I recently posted on here because I feel my doctor doesn't really take an interest in my hpothyroidism. And so I've recently taken some private bloods to check my doses are OK.
I finally have them back now - bit of a mess as the lab only tested some things. At first I was told they couldn't test because there wasn't enough blood (although there was!) and then they suddenly appeared - weird.
On MonitorMyHealth, all thyroid levels have a green light. Does that mean my levels are good? I still have lots of low-thyroid symptoms!
TSH level: Your result is 2.39 mu/L (normal range 0.27 - 4.2 mU/L)
FT3 level: Your result is 4.8 pmol/L (normal range 3.1 - 6.8 pmol/L)
FT4 level: Your result is 19.4 pmol/L (normal range 12 - 22 pmol/L)
Unfortunately they didn't do all the other tests - B12, folate, etc, frustrating! They're sending me a second test-kit for free.
Any help interpreting these welcome. Thanks in advance.
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mids_thyman
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Thanks SlowDragon. Thats really interesting... and shows me how little I know, as on the surface MonitorMyHealth gave me loads of green lights!
I'm currently on 50mg Levothyroxine, which is always the same, branded and made by Accord. My 50 mg is a starter dose I've been on for 4 years.
I've recenly had my blood tested by a doctor, who tells me foliate and Vit12 are in an acceptable range. When I started this journey a few weeks ago, I was experiencing all sorts of symptoms including tingling in my feet and hands. Am I right in assuming my dose shortfall isn;t significant enough to account for this?
And can you tell me how you worked out those ratios and what they mean?
Levothyroxine is Ft4 and is inactive. Ft4 has to be converted in cells to Ft3.
For good conversion of Ft4 to Ft3 it’s important to have optimal vitamin levels
Most people when adequately treated will have Ft3 at least 50-60% through range
guidelines on dose levothyroxine by weight
Even if we frequently start on only 50mcg and don’t start on full replacement dose, most people need to increase levothyroxine dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until eventually on, or near full replacement dose
Consider starting levothyroxine at a dosage of 1.6 micrograms per kilogram of body weight per day (rounded to the nearest 25 micrograms) for adults under 65 with primary hypothyroidism and no history of cardiovascular disease.
In the majority of patients 50-100 μg thyroxine can be used as the starting dose. Alterations in dose are achieved by using 25-50 μg increments and adequacy of the new dose can be confirmed by repeat measurement of TSH after 2-3 months.
The majority of patients will be clinically euthyroid with a ‘normal’ TSH and having thyroxine replacement in the range 75-150 μg/day (1.6ug/Kg on average).
The recommended approach is to titrate thyroxine therapy against the TSH concentration whilst assessing clinical well-being. The target is a serum TSH within the reference range.
……The primary target of thyroxine replacement therapy is to make the patient feel well and to achieve a serum TSH that is within the reference range. The corresponding FT4 will be within or slightly above its reference range.
The minimum period to achieve stable concentrations after a change in dose of thyroxine is two months and thyroid function tests should not normally be requested before this period has elapsed.
I just had a phone appointment with my doctor following me expressing concerns re: thyroid lvels during my diabetic nurse appointment last week.
He was looking at the last tests done by him, which were in October last year. I was preparing to unveil my lastest private test results (TSH 2.39, etc), to convince him to increase my levo.
Instead, he got in ahead of me by quoting the previous results. I hadn't realised (as I hadn't actually been told), but at that point my TSH was 4.2 and FT4 was 13.2.
"Easy job", I thought, as that makes the case even more obvious. But then he told me that everything was bang-on in-target, so no need to change my medications. And despite me making the case otherwise that TSH should be closer to 1, he simply would not budge.
So, as he holds the key to my medicine, I am a bit lost now. And this is depsite going thorough a pretty rough time of it lately with various symptoms like tingling feet and tinnitus that COULD be thyroid related.
The majority of GPs (it seems to me) have no clue about how best to treat patients who're hypothyroid. So that's probably the reason he wouldn't give you a small increase in dose as your result was within the 'range' when it should be 'optimal'.
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