Hello, first time posting here but I have been following this group for a little while now. A bit of background - I was diagnosed with underactive thyroid in October '22 and have been taking 50mcg Levo since then. My main symptoms were fatigue, feeling cold and hair loss. My hair has been shedding excessively for around 18 months now and I have not seen an improvement since starting medication.
My latest thyroid results from medichecks (Feb '23) were:
TSH 1.78 mu/L (0.27-4.2)
T3 5.22 pmol/L (3.1-6.8)
T4 20 pmol/L (12-22)
Thyroglobulin 212 IU/mL (<115)
Thyroid Peroxidase 133 IU/mL (<34)
Following these results in February, I went to see my doctor about my hair loss and he said I was on the correct Levo dose and confirmed I have Hashimoto's. He checked my scalp and said I have seborrheic dermatitis and should use Nizoral shampoo and come back in 6-8 weeks for follow up bloods.
Follow up blood results on 17th May were:
TSH 1.87 mu/L (0.27-4.2)
Serum ferritin 75.1 ng/ml (13-150)
Since that appointment, I have not seen any improvement with the amount of hair I shed and it's really starting to impact my confidence and mental health. I have arranged a telephone appointment with the doctor on the 15th of June to discuss a possible Levo increase. I am just looking for some advice on what I should be asking for, and if he does not agree to an increase, if I should be asking to be referred to a dermatologist or someone else.
Sorry for the long post! Thank you for reading.
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KatrinaN
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your TSH should be below 1 preferably between 0.2 and 0.5 and the t3 and t4 in the top third of their ranges, but there’s still room for an increase .
email thyroid U.K. admin for Pulse Dr Toft qu 6 article to show to your GP stating these numbers to get an increase in dose. He was surgeon to the Queen when she was in Scotland and a highly regarded endocrinologist and Thyroid U.K. is recommended by nhs choices should you get any questioning of sources. That TSH is far too high
Welcome to the group. If you could complete your profile it helps members understand your thyroid journey so far and offer recommendations better. Click on your image icon to start.
When did you last take your levo before this test?
Recommended blood test protocol: Test at 9am (or as close as possible), fasting, last levo dose 24hrs before the blood draw, last T3 dose 8-12 hours before blood draw & no biotin containing supplements for 3-7 days (Biotin can interfere with thyroid blood results as it is used in the testing process)? Testing like this gives consistency in your results and will show stable blood levels of hormone and highest TSH which varies throughout the day. Taking Levo just prior to blood draw can show a falsly elevated result and your GP/Endo might change your dose incorrectly as a result.
Your conversion is pretty good but you could possibly benefit from a small increase, even only 12.5mcgs.
Are you a tiny person. Approx how much do you weigh in kilos?
Do you have any other vitamin results? Folate, B12 & D3?
When hypo we get low stomach acid which means we cannot absorb vitamins well from our food, regardless of a great diet. For thyroid hormone to work well we need OPTIMAL levels of vitamins. Have you recently or could you ask your GP to test levels of ferritin, folate, B12 & D3? Private tests are available, see link for companies offering private blood tests & discount codes, some offer a blood draw service at an extra cost. thyroiduk.org/help-and-supp...
There is also a new company offering walk in & mail order blood tests in Crawley, Hove and Reigate areas. No charge for blood draw in clinic. Check to see if there is a blood test company near you. onedaytests.com/products/ul...
It's ideal if you can always get the same brand of levo at every prescription. You can do this by getting GP to write the brand you prefer in the first line of the prescription. Many people find that different brands are not interchangeable.
Your ferritin isn't terrible but aiming for 100 would improve your symptoms and help your thyroid hormone work well. Suggest increasing iron rich foods in diet and eating them often. Chicken livers, pate, red meat etc
Also a full iron panel might be beneficial.
Many with autoimmune thyroid disease aka Hashimoto's benefit from a gluten free diet. A smaller percentage of those also need to remove dairy from their diet to feel well. These are intolerances and will not show up on any blood test. It’s worth trialling a strictly gluten free diet to see if it helps symptoms.
If you were already taking supplements when this test was taken you need to increase the amount of vit D you are taking, also probably add K2.
Vitamin D should be around 100 - 150. Buy one that includes vit K2 to help it go to your bones. Some are available in oil or you can take it with an oily meal for better absorption. Use this calculator to work out how much to take to get your level to 100-150. wildatlantichealth.com/vita...
Thats a good B12 result so I suspect you are taking something with B12 in it. Your folate is not so good at all and with that range you should be aiming for 20.
Recommend taking an active/methyl (should say on label) B complex which contains 400mcgs folate (also B12)and will help keep all your B vitamins in balance. This B complex has all the right vitamins at a not unreasonable cost for 90 days supply. amazon.co.uk/Liposomal-Soft...
I think if you double down on your vitamins that might improve things. Unless we have OPTIMAL results for all key vitamins our thyroid hormone cannot work well.
Free T4 (fT4) 20 pmol/L (12 - 22) 80.0%
Free T3 (fT3) 5.22 pmol/L (3.1 - 6.8) 57.3%
Thyroid wise you're not too far off at all but even a 12.5mcg dose increase might help.
Try and pick the most sympathetic GP at the practice, go armed with evidence from here to back up your need for an increase and stand firm. If that GP says no then try the next one. Be persistent - nicely.
Thank you for your advice. I have spoken to the doctor today and he has agreed to up my dose to 75mg. I was half expecting him to be difficult but he said he had no problems in prescribing a higher dose. I will go back in 6-8 weeks for a follow up so fingers crossed.
I'm so greatful to be part of this supportive group
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