I was diagnosed with hypothyroidism 9 years ago whilst pregnant. I’ve been on 50mcg since then. It was only recently that I was seeing an osteopath at my gym and we started talking weight management. He said he thought I was under medicated. Anyway, thought about it and actually I have lots of symptoms still. Weight, fatigue, cold, thin hair, muscle cramps, no libido, dry skin. Rang my GP got a blood test last week. Results:
TSH: 2.91 (0.35-5.5)
T4: 13.9 (10.5-21.0)
I’m tested annually anyway and results from January 2023:
TSH: 1.94
T4: 15.7 ranges as above.
GP says I’m in range still and he wants to test for for diabetes, anemia and look at menopause. Slightly irritated they didn’t do that in the first place. Also my levels have clearly changed and I pointed out I’m on a starter dose of Levothyroxine and he agreed most people are on at least 75mcg in my position.
Just to add, I’m 46, I haven’t had a period for nearly 4 years. I’ve not had any menopause symptoms but apparently I’m through it as they scanned my womb and did a blood test. I tried patches briefly but didn’t see any difference in libido.
GP reluctantly agreed to increase my Levothryoxine by 25mcg. If it’s not my thyroid I’m now worried I’ll be over medicated.
Any thoughts would be greatly received.
thanks 🤩
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Wilma76
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You are correct 50mcg is only standard STARTER dose
Highly likely under medicated and very low vitamin Levels as direct result
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 do your tests?
ESSENTIAL to test vitamin D, folate, ferritin and B12 at least annually
Please add most recent results
Have you had thyroid antibodies tested to confirm if your hypothyroidism is autoimmune
Which brand of levothyroxine have you been taking for 50mcg
Don’t change brand as you increase dose
Retest thyroid levels 6-8 weeks after any dose change or brand change in Levo
Testing options and includes money off codes for private testing
Even if we frequently start on only 50mcg, most people need to increase levothyroxine dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until eventually on, or near full replacement dose
In the majority of patients 50-100 μg thyroxine can be used as the starting dose. Alterations in dose are achieved by using 25-50 μg increments and adequacy of the new dose can be confirmed by repeat measurement of TSH after 2-3 months.
The majority of patients will be clinically euthyroid with a ‘normal’ TSH and having thyroxine replacement in the range 75-150 μg/day (1.6ug/Kg on average).
The recommended approach is to titrate thyroxine therapy against the TSH concentration whilst assessing clinical well-being. The target is a serum TSH within the reference range.
……The primary target of thyroxine replacement therapy is to make the patient feel well and to achieve a serum TSH that is within the reference range. The corresponding FT4 will be within or slightly above its reference range.
The minimum period to achieve stable concentrations after a change in dose of thyroxine is two months and thyroid function tests should not normally be requested before this period has elapsed.
Graph showing median TSH in healthy population is 1-1.5
If symptoms of hypothyroidism persist despite normalisation of TSH, the dose of levothyroxine can be titrated further to place the TSH in the lower part of the reference range or even slightly below (i.e., TSH: 0.1–2.0 mU/L), but avoiding TSH < 0.1 mU/L. Use of alternate day dosing of different levothyroxine strengths may be needed to achieve this (e.g., 100 mcg for 4 days; 125 mcg for 3 days weekly).
Thank you for coming back to me and providing that information. It’s all so helpful. I did my recent blood test using the guidelines I saw on here about not taking meds and only having water. This is a really great forum because I’ve always felt in the dark about this condition.
I’ve started on my new dosage today so fingers crossed I see an improvement
Great that you got an increase, you could just add 12.5mcg and see how you feel, quite unlikely you'll overdo it with those results Free T4 (fT4) 13.9 pmol/L (10.5 - 21) 32.4%
You still sound very Hypo, do you take any supplements? Got any results for folate, ferritin, B12 and Vit D?
With only TSH and fT4 results you have no idea how much you are converting to fT3 which is the active bit so I would also suggest getting a Full Thyroid Panel from MMH (THYROIDUK10 saves you 10%) usual testing before 9am fasted other than water and last dose of Levo 24 hours before 🤗
Any HRT takes a good few months to make a difference and you may have been underdosed, testosterone is the key to libido... and not being Hypo 😕
You can get a finger prick test kit from Randox to see where your sex hormones are and if low perhaps re-introduce HRT for bone and heart health? But do your research there are various options which GP's aren't necessarily up to speed on
Thank you for coming back to me. I don’t take any supplements but that’s my next thing. The GP has included all those vitamins in my next blood test.
I did have HRT patches for a good 3/4 months, ironically that’s all I could have because he said I was overweight. They kept coming off though when I work out no matter where I placed them. I also had a bleed one month out of the blue and had a whole range of scans but that came back as a blip. Then they didn’t want me to have anymore HRT. I also requested a testosterone test and that came back normal. However, thanks for the link to Randox, I will explore that.
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