Sheila

[Mavis29]

I’ve been diagnosed with hypothyroidism for 9 years with levels up and down throughout this time. I normally take thyroxine 75 mg. On my last blood test my TSH level was 10 and my T4 - 14 I had many symptoms including fatigue, dizziness and low heart rate Could low thyroxine also cause some discomfort in my breast usually in the morning. My medication has been increased to 100mg

[SlowDragon Administrator]

So you were on too small a dose of levothyroxine

On levothyroxine TSH should always be below 2

Most people when adequately treated will have TSH around or below 1

So it’s correct dose levothyroxine should have been increased to 100mcg

Which brand of levothyroxine was 75mcg

Which brand is 100mcg

You will need new blood test in 6-8 weeks time

Request vitamin levels are tested too

what vitamin supplements are you currently taking

For full Thyroid evaluation you need TSH, FT4 and FT3 tested

Also both TPO and TG thyroid antibodies tested at least once

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

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.

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

20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis

In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)

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)

[SlowDragon Administrator]

Sorry, didn’t realise this was your first post….welcome to the forum

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)

If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test

If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal

Presumably you have B12 injections if you have PA

Are you also taking daily vitamin B complex

[greygoose]

It's low T3 that causes symptoms, not T4. T4 is basically a storage hormone that doesn't do much until it's converted to T3.

But, low T3 symptoms can be anywhere and everywhere. The only way to know if something is a hypo symptom is to increase your dose and see if it goes away. With a TSH that high, your FT3 was probably very low.

[Mavis29 in reply to greygoose]

Thank you GP doesn’t test for T3 so I’ve no idea about my level. I’ve been told to take another blood test in 3 months After being on new dose of thyroxine for 2 weeks some symptoms are already improving (fatigue,dizziness)

[greygoose in reply to Mavis29]

Yes, but in three months they could come back again! That is far too long to wait. I would suggest you do a private test after six weeks on that dose and do full thyroid testing:

TSH

FT4

FT3

TPO antibodies

Tg antibodies

vit D

vit B12

folate and ferritin

to give you a full picture of what is going on.

[Mavis29 in reply to greygoose]

I think I’ll take a private test maybe it’ll give me the results I need to discuss the correct medication with my GP. I did have a B12 test last year after I requested it which came back in the lowest levels but GP said it was within range 178

I don’t recall GP testing anything else I’ll book a private test for 4 weeks time

[Bearo]

what was the range on your B12 test? Your result for last year seems very low and the usual range is often seen as being too wide. It is usually recommended here that B12 is over 500. Anyway, that test is now too long ago.

With low B12 results it is recommended that you ask GP for a coeliac test before taking any B12 supplements. You should also test folate before taking any B12 supplements - if both need supplementing one must be started before the other but I forget which should be started first!

Look up the symptoms of B12 deficiency - if you can tell the GP you have some symptoms you are more likely to get B12 and folate tested.

After any tests put the results here for comment.

You can buy your own supplements once you’ve tested - there are recommended brands mentioned on the forum. A b complex is also recommended to maintain a balance.

[Bearo]

I didn’t mean to type coeliac test, I meant test for pernicious anaemia!

A test for coeliac is before trying gluten free and nothing to do with B12!

Sorry - brain fog!