TSH LEVELS

[LINDYLOU18]

HI

My tsh levels are 3.8 - currently taking 20mg of Levo

Would you advise that I need to up my medication?

Thanks

[PurpleNails Administrator]

Welcome to forum.

How long have you been on current dose?

How do you feel?

Levo comes in doses starting at 25mcg. Usually starting dose is 50mcg then it’s usually increased in stages by 25mcg every 6-8 weeks.

Most find symptoms are not resolved until TSH under 2 or more specifically thyroid hormones are high within range.

Was anything else tested as TSH is not reliable you also need FT4 & FT3 tested.

[LINDYLOU18 in reply to PurpleNails]

Hi i feel really tired & lethargic. No energy or motivation to do anything. Im on 25mg not 20mg. Ive been on this dose for 18months or more. GP started me on 100mg which caused me to go overactive. Then i didnt take any for about 6 months. Tested again and started on the 25mg.My T3 & T4 havent been tested as far as I know.

[SlowDragon Administrator in reply to LINDYLOU18]

Many people can’t tolerate starting on higher than 50mcg

We have to build up slowly

But not waiting 18months!

Increase to 50mcg and then retest in 2 months

Likely ready for next increase to 75mcg by then

Request GP test vitamin D, folate, ferritin and B12 …..highly likely low as been under medicated a long time now

Ideally don’t change brand of levothyroxine as you increase

Only change one thing at a time

[LINDYLOU18 in reply to SlowDragon]

Hi thank you...i was very low in Vit D so had to take high strength for 3 months & then lower dose for 2 months. Felt bit better after but back to feeling crap now. Im sure they tested for others you mentioned but came back as normal. I think i should ask for T3 & T4 levels testing also. Is there any other tests I should ask for?

[SlowDragon Administrator in reply to LINDYLOU18]

How much vitamin D are you currently taking

Many (most?) thyroid patients need to supplement vitamin D, magnesium and vitamin B complex continuously to maintain optimal levels

Essential to test annually (and get actual results) folate, ferritin and B12

Test vitamin D twice year when supplementing

You may need to take higher dose in winter than summer

[SlowDragon Administrator in reply to LINDYLOU18]

Presumably you have had thyroid antibodies tested?

What are TPO and TG antibodies results

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.

[SlowDragon Administrator]

welcome to the forum

Standard starter dose levothyroxine is 50mcg unless over 65

What were your thyroid levels BEFORE starting on levothyroxine

which brand of levothyroxine are you taking

How long have you been on just 25mcg

Yes request 25mcg increase in levothyroxine to 50mcg

Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine

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)

On T3 - day before test split T3 as 2 or 3 smaller doses spread through the day with last dose 8-12 hours before test

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

Testing options and includes money off codes for private testing

thyroiduk.org/testing/

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/testing/thyro...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

Symptoms of hypothyroidism

thyroiduk.org/signs-and-sym...

Tips on how to do DIY finger prick test

See detailed reply by SeasideSusie

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

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As others have mentioned, the dose is in mcg's- micrograms- NOT mg's- milligrams! You'd be flying through the air on that sort of dose!