New results - TSH up despite levo

[jenny876]

Hi, I have been taking 25mcgs levothyroxine for 6 and a half weeks now and my previous results from 24th November 2023 were:

TSH 4.18 (0.27-4.2)

T4 12.7 (12-22)

My latest results are

TSH 4.36 (0.27-4.2)

T4 14.1 (12-22)

So my TSH has gone up - which seems strange. I did try taking 50mcgs for a few days over Christmas but got heart palpitations and have also had Covid so went back to 25mcgs.

Anyone experienced something similar? Could this indicate that I am a poor converter? GP does not test T3 and havent been able to get done privately due to being unwell. thank you

[SlowDragon Administrator]

So you are now ready to increase to 50mcg

Which brand of levothyroxine is 25mcg

Have you got 50mcg tablets, if yes what brand is it

Initially you could add 1/2 a 25mcg tablet for 2-3 weeks before increasing to 50mcg daily

Are you taking levothyroxine waking or bedtime

You could experiment with taking 25mcg waking and 25mcg at bedtime

Meanwhile when were vitamin D, folate, ferritin and B12 last tested

What vitamin supplements are you taking

Retest again 8 weeks after increasing to 50mcg daily

Likely to need further increases over coming months

TSH should 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).

[jenny876 in reply to SlowDragon]

I take Vencamil which only come in 100mgs so been cutting it into 4. I take it in the morning - tried taking it at night but found it kept me awake and more heart palpitations. Will try adding half of a 25mcgs for 2-3 weeks before going to 50mcgs, I think that will work for me.

Due to get vitamins retested when I get over covid - have been taking all the supplements that im low in since last September so levels should be good. Thanks SlowDragon.

[pennyannie in reply to SlowDragon]

Topsy33 please see SDragons reply above - especially the piece at the bottom in Italics :

[serenfach]

Think of it as your thyroid has been struggling, and along comes a pill and the body says "oh, I dont have to work so hard" so your TSH goes up. All this is doing is signalling that your body says "more please". Low T3 can cause heart palpitations, so it may be wise to ask for your GP to "check my T3 because of my heart". They probably wont though.

As other wiser heads have suggested, go up gradually. I hope you feel better soon.

[jenny876 in reply to serenfach]

I just saw your reply, thank you - much appreciated