Bloods after 6 weeks back on levothyroxine

Hi , thought I'd update my bloods after 6 weeks back on levothyroxine. I started back on 50mg eltroxin.

Current results....

T4 12.80 (7.86-14.41)

Tsh 3.66 (0.35- 5.50)

Testosterone 15.1 (6.1-27)

6 weeks ago they were....

T4 10.4 (7.86-14.41)

Tsh 8.09 (0.35-5.50)

Testosterone 9.2 (6.1-27)

Currently supplementing vitamin D and k2 at 3000iu daily.

Still feeling very fatigued , heat sensitivity( sweating ... even trying clothes on !), light headedness , brain fog... and generally not in a good head space!! ....

Also recently been waking at night with really bad pains in my joints...to the point I need to get painkillers

I'm trying to change my lifestyle , for the last 6 weeks I've been fully Gluten free, no Alcohol, eating healthy, lost weight and also trying to exercise....... im giving this a good go !!

I'm also toying with supplementing a vitamin b complex and magnesium to see if this helps with the sweating........ someone also mentioned Adrenal tonic ... does anyone have any experience with this ?

Thanks

[GlowCoach Administrator]

Its not surprising that you are so fatigued with a TSH of 3.66. To feel well we need our TSH to be at or just under 1. So you are ready for the next dose increase, see GP and insist on it.

Did you remember not to take your Levo before the test and at what time of day was this test taken? This makes a big difference to your results.

You were given some advice about supplementing vitamins in this post. You were going to add some B12 and then a separate B complex. healthunlocked.com/thyroidu...

For myself, pains in joints were caused by dairy intolerance. That may be something you might want to try eliminating from your diet.

[Hidden in reply to GlowCoach]

Hi Jaydee....I never take levo before bloods and always do them before 9am

I'm due to see doc next week , but the comment on blood test was " in range"😒

Thanks for reminding me about the b vits you suggested.... there is such a wide range out there 👍

[GlowCoach Administrator in reply to Hidden]

Many hypo people find they need to step into the driving seat to make any progress at all with their health. You need a small amount of knowledge and to become assertive in your consultations. Take with you information about keeping TSH lower and if you don't get anywhere with the first doctor then try another one.

healthunlocked.com/thyroidu....

[tattybogle in reply to Hidden]

Hi HashiJ .

'in range' means didly squat where TSH is concerned .

GP's are consistently advised to aim to KEEP TSH between about 0.4/0.5 and 2/ 2.5 in ALL patients on levo . Multiple recommendations, some written specifically for GP's here: healthunlocked.com/thyroidu.... my-list-of-references-recommending-gps-keep-tsh-lower-in-range-

Some were taken directly from GP's 'update' sources, one written specifically for GP's by Specialist Registrars in Cardiology and Endocrinology.. so there should be no argument from any GP / Endo about their validity.

This post helps explain why TSH 'in range' is not the same as 'optimal for that individual' :

healthunlocked.com/thyroidu... the-shoe-size-analogy

[SlowDragon Administrator]

Which brand is 50mcg levothyroxine

Obviously you need next increase to 75mcg daily

Stick to same brand levothyroxine as you increase the dose

Bloods retested in another 8 weeks

Comprehensive list of references for needing LOW TSH on levothyroxine

healthunlocked.com/thyroidu....

TSH should be under 2 as an absolute maximum when on levothyroxine

gponline.com/endocrinology-...

NHS England Liothyronine guidelines July 2019

sps.nhs.uk/wp-content/uploa...

Page 9

Test for Deficiency of any of the following: Vitamin B12, Folate, Vitamin D, Iron

See page 13

1. Where symptoms of hypothyroidism persist despite optimal dosage with levothyroxine. (TSH 0.4-1.5mU/L)

Graph showing median TSH in healthy population is 1-1.5

web.archive.org/web/2004060...

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.

[Hidden in reply to SlowDragon]

Thanks ..... im currently been on eltroxin for last few yeard

[greygoose]

someone also mentioned Adrenal tonic

Do you mean Adrenal Cocktail? Potassium and salt in orange juice? It can be helpful in you need an electrolyte boost to help your adrenals. Has your cortisol been tested at all?

What you really need is your FT3 tested. Your FT4 is quite good, but maybe you're not converting enough of it to T3, because your TSH is saying you're under-medicated. And it's low T3 that causes symptoms. So be very careful not to over-exercise, because that can have a negative effect on conversion at this stage. No more than gentle walking or swimming.

[Hidden in reply to greygoose]

Yes, someone said it helped them with sweating... was hoping to be able to buy a ready made tonic.I don't think I've ever had cortisol tested.

My endo has put a blood test together to test t3 ... but not until next may😒

[SlowDragon Administrator in reply to Hidden]

So you need to test TSH, Ft4, Ft3, vitamin D, folate, ferritin and B12 at next test ……8 weeks after next increase in levothyroxine

Re testosterone……How old are you

Hashimoto’s and how it affects men

thyroidpharmacist.com/artic...

[Hidden in reply to SlowDragon]

Will see doc next week , will ask for them tests.I'm 45yo 👍

[SlowDragon Administrator in reply to Hidden]

You may likely need to test privately

GP rarely tests more than TSH

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins

bluehorizonbloodtests.co.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...

Tips on how to do DIY finger prick test

healthunlocked.com/thyroidu...

Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee

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...

[Hidden in reply to SlowDragon]

Thank you for the link , very informative

[ade1961]

Hi Hashij, I haven’t commented on here for a long time but having read your posts and history I would like to as I suffered very similar problems. I cannot add to the good advice you’ve been given but would like to give you my experience with regard excessive sweating. To try and keep it short I was diagnosed hypo, sub clinical, treated with levo but couldn’t rid myself of terrible heat intolerance and sweating plus other symptoms. Two endos failed to help nor gp. I can expand but my answer was very low testosterone ! I discovered this myself. I am now prescribed testosterone gel. Massive improvement in sweating problem and other symptoms. I advise investigating testosterone levels further. I hope this helps and I can explain further if you wish, good luck

[Hidden in reply to ade1961]

Thankyou for your reply , I was really hoping that my most recent testosterone test was similar to the one before but it seams to have increased back up .... ... any advice on how I can further investigate on this please

[ade1961 in reply to Hidden]

yes I see the results you posted appear ok. Medichecs do the testosterone blood test including ‘free testosterone’ . My results were below range so maybe this doesn’t help but worth checking. I worked it out as a friend being treated for prostate cancer experienced exact same sweating as myself. In prostrate cancer treatment testosterone is chemically reduced to zero. My endo tells me that ‘sex hormones and thyroid hormones’ are closely linked.

[Hidden in reply to ade1961]

I've been tested for serum testosterone.... Will a free testosterone show any difference

[ade1961 in reply to Hidden]

I don’t feel qualified to say as both my free testosterone and testosterone were low. I can say ,with confidence, that the glands of the endocrine system are closely linked so the advice given on hypo is very pertinent. As an aside how’s your sleep ? Have you ever been told you stop breathing or snore heavily. Sleep apnea is common with low sex hormones. It’s easy to record your sleep with apps like ‘dream catcher’. I suffered apnea and wasn’t overweight at the time, not sure if sleep apnea is cause or effect. I don’t want to bore you with my experiences but often the clues can add up to a Urika moment 👍

[ade1961]

just wanted to add one more thing, I researched and apparently the brain interprets low testosterone as a signal the body is overheated ( weirdly it confuses/tricks the brain) in my case, besides sweating on physical effort I deteriorated to the point of sweating for no apparent reason.