Help with latest blood test results and NDT dose please

[pixieforest]

Hello, long story short... I've had hypothyroidism for around 14 years now, I've had a mixture during those years of either levothyroxine - GP never prescribed the right dose and I had reactions to it, so started buying NDT and did well, until covid hit and I found it difficult to get it. My latest blood test (as far as I know) shows an underactive thyroid yet my GP isn't prescribing me anything, which I'm so surprised about as I have all the usual symptoms I've had for 14 years. I've just ordered some NDT and would like advice on the dose to start with please. (Ferritin, B12 and vit D are on the low side and being treated). The results are;

TSH 5.46 mu/l range 0.38-533

T4 10.2 pmol/L no range given.

Thanks for any advice.

[SlowDragon Administrator]

TSH 5.46 mu/l range 0.38-533

T4 10.2 pmol/L no range given.

Was test done early morning, ideally around 9am for highest TSH

Have you had thyroid antibodies tested for autoimmune thyroid disease?

Ft4 looks very low

Your legally entitled to results and ranges

Ferritin, B12 and vit D are on the low side and being treated

Can you add actual results

Low vitamin levels tend to lower TSH

[pixieforest in reply to SlowDragon]

Thanks for the reply. Yes the test was done first thing in the morning. They have previously refused to test for antibodies saying they only test in hyperthyroidism. I don't have the other test results at the moment as I'm away from home.

I'll think I'll go back to medichecks to get a full picture of everything.

[pennyannie]

Hello Pixieforest ;

What dose of NDT were you on before that gave you back your wellness ?

[pixieforest in reply to pennyannie]

Hello, I was on one and a quarter grains a day. Considering I haven't taken anything for around 18 months now I didn't know whether it was safe to go straight back onto that dose. I'm thinking of starting off on half that dose and testing in around 6 weeks.

[pennyannie in reply to pixieforest]

OK then - maybe start off again at half a grain - monitor on pulse, blood pressure and temperature twice daily so you have some idea how things are progressing

No thyroid hormone replacement works well until your core strength vitamins and minerals are up and maintained at optimal levels :

I now aim for a ferritin of around 100 : folate around 20 : active B12 75++ ( serum B12 500++) and vitamin D at around 100:

[pixieforest in reply to pennyannie]

Great thanks for the advice. I definitely need to get these vitamin levels up as they are all only just in range so GP isn't treating me and am having to deal with everything myself.I'm having terrible hair loss, I'm guessing it's due to the hypothyroidism and vitamin levels combined. Doesn't do a lot for my confidence!

[SlowDragon Administrator]

If you’re going to test ….test now BEFORE starting back on NDT (or any replacement thyroid hormone)

Or wait until at least 6-8 weeks on constant unchanging dose

all thyroid blood tests early morning, ideally just before 9am and last dose levothyroxine 24 hours before test 

On NDT…..day before test ALWAYS split dose into 2 or 3 smaller doses spread through the day and last dose approx 8-12 hours before test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

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...

Medichecks Thyroid plus BOTH TPO and TG antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes BOTH antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

If you can get GP to test vitamins then cheapest option for just TSH, FT4 and FT3 and includes BOTH TPO and TG antibodies -£29 

randoxhealth.com/at-home/Th...

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...

NHS easy postal kit vitamin D test £31 via

vitamindtest.org.uk

Only do private testing early Monday or Tuesday morning. 

Link about thyroid blood tests

thyroiduk.org/getting-a-dia...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

Symptoms of hypothyroidism 

thyroiduk.org/wp-content/up...

[pixieforest in reply to SlowDragon]

Thanks for the advice. It's not possible to test just yet, so I'll start the NDT when it arrives and test in around 6 weeks.