Firstly, thank you for all the useful information and advice.
I started taking 50mcg of levothyroxine in June and had a follow up blood test at the end of August which showed my TSH was 2.54 (0.27 - 4.2). The GP did not increase my dosage of thyroxine and I did not have the energy to push for it!
I have become very tired again in September/October and saw a new GP in October, who requested another blood test. I also decided to do a thyroid test with Monitor My Health as they would also check FT4 and 3 levels.
I did the Monitor My Health test at 8am, fasting, stopped B vits a week beforehand and having taken thyroxine 24+ hours beforehand. The results are:
TSH 2.59 (0.27 - 4.2)
FT4 14.4 (12 - 22) 24% through range
FT3 4.1 (3.1 -6.8) 27% through range
At 9am the same day I had blood taken at the hospital and the results are:
TSH 2.09 (0.27 - 4.2)
FT4 14.5 (10.8 - 25.5) 25%
I do not understand why there would be a difference in TSH levels, any advice would be welcome. Should my levothyroxine be increased?
Thank you!
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Amtired
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Well, the difference is only 0.09, which is nothing in TSH terms, but probably explained by the difference in time. A drop of 0.09 in one hour sounds reasonable to me.
I can share I have had the same issue. TSH drops throughout the day, but given my FT4 was different between the two, I am not sure I have as much faith in finger pricks tests.
Its really hard having the energy to be proactive in your own healthcare when you don't have any spare energy at all. You do have to find it from somewhere though otherwise you will remain that way.
You could take someone else along to support you or speak for you at the appointment. Perhaps try a different more helpful and open minded GP too.
Many GPs are very happy to have TSH within the normal range but this is far from good enough and will not make us well.
How have you got on tackling low vitamin levels? You had some good advice on a previous post here: healthunlocked.com/thyroidu...
Regarding differing TSH levels, we are not machines. There are multiple factors including different times of day and different labs, what you have eaten etc. Its a tiny difference and nothing to take any notice of.
Thanks for your reply Jaydee. Most of my appointments have been phone calls which makes it difficult to take someone else along to. I have changed GP surgeries and have actually seen a GP!!
Re vitamins, I am now taking Thorne Basic B, BetterYou Vitamin D & K2, Thorne citramate and B12.
Just thought I would let you know that I have had a phone call with a GP and I am now taking 75mcg of levothyroxine 😀
Only after the GP told me that my TSH level was fine and I didn't need a thyroxine dose increase. If I was tired etc again there was something else going on. She could recommend a book to read, although she couldn't remember the title, and increasing the thyroxine wasn't getting to the reason behind my auto immunity!
I expressed my frustration, that I felt similar to before I commenced the levothyroxine and suggested that I try 75mcg to see how I got on. She agreed muttering that my TSH might be too low next time I have a blood test!
That is excellent! It never hurts to ask for an increase.
You may even need further increases but get the test booked in for 6-8 weeks time at 9am or earlier. Remember not to take your levo that morning. Take it after the test that day.
Thanks Slowdragon, will push for an increase in dosage when I speak to GP.
Am taking separate B12 and B complex. I also ensure that I have iron rich foods at every meal and do sometimes use supplements. I do not think I have had a full iron panel blood test.
Will also have another read through of previous links.
As vegetarian with Hashimoto’s you will almost certainly need iron supplements
Never supplement iron without doing full iron panel test for anaemia first and retest 3-4 times a year if self supplementing. It’s possible to have low ferritin but high iron
Test early morning, only water to drink between waking and test. Avoid high iron rich dinner night before test
With serum Active B12 result below 70 (Or serum B12 below 500) recommended to be taking a separate B12 supplement and a week later add a separate vitamin B Complex
Then once your serum B12 is over 500 (or Active B12 level has reached 70), you may be able to reduce then stop the B12 and just carry on with the B Complex.
As you are Vegetarian you will need ongoing separate B12 at least few times a week, if not every day
Igennus B complex popular option too. Nice small tablets. Most people only find they need one per day. But a few people find it’s not high enough dose
IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results
In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg) and continue separate B12 until Active B12 is over 70 minimum
Post discussing how biotin can affect test results
The present review of the literature regarding B12 status among vegetarians shows that the rates of B12 depletion and deficiency are high. It is, therefore, recommended that health professionals alert vegetarians about the risk of developing subnormal B12 status. Vegetarians should also take preventive measures to ensure adequate intake of this vitamin, including the regular intake of B12 supplements to prevent deficiency. Considering the low absorption rate of B12 from supplements, a dose of at least 250 μg should be ingested for the best results.3
Due to previous advice when I joined the Forum I took a B12 supplement before starting a B Complex. I have been taking 1 Thorne Basic B Complex and Thorne Magnesium CitraMate tablet daily. 3 squirts of Better you D3 & K2 and 1 Nutrition Geeks Iron Energy + every other day.
Should I increase the Basic B and Iron Energy+ (which includes B12)?
The comments section on my report said that I 'do not have anaemia and have adequate levels of iron, Vit B12 and folate'!
Another measurement, called transferrin saturation, checks how many places on your transferrin that can hold iron are actually doing so. Normal values are 15% to 50%. In severe cases of iron-deficiency and anemia, this number may fall below 10%.
Serum ferritin level is the biochemical test, which most reliably correlates with relative total body iron stores. In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency.
Never supplement iron without doing full iron panel test for anaemia first and retest 3-4 times a year if self supplementing. It’s possible to have low ferritin but high iron
Test early morning, only water to drink between waking and test. Avoid high iron rich dinner night before test
Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption
This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.
We have received further information the lab about ferritin reference ranges. They confirm that they are sex dependent up to the age of 60, then beyond the age of 60 the reference range is the same for both sexes:
Males 16-60: 30-400 ug/L
Female's: 16-60: 30-150
Both >60: 30-650
The lower limit of 30 ug/L is in accordance with the updated NICE guidance and the upper limits are in accordance with guidance from the Association of Clinical Biochemists. ‘
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