Advice on recent tests please

[Cabbages123]

Hi I've just had my results of recent tests back as follows:T4 14.5 pmol/L range 9 - 19 pmol/L

TSH 5.3 miu/L range 0.35 - 4.94 miu/L

Previous from 4 Dec 2023

T4 10.5

TSH 6.9

Had a text message from the surgery saying thyroid levels are improving test again in 2 to 3 months.

Advice on next steps please, I have also started b12 loading injections on 19th Feb I did feel slightly better 19th and 20th Feb but today feeliawful again, dizzy, numb head, headache, head pressure, inner vibrating in legs and feet just don't know if this is from thyroid or b12, before first b12 injection I was feeling terrible, but also since 4 Dec when I started on levothyroxine I have been given 3 different brands of levo.

Thanks in advance

[SlowDragon Administrator]

Looking at previous post you are only on 25mcg levothyroxine

Push to increase to the standard STARTER Dose of 50mcg

As you prefer Wockhardt request prescription is for 2 x 25mcg per day

Retest in 6-8 weeks

Likely to need further increases in levothyroxine over coming months

[SlowDragon Administrator]

was test done early morning and last dose levothyroxine 24 hours before test

Free T4 (fT4) 14.5 pmol/L (9 - 19) 55.0%

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).

[Cabbages123 in reply to SlowDragon]

Yes test was at 8.20am, I take my levo between 7.30am and 8.30am usually, but took it after the blood test.