Hi all I’ve been on 50mcg Levothyroxine now for around 7 weeks ish and I tested Monday privately. I increased my dose to 75mcg thinking I needed it but my TSH has come back as 1.35 which was a bit of a shock I was still expecting it to be in the 3’s. My T4 looks to be at around 50% while my T3 is around 40%. Should I stay on 50 do you think? I didn’t test b12 as I’m having injections and I tested vitamin D to check if I’m over-dosed as I’ve had a few vitamin D injections lately. Should I cut back on them aswell? I haven’t had antibodies tested as they were negative a few months back. I’m a bit disappointed because I don’t feel particularly great at the moment. Bit more energy but nothing major. Any advice much appreciated thank you.
TSH is 1.35 (0.7-4.2)
T4 is 16.8 (12-22)
T3 is 4.6 (3.1-6.8)
Vitamin D is 201 (50-200)
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I'm a bit confused (could be me!). Was this test done when you were on 50mcg or 75mcg? If 75mcg how long had you been on that dose?
There's nothing wrong with those results other than they show the need for an increase. The aim of a treated hypo patient on Levo only, generally, is for TSH to be 1 or below with FT4 and FT3 in the upper part of their reference ranges.
Always allow 6-8 weeks after any dose change for levels to settle before testing following our advised protocol.
Are your Vit D injections prescribed? Are they checking your levels? 201nmol/L is higher than that recommended by the Vit D Council, Vit D Society and Grassroots Health (which is 100-150nmol/L) so I would say you don't need Vit D injections any more but keep an eye on your level, maybe retest in a couple of months and if necessary supplement with an oral D3 along with it's important cofactors magnesium and Vit K2-MK7. You can work out how much you would need by visiting the Vit D Council website, check out my recent post here:
Yes sorry I was on 50mcg when I took the test Monday then moved to 75mcg because I thought I was ready. It was the TSH that surprised me that’s all. I was just thinking the 75mcg may be too much and will suppress the TSH. I have been on 50mcg now for around 7 weeks. Also my T3 has barely moved even with the increase in T4 over the 7 week period. Does T3 take a while to increase? No my Vit D injection ms are not prescribed just a nurse friend of mine does them.
OK, so don't worry about a suppressed TSH, as long as FT3 is within it's range there is no problem.
With those results you have FT4 at 48% through range and FT3 at 40.54% through range so conversion isn't too bad.
You could stick with the 25mcg increase in Levo but if you want to be more cautious then just increase by 12.5mcg (get a pill cutter or sharp craft knife to cut tablets) and do it more slowly.
How are your other key nutrients - B12, Folate, Ferritin? All these need to be optimal for thyroid hormone to work well and good conversion.
Thank you yes I’m supplementing folate and having b12 injections. My ferritin was good last time so I didn’t bother testing. I eat a lot of beef eggs etc daily. Thanks for the advice 🙏 I’ll carry on with the 75mcg and re test in a few months.
After a dose change it's best to test 6-8 weeks later, I wouldn[t wait a few months, you need to see what effect the increase has had and make any further changes as necessary.
Better than being worse. I guess it depends on how long you’ve been on 75mcg for. For me, so far, I noticed a difference within a few days, certainly less than a week be that good or bad but stick to the same dose for at least 6 weeks before retesting. It’s so difficult and long to get on the right dose.
Thank you yes I think I was just expecting to at least begin to feel more like my normal self. I do have more energy but when I think back to where I was 4-5 years ago I’m nowhere near that. Did you notice an improvement?
Yes and then no. Some symptoms improve and others get worse, and it’s not clear if it’s under or over medication or side effects. Or, indeed something else entirely! It’s been bumpy to start, 100mcg too much, 50mcg too less, so we shall see. I remind myself is to trial and error with it all yet and the thyroid seems to be like Goldilocks.
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