Hi Everyone,
I have just had my blood test results after 10 weeks of increase in levothyroxine from 100 to 125mg per day.
T3 - 4.0 pmol/L ( 2.4 to 6.0)
T4 - 13.4 pmol/L ( 9.0 to 19.0)
TSH - 0.02 miu/L ( 0.35 to 4.94)
Should I be on a higher dose?
Thanks in advance.
Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)
is this how you did your test
Which brand is 25mcg levothyroxine
Looking at previous post- 100mcg is Almus (Accord )
As per previous posts
ESSENTIAL to test vitamin D, folate, ferritin and B12
what vitamin supplements are you taking
What are most recent vitamin results and ranges
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...
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
FT4: 13.4 pmol/l (Range 9 - 19)
Ft4 is only 44.00% through range
FT3: 4 pmol/l (Range 2.4 - 6)
Ft3 virtually identical at 44.44% through range
Shows you have excellent conversion rate but not on high enough dose levothyroxine yet
However GP will only look at TSH and want to REDUCE levothyroxine
Refuse to do so
Retest thyroid again in another 2 months
Meanwhile work on vitamin levels if necessary
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. "
Stay on current dose levothyroxine, likely to see TSH increase at next test
Thank you both for your messages. I did indeed test the way recommended but they only tested my thyroid.
My confusion is this:
My TSH seems to have suddenly changed when I increased my dose from 100mg to 125mg.
March 2023 100mg
TSH - 5.21
T4 - 13.8
June 2023 125mg
TSH - 0.07
T4 - 14.7
August 2023 125mg
TSH - 0.02
T3 - 4.0
T4 -13.4
I have stuck to the same brand throughout.
Going by these stats does it mean I'm on too high dose?
Sorry for all the questions but it's baffling me.
No …..because Ft4 and Ft3 are nowhere near top of range
TSH will slowly increase again over coming months
Taking levothyroxine is an unnatural way of getting thyroid hormones
A normal functioning thyroid doesn’t tip a whole day’s dose of thyroid hormones in at once ….it responds slowly through the day
LEVO DOSE SHOULD NOT BE DETERMINED BY TSH
Diogenes/Toft paper:
bmcendocrdisord.biomedcentr...
healthunlocked.com/thyroidu...
The link between TSH, FT4 and FT3 in hyperthyroidism is very different from taking thyroid hormone (T4) in therapy. In hyperthyroidism, FT4 and FT3 are usually well above range and TSH is very low or undetectable. In therapy, FT4 can be high-normal or just above normal, TSH can be suppressed but FT3 (the important hormone that controls your health) will usually be in the normal range. FT4 and TSH are of little use in controlling therapy and FT3 is the defining measure. A recent paper has shown this graphically:
Heterogenous Biochemical Expression of Hormone Activity in Subclinical/Overt Hyperthyroidism and Exogenous Thyrotoxicosis
February 2020 Journal of Clinical and Translational Endocrinology 19:100219
DOI: 10.1016/j.jcte.2020.100219
LicenseCC BY-NC-ND 4.0
Rudolf Hoermann, John Edward M Midgley, Rolf Larisch, Johannes W. Dietrich
LlINK TO PAPER:
you will probably need to arrange testing of vitamin levels
GP should do it …..but they frequently won’t
Hi craigdaddy
How do you feel? Has increasing your thyroxine made a difference to you?
Best wishes
Hi Hollins,
In all honesty I have not noticed any difference. I still feel tired at times and lethargic but I'm conscious that approaching 50 could also be why I feel this way.
If it were me I would up the dose without saying anything to the GP and see how you feel. That’s assuming you have enough Levo. Perhaps by 12.5 mcg. Then if you feel better you can argue with your GP by listing the symptoms that you DONT have anymore.
At 50yrs you should not be feeling tired.
Unless you are female and you are going into the menopause. Is that a possibility?
Hi Sarahjane1471,
I'm a male so definitely not.
I do have spare Levothyroxine, so it's a possibility.
🤣ok. It would be a medical miracle if you were menopausal!
We all try different things . SlowDragon Gave great advice ( as always). You could wait, improve vitamins and see how you improve or try a little extra Levo as an experiment
Hi
It's annoying that the blood levels lag well behind the medication change, like towing a car on a length of elastic.
It looks to me like you've got room for your T3 to go higher ( do you have earlier T3 levels?) but as you imply that might not be the issue.
A face to face with your GP might help & won't do any harm. Along the lines of 'you've upped my thyroxine but I still feel knackered could you check me over?'
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