Do I need Levothyroxine?

[nedbites]

Hello

I know best bet is to speak to a GP about this but that is pretty impossible getting an appointment or finding a knowledgable Doctor.

My TSH is 6.8

Free Thyroxine 11.8

Free T3 4.9

Thyroglobulin AB’s 311

A ‘virtual’ doctor prescribed me 25 Levothyroxine but one stopped taking it as didn’t feel any different and didn’t want to be chewing tablets if I didn’t need them.

My question is - Do I need to be taking medication? I’m tired a lot, can’t shift weight but I put this down to busy lifestyle. Confused.

Thanks

Brac

[SlowDragon Administrator]

Graph showing median TSH in healthy population is 1-1.5

web.archive.org/web/2004060...

Starting levothyroxine - flow chart

You need 2 separate NHS tests with TSH over 5

gps.northcentrallondonccg.n...

please add range on Ft4, Ft3 and antibodies results

Thyroglobulin AB’s 311

Have you tested TPO antibodies too

ESSENTIAL to test vitamin D, folate, B12 and ferritin

Low vitamin levels likely when hypothyroid

[nedbites in reply to SlowDragon]

Hiya

TPO’s in range (fine). Vitamin D always just above insufficient (53 ish). B12 okay. Other vits okay. Thank you for your reply.

[SlowDragon Administrator in reply to nedbites]

Vitamin D always just above insufficient (53 ish). B12 okay. Other vits okay.

So what are actual B12, folate and ferritin results and ranges

How much vitamin D are you taking

GP will often only prescribe to bring vitamin D levels to 50nmol.

Some areas will prescribe to bring levels to 75nmol or even 80nmol

leedsformulary.nhs.uk/docs/...

GP should advise on self supplementing if over 50nmol, but under 75nmol (but they rarely do)

mm.wirral.nhs.uk/document_u...

But improving to around 80nmol or 100nmol by self supplementing may be better

pubmed.ncbi.nlm.nih.gov/218...

vitamindsociety.org/pdf/Vit...

Once you Improve level, very likely you will need on going maintenance dose to keep it there.

Test twice yearly when supplementing

Can test via NHS private testing service

vitamindtest.org.uk

Vitamin D mouth spray by Better You is very effective as it avoids poor gut function.

There’s a version made that also contains vitamin K2 Mk7.

One spray = 1000iu

amazon.co.uk/BetterYou-Dlux...

It’s trial and error what dose we need, with thyroid issues we frequently need higher dose than average

Vitamin D and thyroid disease

grassrootshealth.net/blog/t...

Vitamin D may prevent Autoimmune disease

newscientist.com/article/23...

Web links about taking important cofactors - magnesium and Vit K2-MK7

Magnesium best taken in the afternoon or evening, but must be four hours away from levothyroxine

betterbones.com/bone-nutrit...

medicalnewstoday.com/articl...

livescience.com/61866-magne...

sciencedaily.com/releases/2...

Interesting article by Dr Malcolm Kendrick on magnesium

drmalcolmkendrick.org/categ...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

[nedbites in reply to SlowDragon]

NHS is so hard trying to get some sense out of about medication (nothing against the nurses or doctors as they do their best under circumstances), but I hear between 4-10 TSH is sub clinical and doesn’t need medication. I’m at 6.9 so some places I hear I need medication, other places I hear I don’t 🤷🏻

[FancyPants54 in reply to nedbites]

If you could find a still functioning doctor with a TSH of 9.5, I might believe that rubbish about subclinical. As it is, it's rubbish. Anything over 4.5 needs treating. I travelled to London to see a private doctor about something else a good few years ago now. I was exhausted when I got there. As we talked about whatever it was I'd gone about and she looked at the raft of results I'd been asked to take, she noticed my TSH (on Levo, but not enough of it) was 7.3. She herself has no thyroid and is totally reliant on T3 for her treatment. She looked at me and said that she would not be able to get out of bed in the morning if her TSH was over 7. And there was I, struggled down to and across London.

You need medication. But 25 is a baby starter dose and that's why you felt no different. Some of us feel much worse until we reach at least 75mcg or even 100mcg. Titrating the dose is a slow process and requires tests 6-8 weeks after each 25mcg increase. You need a GP to work with you on it. And you have to keep going.

[greygoose]

You have high antibodies, so Hashi's/Ord's, so things are going to get worse, rather than better. Your TSH is much too high and your Frees look low - although impossible to say for sure without the ranges. So, yes, you do need thyroid hormone replacement.

A ‘virtual’ doctor prescribed me 25 Levothyroxine but one stopped taking it as didn’t feel any different and didn’t want to be chewing tablets if I didn’t need them.

You chew your tablets??? Not a good idea. Just swallow them whole with water, that's what they're designed for.

But, of course you didn't feel any better on 25 mcg levo - you're lucky you didn't feel worse! A 'normal' starter dose is 50 mcg which should be increased slowly until you reach your sweet-spot and feel better. Obviously vitual doctors don't know any more about thyroid than real ones!

[nedbites in reply to greygoose]

Haha no ‘hypothetically’ chew em! I take them as should ie on empty stomach in morning swallowed.

[Jaydee1507 Administrator]

25mcgs Levo won't get you well. It a very low starter dose, 50mcgs is actually the usual starter dose and even then you need to take it for 6-8 weeks, retest bloods then increase the dose.

Rinse and repeat until your TSH is at or just under 1 where most people feel well.

So there's a long, slow road to feeling well with hypothyroidism nd you need to be prepared to stick with it for the long term.

Yes you need to be on Levothyroxine with that TSH.

When hypo we get low stomach acid which means we cannot absorb vitamins well from our food, regardless of a great diet. For thyroid hormone to work well we need OPTIMAL levels of vitamins. Have you recently or could you ask your GP to test levels of ferritin, folate, B12 & D3? Private tests are available, see link for companies offering private blood tests & discount codes, some offer a blood draw service at an extra cost.thyroiduk.org/testing/priva...

There is also a new company offering walk in& mail order blood tests in London, Kent, Sussex & Surrey areas. Check to see if there is a blood test company near you. onedaytests.com/products/ul...

Only do private tests on a Monday or Tuesday to avoid postal delays.

It's ideal if you can always get the same brand of levo at every prescription. You can do this by getting GP to write the brand you prefer in the first line of the prescription. Many people find that different brands are not interchangeable.

Always take Levo on an empty stomach an hour away from food or caffeine containing drinks & other meds. Many people find taking it at bedtime works well for them.

Recommended blood test protocol: Test at 9am (or as close as possible), fasting, last levo dose 24hrs before the blood draw & no biotin containing supplements for 3-7 days (Biotin can interfere with thyroid blood results as it is used in the testing process)?

Testing like this gives consistency in your results and will show stable blood levels of hormone and highest TSH which varies throughout the day. Taking Levo/T3 just prior to blood draw can show a falsely elevated result and your GP/Endo might change your dose incorrectly as a result.

[serenfach]

In most countries in the world you would be diagnosed by now. UK has a ridiculously high range.

Your body currently is like a car trying to climb a steep hill in 4th gear. Your thyroid is doing its best, but it needs help, Good advice above, and you need a precription of at least 50 levo in order to change to 3rd gear. Ongoing test will find out what gear you need.

Sorry - been working on my car all day!