I am asking for advice before I speak to my GP. All advice gratefully received.
I know when I posted my last results on here people said my high cholesterol was possibly due to my Thyroid levels.
My TSH was 2.5 (range 0.27-4.2) which people here said was too high as I’m on Levothyroxine and should be nearer 1.
My Cholesterol was 8.2.
I’m on 100 mcg or 125mcg Levothyroxine alternate days.
I want to go fully armed with information regarding the fact that my thyroid levels could be making my cholesterol high. I have no idea what my FT4 or FT3 are as my GP only tests for TSH as far as I know. I have only seen my last blood test results as I have never been given results before just told my levels were either normal or not. I don’t know whether I have autoimmune thyroid or not.
I need to have an in depth chat with my GP regarding my hypothyroidism. I will try to see whether she will test my FT4 and FT3 levels and find out whether I have ever been tested for thyroid antibodies.
In case it makes a difference, my Father had hypothyroidism and one of my sons has hypothyroidism, my other son had Graves’ disease (hyperthyroidism) when he was 10-15yrs but is ok now (he’s now in his 20s), so thyroid issues do tend to run in my family.
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AlphaWolf5195
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Thank you for your reply. I’ll definitely mention that to her. The problem I can see coming up is that my GP thinks my thyroid levels are perfect with a TSH of 2.5.
when i was on 50mcg i felt ill again after a few weeks and my medichecks test showed a tsh of around 2.8 and i think the repeat nhs test came back as 1.9 or so. I also had an nhs t4 test that showed my t4 had dropped down again so i had that info too.I felt like i needed an increase in levo so i asked if i could “trial” a small increase of the dose (as per SlowDragon advice at the time . It worked as the GP seemed happier to agree to that. I’m still on the increased dose now.
If you have an underactive thyroid (hypothyroidism), treatment may be delayed until this problem is treated. This is because having an underactive thyroid can lead to an increased cholesterol level, and treating hypothyroidism may cause your cholesterol level to decrease, without the need for statins. Statins are also more likely to cause muscle damage in people with an underactive thyroid.
TSH should be under 2 as an absolute maximum when on levothyroxine
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).
just testing TSH is completely inadequate
Presumably your hypothyroidism is autoimmune, usually diagnosed by high thyroid antibodies
Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine
For full Thyroid evaluation you need TSH, FT4 and FT3 tested
Also both TPO and TG thyroid antibodies tested at least once to see if your hypothyroidism is autoimmune
Very important to test vitamin D, folate, ferritin and B12 at least once year minimum
About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high TPO and/or high TG thyroid antibodies
Autoimmune thyroid disease with goitre is Hashimoto’s
Autoimmune thyroid disease without goitre is Ord’s thyroiditis.
Both are autoimmune and generally called Hashimoto’s.
Significant minority of Hashimoto’s patients only have high TG antibodies (thyroglobulin)
Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease
20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis
In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)
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)
Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins
Testing options and includes money off codes for private testing
Many thanks for all the info and links, they will be very helpful. I will read through them thoroughly and let my GP know. I am going to see whether I can get my GP to test my FT4, my FT3 and my TSH (although my TSH was recently tested). I will ask her whether I have ever been tested for thyroid antibodies and if I haven’t can she test for that. Failing my GP arranging all these tests, I’ll have to try to have a private test done.
I take Fultium D3 800iu, plus a calcium and Vitamin D supplement which has 100iu vitamin d in so total 900iu Vitamin D a day. I don’t know when I was last tested for Vitamin D or what the results were.
I was on cyanocobalamin (b12) 100mcg a day but as my levels were high at my last blood test, they were 751 (range 145-569) my GP has told me to take just one tablet a week until they are gone then stop them.
I was on ferrous sulphate 200mg alternate days (which I have been on for several years) but my GP said my iron levels were good so to take one tablet a week until they are gone, my Serum ferritin was 125 (range 13-150).
I had been on both B12 (originally injections then after several years changed to tablets) and ferrous sulphate for several years but my GP seems to think I no longer need them although she did say if my levels drop too much she can put me back on them.
I take vitamin c and zinc (it possibly doesn’t help but I have neutropenia, low white blood cell count so anything that might help my immune system is worth a try).
My last folate blood test was on 4th Jan 2024 serum folate 15.8 (range 8.80-60.80).
Many thanks for the info. I didn’t know that. My last blood test I had I can view on the NHS app but I can’t view any previous blood test results. I’ll ask my surgery for enhanced access as it would be very helpful to be able to view all my past blood test results.
oh sorry…that’s what i meant really. Although thinking about it, when i asked for enhanced access they did actually ask me how far back I wanted to see/to go. I only opted then for the most recent thyroid results onwards. on the app, and then later the clinical pharmacist told me my past tsh results on the phone.
Cholesterol levels are only indirectly related to TSH. It's actually low FT3 that causes high cholesterol.
Cholesterol is made in the liver - nothing to do with your diet - and the liver keeps levels stable by making more when you consume less, and vice versa. But, when T3 - the active thyroid hormone - is low, the body cannot process cholesterol correctly and it builds up in the blood.
But, when I say 'builds up in the blood', I don't mean blocking your arteries! The cholesterol is inside the protein carriers, HDH and HDL, which is what the blood test tests. Blood tests do not test the cholesterol itself. So, all this panic about high cholesterol is totally misplaced. It's not going to do you any harm, your body needs cholesterol.
If you have an untreated underactive thyroid, your risk of developing cardiovascular disease is increased.
This is because having low levels of the hormone thyroxine can lead to increased levels of cholesterol in your blood. High cholesterol can cause fatty deposits to build up in your arteries, restricting the flow of blood.
Contact your doctor if you're being treated for an underactive thyroid and you develop chest pain, so that any problems can be detected and treated, if necessary.
nhs.uk/conditions/underacti...
That was copied from this NHS site - sorry for the poor link, it continues: underactive thyroid, obviously
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Advice please!?
Advice regarding Thyroid levels
What should I do next ?
I'm trying to find a doc who is willing to treat my symptomatic hypothyroidism when TSH is high but within UK 'normal' range, with low FT4.
