Increased LEVO from 125 to 150 but TSH has gone up?

[dexterholland91]

Hey everyone,

Here is my latest round of bloods - the ones listed are the only ones taken.

TSH 4.52 mIU/L (0.30 - 4.20) 108.2%

Free T4 (fT4) 14.7 pmol/L (9.0 - 19.0) 57.0%

Folate - Serum 15.9 ug/L (3.0 - 20.0) 75.9%

Vitamin B12 497 nmol/L (180 - 900) 44.0%

Ferritin 71 ug/L (20 - 300) 18.2%

My last round of bloods were in December which were:

TSH 3.27 mIU/L (0.30 - 4.20) 76.2%

Free T4 (fT4) 13.2 pmol/L (9.0 - 19.0) 42.0%

Free T3 (fT3) 4.1 pmol/L (3 - 5.4) 45.8%

T4:T3 Ratio 3.220 

Thyroid Peroxidase Antibodies (TPO) 528 IU/mL (≤ 35)

C-Reactive Protein (CRP) 0.2 mg/L (≤ 5)

Vitamin B12 (active) 512 nmol/L (180 - 900) 46.1%

Vitamin D 64 nmol/L (50 - 250) 7.0%

Since mid January I have been trialling 125mcg-150mcg alternate days. I haven't felt any difference since taking the 150. Still struggling day to day, even with all the correct vitamins previously suggested to me on here (thank you).

Why would my TSH be going back up? I accidentally took my LEVO within 12 hours of the test too which has porbably brought the TSH figure down slightly, so it could actually be higher than 4.52!

I recently has a US on my thyroid which came back clear. I managed to talk to the endocrine there, which has been my first ever time seeing someone other than a GP and I explained my situation how I'm an "athlete" and male etc and how I still feel rubbish. He said I need to be getting down to below 1 TSH. But how is that going to happen if it just keeps going up? surely 150mcg is already quite a high dose?

Does anyone have any thoughts?

Thank you so much

[SlowDragon Administrator]

accidentally took my LEVO within 12 hours of the test

That won’t have affected TSH, but Ft4 would be higher result than if took last dose 24 hours before test

Many people need higher dose levothyroxine than you are currently taking

Get prescription increased to 150mcg daily retest again in another 6-8 weeks

Do you always get same brand levothyroxine at each prescription

What vitamin supplements are you currently taking

Your ferritin is still low for a bloke, but as vegetarian it will be difficult to improve

[dexterholland91 in reply to SlowDragon]

Morning SlowDragon,

Thank you for the hasty reply as always.

Yes I do now, I battle with the pharmacy every time I go, but they are good to me haha.

Accord - 100

Accord - 50

Teva - 25

These are the combo's that give me the least side effects (heart palpitations and breathlessness etc) but that's not to say they are the best for my thyroid?

I am on Vit D, complex B12, magnesium and iron to try biring my ferritin up (and dark chocolate).

[GlowCoach Administrator]

No FT3 result this time?

As far as TSH goes and increasing with a dose increase, it's something that does happen. It definitely happened to me when I first started treatment. The body has done a lot of compensating while you have been undiagnosed. Naturally when you get an increase in Levo you would expect TSH to reduce but the body works in mysterious ways and healing is not in a straight line. See graph below. It won't continue to go up I'm sure.

Taking levo within 12 hours of test would not affect TSH. That would make your FT4 slightly higher only.

No vit D result.

When did you stop taking supplements before the test? B12 is not above 50% yet.

Ferritin still needs a bit of work with iron rich diet.

You will be struggling with numbers like that but hang in there, get dose increased and slowly things will improve. From previous test it does look like you convert well.

Healing graph

[dexterholland91 in reply to GlowCoach]

Nope, no FT3. I asked for it and got "no, we don't need it"!!

I actually thought I got Vit D this time round too but the result hasn't come through annoyingly.

I stopped all vitamins 4 days before the tests.

What's interesting is, since being on the B12 complex, my B12 has actually reduced! Is there a certain time of day that is best to take this as clearly i am doing something wrong?

Thank you so much - that graph is most definitely true in my case!

[GlowCoach Administrator in reply to dexterholland91]

Perhaps you need some extra B12. Could get a sublingual spray or lozenges.

Usually recommended to take B vits after breakfast as they can be stimulating and keep you awake if taken later in the day.

SeasideSusie can advise about B12 level dropping on supplements.

[SeasideSusie Remembering in reply to dexterholland91]

dexterholland91

What's interesting is, since being on the B12 complex, my B12 has actually reduced!

Sorry, I can be a bit pedantic at times, but it's only to avoid confusion and that any suggestions made are appropriate.

Exactly what supplement are you taking? There is B Complex which contains all the B vitamins. Then there is a B12 supplement which contains only B12 and no other B vitamins.

I'm guessing you might be taking a B Complex and not a separate B12 supplement as well.

Does your B Complex contain Vit C? Or do you take Vit C within 2 hours of taking your B Complex or B12? Vit C affects absorption of B12 so they should be taken at least 2 hours apart, so even if you only take a B Complex you still shouldn't take Vit C within 2 hours.

I am on Vit D, complex B12, magnesium and iron to try biring my ferritin up (and dark chocolate).

Be extremely careful about supplementing iron. Maybe have a read of your previous thread where you gave your iron panel results

healthunlocked.com/thyroidu...

where I pointed out what the optimal levels are said to be according to rt3adrenals.com

Serum iron: 55 to 70% of the range, higher end for men - yours is currently 70.38%

Your result 26 (5.8-34.5)

Saturation: optimal is 35 to 45%, higher end for men - yours is currently 41.6%

Total Iron Binding Capacity (TIBC) or Transferrin: Low in range indicates lack of capacity for additional iron, High in range indicates body's need for supplemental iron - yours is 48.61%

Your result 62.5 (45-81)

So your TIBC is mid-range and does not suggest that you need to supplement iron, it is not considered low which would suggest that supplements are needed.

Your ferritin result was 66.7 (30-400) and yes it was low and could be improved. The rt3adrenals.com comments say

Ferritin: Low level virtually always indicates need for iron supplementation;

so that does not say "always, without fail, low ferritin needs iron". You have to look at the iron panel as a whole. You have a serum iron level and saturation percentage both close to the top of their ranges. Supplementing with iron can take these over the top and lead to toxicity. It is absolutely essential that if you supplement with iron you test with an iron panel every couple of months. Yours is more a case of trying to raise ferritin through diet.

[dexterholland91]

Hi SeasideSusie,

No need to apologise, i appreciate all the help I can get.

I was taking Thorne, but couuldnt get it last time so I am on this instead -

amazon.co.uk/dp/B0B4VXQ638?...

I am not taking a Vit C supplement nor does the B12 supplement contain it.

I shall lay off the Iron the supplement then. I did just have Iron checked also in these last round of bloods and it 27.7 in a 14-31 range. 10th Jan it was 26. So I havent put myself into toxicity.

Thank you