Just been told I have subclinical hypothyroidism

[Lemonandginger1]

TSH +8.71Free T4 9.6

I've just got thyroid function test results back from the GP and been told I've got subclinical hypothyroidism. So I'm starting on medication (25mg) but this is all new to me

Any advice?

[TiggerMe Ambassador]

Loads!! 🤗

First up, when you put your results up you need to include the range as labs vary

25mcg is the lowest starter dose usually for children or seniors with heart issues?

Have they told you to book in for a blood test in 6-8 weeks time (before 9am/ levo/food)

General rules about taking levo... empty stomach no food or drink for a hour after so first thing in the morning, last thing at night or when you get up for a wee

Did they run any blood tests for folate, B12, ferritin and Vit D... all essential to convert T4 to fT3... so we are looking for optimal not just within range

[Lemonandginger1 in reply to TiggerMe]

TSH +8.71 mu/L (0.35-5.00)Free T4 9.6 pmol/L (9.0-21.0)

[TiggerMe Ambassador in reply to Lemonandginger1]

So you might feel better for a couple of weeks each time and then worse again until you get up to a full replacement dose... as a rough idea if you times your weight in kilos by 1.6

You get to your optimal dose by raising and checking every 6-8 weeks as it takes that long to settle, as you get nearer to your optimal you sneak up in smaller amounts

Any other results to share? Highly likely you'll need some supplements as hypo's are terrible at absorbing even on the best diet due to low stomach acid

[Lemonandginger1 in reply to TiggerMe]

What supplements do you take?

[TiggerMe Ambassador in reply to Lemonandginger1]

Pretty standard ones for hypos... B complex, magnesium, Vit D & K2, heme iron, Vit C... more specific to me ubiquinol (heart) glutathione (liver) and TUDCA (bile production) full spectrum amino acids (I struggle to eat enough protein) turmeric & curcumin (reduce inflammation) selenium and zinc as my levels were low

I've Ord's (Hashimoto's) autoimmune hypothyroidism, made me dairy, nightshades and histamine intolerant

[SlowDragon Administrator]

previous post here

healthunlocked.com/thyroidu...

Please add range on Ft4

As TiggerMe says

Levothyroxine is an extremely fussy hormone and should always be taken on an empty stomach and then nothing apart from water for at least an hour after

Many people take Levothyroxine soon after waking, but it may be more convenient and perhaps more effective taken at bedtime

verywellhealth.com/best-tim...

markvanderpump.co.uk/blog/p...

markvanderpump.co.uk/blog/p...

No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap.

Some like iron, calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away

(Time gap doesn't apply to Vitamin D mouth spray)

If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test

If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal

Standard starter dose of levothyroxine is 50mcg unless you are over 65 years old

Retest bloods 6-8 weeks after each dose increase

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)

Have you also had thyroid antibodies and vitamin D, folate, ferritin and B12 levels tested

If not get these included at next test

[ElRR]

What blood tests did your doctor perform?

[Lemonandginger1 in reply to ElRR]

Glucose, C-Reactive Protein, Urea & Electrolytes, Thyroid, Ferritin and Full Blood Count

[TiggerMe Ambassador in reply to Lemonandginger1]

Nothing flagged? How is your ferritin?

[Lemonandginger1 in reply to TiggerMe]

Low glucose and ferritin. Didn't comment on those though so I guess nothing to worry about?

I'm 5 months post partum and was on iron tablets during pregnancy due to low levels at routine midwife blood tests.

[TiggerMe Ambassador in reply to Lemonandginger1]

How funny... in my head I'd assumed you were considerably older after your previous comment about testing after a certain age 😆

So you really need to ask for a full iron panel to see where you are before supplementing again, you need good ferritin/ iron levels for the levo to work well along with B12, Vit D and folate.

You could say that Thyroid UK have recommended you get these tested if it helps get your GP up to speed 🤗

[Lemonandginger1 in reply to TiggerMe]

Ferritin is 66 so normal (15-200 ug/l). I'm also taking Vitamin D anyway for breastfeeding so hopefully the level is good

[TiggerMe Ambassador in reply to Lemonandginger1]

That's not too awful then, do you take a Vit D that also contains K2-MK7?

[ElRR]

Thyroid antibodies are very useful to know what is going on in your body. Additionally, if you have these antibodies, there are things you can do that can possibly help reduce or eliminate them. Doesn't work for everyone, but worth a try, especially before things get bad.

[DippyDame]

Your GP needs to study his medical books!

You are miserably undermedicated on 25mcg levo and will most likely find no improvement until this is considerably increased..

The others have already given you good advice so I'll add this link which explains a lot about hypothyroidism

thyroiduk.org/if-you-are-hy...

Recovery will take a little time, so important to be patient!

Hope treatment improves fairly soon and you start to feel.

We're all here to help.