Hi so due to my last t3 level I had more tests...these are 12.5mg t3..100mcg levo. Both taken in the morning together with water.No other supplements and last dose taken enough time for test.TSH...7.22 MLU/L...(0.3_5.5)
T3...2.8PMOL/L...(3.1_6.8)
T4...11.7PMOL/L...(12.0_22.0)
My doctor says not urgent and no increase?
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
TSH...7.22 MLU/L...(0.3_5.5)
T3...2.8PMOL/L...(3.1_6.8)
T4...11.7PMOL/L...(12.0_22.0)
How long before test was last dose levothyroxine?
On replacement thyroid hormones your TSH should ALWAYS be below 2
Clearly you are not on high enough dose
You need increase in levo initially as shown by below range Ft4
Request/insist on 25mcg dose increase in Levo now
Retest correctly in 8 weeks
Meanwhile test vitamin D, folate, ferritin and B12
I really don't understand..the message from receptionist was no need for an increase because of TSH?...I really don't think they know what they are talking about.
Since when was a receptionist qualified
Most people when adequately treated will have TSH around or UNDER one
TSH should always be under 2 as an absolute maximum when on levothyroxine.
gponline.com/endocrinology-...
Graph showing median TSH in healthy population is 1-1.5
web.archive.org/web/2004060...
Comprehensive list of references for needing LOW TSH on levothyroxine
healthunlocked.com/thyroidu....
onlinelibrary.wiley.com/doi...
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).
I feel like I need to complain all the time there..and that they see me as a problem patient!...so I really don't know what to do next
What’s your current prescription from GP ?
If only 100mcg Levo you will need them to increase prescription to 125mcg Levo daily
Either email GP those results and request dose increase in Levo to 125mcg daily
Or make a face to face or phone appointment to discuss and politely but firmly insist on dose increase in levothyroxine
Which brand is 100mcg
Ideally 25mcg should be same brand
The information you have provided is so informative. I've learn't more from you than any of my doctors since being diagnosed some 20 years ago! The doctors only ever request a TSH for my bloods and the last results say my TSH level is: Serum TSH level 3.7 mU/L [0.27 - 4.2] and is classed as satisfactory. I have an under active thyroid with a list of autoimmune issues as well which they refused to address. I have just sent off for a testing kit through Thyroid UK. Once I have the results I'm going to write to the practice manager and get them to address my health concerns.
Which brand is 100mcg levothyroxine
Are you taking levothyroxine everyday, always on empty stomach, and then nothing else but water for at least an hour after
No other medications or vitamins within 2 hours
Iron, calcium, vitamin D tablets or magnesium at least 4 hours away from Levo
Is T3 prescribed or self sourced
last dose taken enough time for test.
what time gap?
I take wochhart brand I think it says...source my own T3 and they don't like that ...due to last bloods I agreed to half my dose of 25mg so in 4 weeks that's the change..they never ask to check my vitamin levels.....and when I say my thyroid is autoimmune they shrug that off also.
“they never ask to check my vitamin levels.....and when I say my thyroid is autoimmune they shrug that off also.”
You need to retest vitamin levels yourself privately at least annually, but especially after any dose reduction
NHS not interested in anything other than vitamin deficiencies
But on replacement thyroid hormones it’s essential we maintain OPTIMAL vitamin levels to help conversion of Ft4 (Levo) to FT3
What vitamin supplements are you taking
Many hashimoto’s patients need to supplement vitamin D, magnesium and vitamin B complex daily continuously
Some also need daily B12
Some people have to work hard to maintain ferritin levels too
Before you added T3 you were on 150mcg Levo
Typically Levo dose only needs reducing by 25mcg maximum adding T3
Typical dose T3 is 5mcg (or 6.25mcg - 1/4 tablet) twice a day. Some people need 3 x 1/4 tablet per day
ALWAYS day before test split T3 so that last 1/2 or 1/3rd of daily dose is max 12 hours before test
Many, many hashimoto’s patients find it beneficial or essential to be on strictly gluten free diet and/or dairy free diet too
Dairy free especially for improving possible lipodema
“due to last bloods I agreed to half my dose of 25mg so in 4 weeks that's the change”
That was massive reduction
Usually we recommend only reducing by 1/4 tablet T3 at any one time
Wait 6-8 weeks then retest with CORRECT timing
Well my bloods were taken at 6.30pm...as I work early...so I took last mens 6am that morning
Four weeks is too soon to test after reducing T3
8-10 weeks more realistic
Wockhardt only make 25mcg tablets
So last dose Levo was 12 hours before test?
Or 36 hours before test?
TSH would have been higher at 8-9am
Suggest you get dose increase to 125mcg Levo
Retest again in 8 weeks
You may need further increase after that
TSH has pronounced daily variation
Highest early morning, lowest afternoon
previous post of yours 4 months ago explaining how/why essential to test with correct time gaps
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