Newbie - test results

[Kerry060]

Hi I’m totally new to all of this, went to doctors with what I thought was the menopause and it turned out to be hypothyroidism

First results were Tsh 22, just got today’s results back and it’s up to 34 now 😱 T4 was 9.9

Been put on 25mg to start off with as I have a heart condition

Has anyone else’s been this high before

[SlowDragon Administrator]

Welcome to the forum

So yes, started correctly on 25mcg levothyroxine if you have a heart condition

dose will still increase steadily over coming months, but starting on 25mcg initially instead of 50mcg

Which brand of levothyroxine have you got?

Many people find Levothyroxine brands are not interchangeable.

Most easily available (and often most easily tolerated) are Mercury Pharma or Accord

Mercury Pharma make 25mcg, 50mcg and 100mcg tablets 

Mercury Pharma also boxed as Eltroxin. Both often listed by company name on pharmacy database - Advanz

Accord only make 50mcg and 100mcg tablets. Accord is also boxed as Almus via Boots, 

Wockhardt is very well tolerated, but only available in 25mcg tablets. Some people remain on Wockhardt, taking their daily dose as a number of tablets 

Lactose free brands - currently Teva or Vencamil only

Teva makes 25mcg, 50mcg, 75mcg and 100mcg

Many patients do NOT get on well with Teva brand of Levothyroxine.

Teva is lactose free.But Teva contains mannitol as a filler instead of lactose, which seems to be possible cause of problems. Mannitol seems to upset many people, it changes gut biome.But for some people (usually if lactose intolerant, Teva is by far the best option)

Aristo (currently 100mcg only) is lactose free and mannitol free. March 2023 - Aristo now called Vencamil

List of different brands available in U.K.

thyroiduk.org/if-you-are-hy...

Once you find a brand that suits you, best to make sure to only get that one at each prescription.

Watch out for brand change when dose is increased or at repeat prescription.

Levothyroxine is an extremely fussy hormone and should always be taken on an empty stomach and then nothing apart from water for at least an hour after

Many people take Levothyroxine soon after waking, but it may be more convenient and perhaps more effective taken at bedtime

verywellhealth.com/best-tim...

markvanderpump.co.uk/blog/p...

markvanderpump.co.uk/blog/p...

No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap.

Some like iron, calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away

(Time gap doesn't apply to Vitamin D mouth spray)

Are you currently taking any vitamin supplements or other medications

[SlowDragon Administrator]

Also you need thyroid antibodies tested to see if your hypothyroidism is autoimmune

Both TPO and TG thyroid antibodies tested at least once

About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high thyroid antibodies

Autoimmune thyroid disease with goitre is Hashimoto’s

Autoimmune thyroid disease without goitre is Ord’s thyroiditis.

Both are autoimmune and generally called Hashimoto’s.

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease

Has GP tested vitamin D, folate, B12 and ferritin

If not request these are tested

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum