hi everyone,
I have just got my thyroid results back (I am hypo and have Hashimotos) and confused by them. They are all in ‘normal’ range but I know that’s not always reassuring. Could anyone help please? Am I being over medicated?
TSH 1.61
Free T4 - 17.1
thank you in advance
Welcome lottyA
Could you please tell us a little more so we can offer better advice.
Please add ranges so the results can be interpreted accurately. Ranges vary between labs so alway needed with each test result.
How long have you been diagnosed & what dose & brand of replacement do you take.
Have antibodies been tested?
How was test taken? Recommend thyroid blood test are booked early in morning. Fast overnight (lots of water) delay dose until after blood draw & cease supplements containing biotin 3 days before test.
important to test FT3 The active hormone often need to arrange privately. Also important to test folate, ferritin, b12 & Vit D. Have these been tested?
Hi PurpleNails and thank you for your reply.
Im attaching a screen shot of the ranges below.
Yes I have had antibodies tested so know I have Hashimotos. This was about 15 years ago. Dose is 75 mg brand is Teva UK.
The test was after overnight fast and in the morning 9.30 ish.
Folate, ferritin, and vit D weren’t tested unfortunately but do take a D supplement regularly.
Taking dose prior to test shows FT4 at highest level of day, therefore throughout day this level will decline.
Most feel well when TSH is around 1 & FT4 is in upper part of range. Yours is - FT4: 17.1 pmol/l (Range 9 - 21) 67.50%.
So you may benefit from an increase, no suggestion you are over replaced.
Doctors likely say as in range no adjustments necessary.
FT3 & nutrients not tested so it may nutrient are low & conversation to FT3 isn’t adequate. Low FT3 would make weight loss difficult.
Recommend you arrange a test including FT3 & nutrients.
75mcg is quite a low for full replacement level. A rough guide is 1.6mcg per 1 kg body weight. Only an approximate guide, not an exact calculation.
Teva seems to affect many, possibly as it contains mannitol. It is a lactose free brand, is this why you need teva?
hi PurpleNails,
I have never been offered anything but Tevo - can you ask for a different type of thyroxin? I had no idea it contains mannitol - I avoid any kind of sweetener like the proverbial usually
I will head to the health shop tomorrow or order a multi online I take Vit D, Turmeric capsules and probiotics but not a multi is there a specific multi you would recommend or a combination of single supplements?
Thanks so much for the info.
Some pharmacists will be helpful and supply alternatives, others may say they are only obligated to supply most cost effective brand.
Doctors can specify a brand but they prefer not to.
If you explain you are certain you have issue with excipients of Teva & need another they may argue there no evidence of allergy ect - in which case you can reply you’d be happy to have tests to confirm them - if you saying so can’t be trusted - They will likely not want to arrange this.
Multi are not recommended, they contain the cheapest & least absorbable forms of supplements.
We always advise testing first so the correct level can be sought in optimising them. Never starts lots of new medication & supplements at once - always leave at least a week. To track symptoms & side affects.
thank you for all this. Can I just ask what the other brand (s) of thyroxine are?
Advanz
Activis/Accord
Almus/Accord
Northstar/Accord
Northstar/Teva
Teva
Wockhardt
Aristo
There’s 46 tablets (different doses & brands ) on the British National formulary. (Capsules / liquid won’t be routinely prescribed)
bnf.nice.org.uk/drugs/levot...
ThyroidUK has a list of the different brands and if you click on each one it will show the patient information leaflet (PIL) which will include list of ingredients:
thyroiduk.org/if-you-are-hy...
thank you
Welcome to the forum
Most important question is how do you feel
Please add range on Ft4 result
Was test done early morning and last dose levothyroxine 24 hours before test
Just testing TSH and Ft4 is inadequate
You need TSH, Ft4 and Ft3 plus
Very important to test vitamin D, folate, ferritin and B12 at least once year minimum
How much levothyroxine are you currently taking
Do you always get same brand levothyroxine at each prescription
Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins
List of private testing options and money off codes
thyroiduk.org/getting-a-dia...
If you can get GP to test vitamins 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...
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...
Medichecks Thyroid plus antibodies and vitamins
medichecks.com/products/adv...
Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins
bluehorizonbloodtests.co.uk...
Only do private testing early Monday or Tuesday morning.
Thank you Slow Dragon. And thank you for all the info.
I feel good. A bit frustrated with attempts at weight loss but I think I need to try a bit harder re this.
Range is screen shotted below.
Levo is by Teva UK (always the same brand) and dose is 75 mg. Test done early morning and last Levo quite close to test as nurse had said to take meds as usual. It was a fasting sample from the night before so not 24 hours thank you I’ve just panicked at the result so this is so appreciated
probably under medicated and possibly low vitamin levels
Approx how much do you weigh in kilo
FT4: 17.1 pmol/l (Range 9 - 21)
Ft4 67.50% through range
Are you on strictly gluten free and/or dairy free diet
I’m 81 kg. Need to get on and lose some weight. I am strictly gluten free but not dairy free.
I did a stool test for allergies a while ago but dairy didn’t come up an issue but wondering if I need to cut out dairy also. Is there a multi vitamin you would recommend or do you need to take everything separately? Thanks again.
So guidelines suggest likely to need Approx 129mcg per day ……
81kg x 1.6mcg Levo
Push for next 25mcg dose increase to 100mcg
Retest 6-8 weeks after any dose change or brand change in levothyroxine
guidelines on dose levothyroxine by weight
Even if we frequently 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
NICE guidelines on full replacement dose
nice.org.uk/guidance/ng145/...
1.3.6
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.
Also here
cks.nice.org.uk/topics/hypo...
pathlabs.rlbuht.nhs.uk/tft_...
Guiding Treatment with Thyroxine:
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.
Test folate, ferritin and B12 first BEFORE starting any vitamin supplements
How much vitamin D are you currently taking. When did you last test
Multivitamins never recommended on here
healthunlocked.com/thyroidu...
healthunlocked.com/thyroidu...
yes I understand why. I am careful about what kind of vitamins I take in general. The Vitamin D3 is 4000 IU. Thank you
so you definitely need to test twice year on relatively high dose vitamin D
Thyroid results
Thyroid results
Thyroid Results
Thyroid results
