High TSH

[Helenfeb]

I had a total thyroidectomy many years ago no and am on levethyroxine replacement. I have been on 125mcg for years and over the last 6months my TSH levels have been high resulting in my thyroxine replacement dose being increased.

many suggestions as to how or why please.

[Jaydee1507 Administrator]

Three years ago you said your Levo dose had been reduced. Not sure if you managed to get back on your original dose but doctors love nothing better than to mess with our dose if they think that the numbers they see on paper aren't right.

This doesn't mean that they are correct. They rarely if ever go by symptoms and there are other factors like time of day of blood test and whether you have taken your Levo just before the test to consider.

This can mean that some poor hypo people end up see sawing dose at every blood test.

We have a protocol for blood tests which can eliminate some issues with varying blood tests.

Test at 9am (or as close as possible), fasting, last levo dose 24hrs before the blood draw & no biotin containing supplements for 3-5 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 falsely elevated result and your GP/Endo might change your dose incorrectly as a result.

How are your vitamins looking - ferritin, folate, B12 & D3? Our thyroid hormone will not work well if these levels are not OPTIMAL.

[Helenfeb in reply to Jaydee1507]

thanks Jaydee. The increase in dose this time gets me back to my original dose. Take my thyroxine on an empty stomach. Sodium and iron been low until last bloods when on ferrous tablets.

So it could be my absorption of the replacement thyroxine that is affecting my TSH levels?

[Jaydee1507 Administrator in reply to Helenfeb]

How do you take your blood tests for thyroid though? Always the same time at around 9am in the morning? Always fasted that morning, only drinking water and taking Levo after the blood draw? These things are very important.

Iron should be taken 4 hours apart from Levo as it can affect absorption.

You haven't given us any blood results for comparison. Do also include ranges for each test which vary from lab to lab.

How were your B12, folate & D3 results? What do you supplement with?

[Helenfeb]

Thank you. Don’t have specific test results but will enquire and repost.

[Nanaedake]

If you've been prescribed iron tablets make sure you take them 4 hours apart from levothyroxine or the iron might affect absorption of levo. Also, I've found a brand (or formulation) change can sometimes affect absorption and therefore results.