Am taking 75mg Levothyroxine 5 days and 50mg 2days (spread out in week). Feel ok but still very tired and dry skin. Was on 75mg but after 8 week test had gone out of NHS range so GP suggested alternate days dosage. Just wondering if TSH is creeping up (know from this site recommendation is around 1) if I should go back to 75mg daily? Next blood test NHS due Sept so could do monitor my health test few weeks before for results?
I know my FT4 creeping up too but not sure of significance of that?
Many thanks
Fiona
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Macp17
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Last time I asked for my annual test they said "they were in range last time so we don't test" 🙄
Multivits tend to be a waste of money as they combine things that block each other like iron and don't have enough of anything to make a difference, you'd be better off with a good B complex, Vit D & K2, magnesium and selenium helps conversion
Was on 75mg but after 8 week test had gone out of NHS range so GP suggested alternate days dosage.
What was out of range? TSH? Over or under? Your GP should not be dosing by the TSH! Once on thyroid hormone replacement it is unreliable.
The most important number is the FT3, and yours is low. And your FT4 is going up because you are converting less and less to T3. Do you know what your FT4 and FT3 were on 75 mcg daily?
Hi, on 75mg daily my TSH was 0.11 (range 0.35-4.94) tested by NHS 8 weeks after increase from 50mg daily. As I was out of range, got text from GP asking me to alternate 50/75mg. Presumably as I was out of range they also tested my FT4 which the don’t normally do; this was 16.3 (range 9-19).
Which was well within range, so they should not have reduced your dose. Never, ever agree to reduce your dose based solely on the TSH. It's not even a thyroid hormone.
Stop multivitamins a week before test as contains biotin
Multivitamins never recommended on here anyway
At best a waste of money, but often exacerbate issues. Most contain iodine not recommended for anyone on levothyroxine
You’re currently on inadequate dose Levo
Which brand of levothyroxine are you taking
Do you always get same brand
Increase back to 75mcg daily
Retest 8 weeks later
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)
meanwhile test vitamin D, folate, ferritin B12, privately if necessary
have been in Wockhardt but pharmacy couldn’t get it last time so given mercury pharma. However, back on Wockhardt now. I did say I was happy with either (not Teva though, dreadful stomach issues!) but would like the same brand each time. Was told they have whatever they get sent in stock and no way to request same brand (although GP has specified no Teva)
I have been in Wockhardt but pharmacy couldn’t get it last time so given mercury pharma. However, back on Wockhardt now. I did say I was happy with either (not Teva though, dreadful stomach issues!) but would like the same brand each time. Was told they have whatever they get sent in stock and no way to request same brand (although GP has specified no Teva)
I had stopped multi vits week before test and also take omega 3,6 & 9 which I also stopped althyneither contain Biotin. Which iron and B12 are recommended; only asking as my iron levels have always been good (despite having low ferritin a year ago which has now been treated and considered adequate). I also donate blood every 4 months and they test iron before donation and that always been fine too. Thanks
Which iron and B12 are recommended; only asking as my iron levels have always been good (despite having low ferritin a year ago which has now been treated and considered adequate).
I’m afraid I can’t get these tests done from GP and sadly can’t afford to keep testing privately, especially as having just done my thyroid one. Just knowing a good basic iron and B12 supplement would be helpful as I have been taking a multivitamin but understand they may not be ideal. Although it’s very bad that they sell them if they know the vitamins counteract each other; haven’t heard that anywhere else, you’d think that should be more widely publicised. 😠
With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a separate B12 supplement
A week later add a separate vitamin B Complex
Then once your serum B12 is over 500 (or Active B12 level has reached 70), you may be able to reduce then stop the B12 and just carry on with the B Complex.
If Vegetarian or vegan likely to need ongoing separate B12 few times a week
IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results
In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg) and continue separate B12 until over 500
Post discussing how biotin can affect test results
Vitamin D deficiency is frequent in Hashimoto's thyroiditis and treatment of patients with this condition with Vitamin D may slow down the course of development of hypothyroidism and also decrease cardiovascular risks in these patients. Vitamin D measurement and replacement may be critical in these patients.
Vitamin D insufficiency was associated with AITD and HT, especially overt hypothyroidism. Low serum vitamin D levels were independently associated with high serum TSH levels.
The thyroid hormone status would play a role in the maintenance of vitamin D sufficiency, and its immunomodulatory role would influence the presence of autoimmune thyroid disease. The positive correlation between free T4 and vitamin D concentrations suggests that adequate levothyroxine replacement in HT would be an essential factor in maintaining vitamin D at sufficient levels.
Our results indicated that patients with hypothyroidism suffered from hypovitaminosis D with hypocalcaemia that is significantly associated with the degree and severity of the hypothyroidism. That encourages the advisability of vit D supplementation and recommends the screening for Vitamin D deficiency and serum calcium levels for all hypothyroid patients.
There is a high (approx 40%) prevalence of B12 deficiency in hypothyroid patients. Traditional symptoms are not a good guide to determining presence of B12 deficiency. Screening for vitamin B12 levels should be undertaken in all hypothyroid patients, irrespective of their thyroid antibody status. Replacement of B12 leads to improvement in symptoms, although a placebo effect cannot be excluded, as a number of patients without B12 deficiency also appeared to respond to B12, administration.
Patients with AITD have a high prevalence of B12 deficiency and particularly of pernicious anemia. The evaluation of B12 deficiency can be simplified by measuring fasting serum gastrin and, if elevated, referring the patient for gastroscopy.
Levothyroxine can decrease serum homocysteine level partly; still its combination with folic acid empowers the effect. Combination therapy declines serum homocysteine level more successfully.
Serum ferritin level is the biochemical test, which most reliably correlates with relative total body iron stores. In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency.
Never supplement iron without doing full iron panel test for anaemia first and 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
Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption
This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.
Thank you for your incredible patience while you have been awaiting the outcome of our ferritin reference range review. We conducted this with Inuvi lab, which has now changed the reference ranges to the following:
Females 18 ≤ age < 40. 30 to 180
Females 40 ≤ age < 50. 30 to 207
Females 50 ≤ age < 60. 30 to 264l
Females Age ≥ 60. 30 to 332
Males 18 ≤ age < 40 30 to 442
Males Age ≥ 40 30 to 518
The lower limits of 30 are by the NICE threshold of <30 for iron deficiency. Our review of Medichecks data has determined the upper limits. This retrospective study used a large dataset of blood test results from 25,425 healthy participants aged 18 to 97 over seven years. This is the most extensive study on ferritin reference ranges, and we hope to achieve journal publication so that these ranges can be applied more widely.
Thank you for a very informative answer. Still don’t think GP will agree to annual vitamin testing which seems such a shame for those of us who really can’t afford to do it ourselves so regularly. Thank you again though, you really are such a knowledgeable and helpful group! X
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