Results

[Carri3]

Hi SlowDragon SeasideSusie and Charlie-Farley. Could you please have a look at these latest test results which show a significant change in my TSH levels, I increased my thyroxine to 100mcg's 10 weeks ago. How does my T3 & T4 look also. Thank You. Sorry about the quality of the screen shot, hope you can see it OK

[PurpleNails Administrator]

that’s extremely difficult to read, please could you type out? Inc ranges

[SlowDragon Administrator]

Was test done early morning and last dose levothyroxine 24 hours before test

Just testing TSH an£ Ft4 is inadequate

All four vitamins were terrible

D was 54, B12 292, Ferritin 38,. Folate, 7.1 

You’re now working on improving

Takes months to improve low ferritin

Recommended that all thyroid blood tests early morning, ideally just before 9am and last dose levothyroxine 24 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 antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

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...

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...

Tips on how to do DIY finger prick test 

healthunlocked.com/thyroidu...

[Carri3 in reply to SlowDragon]

The test was done at 8h55am no thyroxine for 24 hours, tasted for 13 hrs (water only).I didn't add thyronine levels which was 5.4 (3.8-6.2)

[SlowDragon Administrator in reply to Carri3]

You mean

FT3: 5.4 pmol/l (Range 3.8 - 6.2)

Ft3 66.67% through range…….if you feel fine ..that’s about perfect level

Personally if you have no symptoms of being over medicated I would sit tight and retest again in another 6-8 weeks

If you must reduce…just reduce by 25mcg per week …75mcg one day per week and 100mcg 6 days per week

Helpful calculator for working out percentage through range

thyroid.dopiaza.org/

Did you stop vitamin B complex a week before test?

Retest vitamin D, folate, ferritin and B12 at next test

[Carri3 in reply to SlowDragon]

I stopped the B complex 8 days before test. I had a phone consultation with my Doctor earlier today and he has prescribed 75mcg's of levo daily as he said my T4 is too high so I can't take the 1×75 -6×100 weekly

[Carri3 in reply to Carri3]

I am feeling much better, tiredness is gone also the aches and pains, and my hair is no longer falling out

[SlowDragon Administrator in reply to Carri3]

Do you have enough 100mcg tablets to take 100mcg and 75mcg alternate days

If not …….firmly request that GP agree to this

Are both tablets same brand?

Approx how much do you weigh in kilo

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.

[Carri3 in reply to SlowDragon]

I weigh 63 kgs

[SlowDragon Administrator in reply to Carri3]

Which suggests 100mcg is may be correct dose

63kg x 1.6mcg = 100.8mcg per day

If GP says " I have to reduce your dose because the guidelines say i can't let you have a below range TSH" .....

The first paragraph in the NICE (NHS) Thyroid Disease, Assessment and Management guidelines says :

nice.org.uk/guidance/ng145

"Your responsibility

The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian. "

[Carri3 in reply to SlowDragon]

Perhaps he is taking my age into consideration as I am 72.

[SlowDragon Administrator in reply to Carri3]

Fair enough

Stick on same brand levothyroxine and retest vitamin levels and thyroid levels TSH, Ft4 and Ft3 at least 6-8 weeks after reducing dose

[Carri3 in reply to SlowDragon]

I am taking 75mcgs levoxine (Australian brand) & 25 mcgs of wockhardt and would like to try Mercury Pharma as the levoxine is almost finished.

[Carri3 in reply to Carri3]

Thank You for all of your guidance and support SD, I really appreciate it 🙂

[Carri3 in reply to SlowDragon]

Also began taking B12, B complex, D3/K2, C & magnesium 12 weeks ago.

[tattybogle]

assuming last dose levo was taken approx 24hrs from test as recommended ?

If so, the over range fT4 result indicates your 100mcg dose is a bit too much ~

fT4 16.8 [7.9 - 14.4]

previous tests were done while taking 75 / 50 mcg alternate .. GP suggested increase to 75mcg/day but you decided to go up to 100mcg in one go ...looks like you might have been better to got to 75/100 alternate .. perhaps you should reduce to that now and give that a try for 6-8 weeks ?

[Carri3 in reply to tattybogle]

Thanks TB (See my reply to SlowDragon). I will will reduce my thyroxine as you suggested, my Doctor is calling later today to discuss levels so no doubt he will prescribe a lower dose.

[tattybogle in reply to Carri3]

if he thinks this is from a small increase to 75mcg / day he will probably be panicked and suggest a massive reduction .. suggest you inform him this was from 100mcg if they are not already aware.

[Carri3 in reply to tattybogle]

Yes of course Tb, I will be sure to tell him, I'll probably get a telling off for the increase 😬