am a bit rubbish at remembering that one though as it's in the fridge and not with my other supplements! But will try better!

My ferritin is very low - I was on prescribed ferrous tablets a couple of years ago and I think I'm dropping back to the levels I was back then. I should have mentioned I'm also vegetarian / slightly vegan (!) so need to supplement iron too, I think (currently not doing this). Do you know a good one you could recommend if the GP won't re-prescribe?

Thanks again for your help

[Jaydee1507 Administrator in reply to SleepingDisco]

Do they really need to be kept in the fridge? Just if they really don't and would help you to remember to take them then store with your other supplements. You do really need to get that B12 level up higher.

I'm not an iron expert I'm afraid. I did a search of the group if you have a look through to see what others are taking. healthunlocked.com/thyroidu...

I'd get some NHS bloods done so you can get that dose increase.

[SleepingDisco]

I've just double checked and they don't have to be in the fridge! No idea why I thought they did!

I'll look at iron recs on the link - thank you

Do you mean get an NHS blood test for iron done?

[SleepingDisco]

Also I forgot to mention in my original post, that a recommended Levo new dose would be greatly appreciated too. Thanks

[tattybogle]

The previous test in Sept /Oct (when TSH was 0.1/ 0.06 and fT4 12.6 ) was taken when you'd been on 100mcg for 3 months .

TSH at that point was low because hypothalamus / pituitary thought . "oh good , thyroid hormone level has gone up to enough for us, thanks ~ no need to keep shouting at thyroid to make more "

Since then you've been taking 100mcg every day (mostly ? sometimes a couple of days of 75mcg / 5 days 100mcg as prescribed )

Now TSH has risen to 2.6, because your fT4 has fallen a bit to 10.3[7.9 -16] .... Hypothalamus / Pituitary have noticed this drop ,and have started shouting (quietly) for a bit more again.

Why has fT4 fallen ? ... either ~some complicated clever stuff happened with your deiodinases once you body had a few more months to settle into having 100mcg .. and it decided it wasn't quite enough after all.... or ~ a bit more of your thyroid was knackered by your immune system and it can't make quite so much T4 as it was before . or ~ (because thyroids with autoimmune disease are a bit unpredictable) who knows .... but whatever the reason , your HPT axis is clearly asking for more T4 and has sent TSH up to shout for it., and your symptoms returning confirm this .

You can use this list of references to persuade your GP it is safe / recommended to increase your levo dose at this point healthunlocked.com/thyroidu...

if you've actually been taking 100mcg every day for most of this time , now is the time to come clean about this to GP (while TSH is this high)

if you don't, they will increase prescription from what they 'think' you are taking.... so you may get offered an increase to 100mcg , which obviously won't improve how you feel if 100mcg is what you are already taking .

if you are taking mostly 100mcg all week you could probably do with an increase to 112.5mcg / day .

Better to try that for few months first to see how it feels once it's settled in , rather than ask for 125mcg/ day which may suppress TSH again and make GP want to take it back off you straight away .

If 112.5mcg is not enough (eg you don't feel better and TSH remains in range , fT4 doesn't improve much ) then it's possible to ask for more using same list above..........

or ~ if TSH is below range and you don't feel better, then this list can be useful healthunlocked.com/thyroidu....

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

p.s re. your question the other day about explaining HPT feedback loops .. this is my attempt

healthunlocked.com/thyroidu...

[SleepingDisco in reply to tattybogle]

tattybogle ; you are brilliant! Thank you so much for this - it's really helped me to grasp what's going on and feel better prepared for a conversation with my GP about levo dosing. I'm assuming to get to 112mcg, I need to cut a tablet up - they don't prescribe such specific doses, do they?

Thanks again, I really really appreciate you taking the time to reply with all thus fab info. Also LOVE your feedback look explanation post too!