Been on 50mcg for a few months and have recently been feeling awful again, so I requested repeat bloods. Results came back today:
TSH 4.37 (0.3-4.2)
T4: 13.8 (9-19)
T3: 4.6 (3-5.4)
really hope the doctors won’t argue about an increase to 75mcg 😭 I feel so shoddy doing even minimal increases so will have to do 2 weeks of 62.5mcg first
Hi Rosestar
This is levothyroxine- a starter dose and you should NOT have been left on it for months. Terrible treatment. I’m so sorry you have experienced this. Please read my bio. Click on my face at the top left of the reply, and it will take you to my profile where my bio can be found and previous posts.
I wrote it as a case study because my experience has been so similar to others before and those quite a few who have come since (you included).
Have you got any vitamin results that you can share with us? Vitamins are very important and work in concert with your thyroid hormones to make you feel well. Vitamin deficiencies in part could be making the process of getting onto a therapeutic dose of levothyroxine problematic.
thank you - I have read it and I’m sorry you also had a fight on your hands! I don’t have any recent vitamins but last time my folate, vit D and ferritin were “fine”, yet the very lower end of the NHS range, so I have taken Thorne B, gentle iron and 1000mcg vit D for a while now
You should not have been left so long on only 50mcg dose
Retest again 8 weeks after getting to 75mcg
Always 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)
Unless extremely petite you will need further increases after that
which brand is 50mcg
Ideally don’t change brand, and especially when increasing dose
Have you had vitamin D, folate, ferritin and B12 levels tested
What vitamin supplements are you taking
Hello,
I had to fight for Wockhardt as seems I can tolerate it best. I don’t have any recent vitamins but last time my folate, vit D and ferritin were “fine”, yet the very lower end of the NHS range, so I have taken Thorne B, Terra Nova gentle iron and 1000mcg vit D for a while now. Is it usual when people need a dose increase that T4/T3 can be ok but TSH is high?
FT4: 13.8 pmol/l (Range 9 - 19)
Ft4 only 48.00% through range
guidelines on dose levothyroxine by weight
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
pathlabs.rlbuht.nhs.uk/tft_...
Guiding Treatment with Thyroxine:
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.
NICE guidelines on full replacement dose
nice.org.uk/guidance/ng145/...
1.3.6
Consider starting levothyroxine at a dosage of 1.6 micrograms per kilogram of body weight per day (rounded to the nearest 25 micrograms) for adults under 65 with primary hypothyroidism and no history of cardiovascular disease.
Also here
SlowDragon has provided oodles of information. I too got the ‘info dump’ 😂 Between SlowDragon and others on the forum they got me well and got me informed enough to take on docs who have not been adequately trained to handle thyroid issues. I would definitely get vitamins and minerals tested. 🤗
vitamin results from 7 months ago
ferritin 39.3 (10-200)
Vit d 81(50-250)
B12 539 (180-900)
Folate 5.6 (3-20)
What vitamins are you taking
Have you retested since
Folate and ferritin were far too low
No I haven’t - I guess I’ll have to pay privately again. I have been taking Thorne B, Terra Nova gentle iron and 1000mcg vit D for a while now
Never supplement iron without doing full iron panel test for anaemia first
retest 3-4 times a year if self supplementing.
It’s possible to have low ferritin but high iron
Test early morning, only water to drink between waking and test. Avoid high iron rich dinner night before test
Stop iron supplements 5-7 days before test
Medichecks iron panel test
Blood results
Private blood results 
Blood test results
Blood results
Blood results
