I was over active then had radio active iodine march 2023 due to medication not controlling it then going under active
I was on 50mcg levo then had it upped to 100mcg by the endocrinologist had repeat bloods and my TSH was then 7 I was upped again on levo to 125mcg
I’m really struggling with my periods they are very heavy I'm flooding and bleeding for upto 10 days. Struggling with headaches and constantly tired I’m getting no where with the gp but back on 8 week appointments with my endocrinologist
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Rubydoo23
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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
Very important to test vitamin D, folate, ferritin and B12 at least once year minimum
with heavy periods low iron/ferritin likely
Essential on levothyroxine to have GOOD ferritin levels
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)
my dose was changed 23rd dec 2023 to 100mcg then my bloods were done again 10th feb my T4 was 10 and TSH was 6.69
Accord levothyroxine
I’m around 84kg
I will request those bloods and get them done. It’s a constant battle with my gp and it’s so frustrating.
I’m at the stage where I can’t go an hour without flooding I’ve tried to explain to them about my ferritin being low in the past but it’s just ignored or they don’t request it on my bloods then I end up constantly on the phone to them trying to get past reception police then I’m told I’m not medically trained but still don’t do what you ask them.
Thank you I will ensure my bloods are done early morning. I’m back with the endocrinologist 19th April he has told my gp to give me TXA and to monitor ferritin B12 and folate but again they haven’t done it. I’m at the stage now where I’m looking to change my gp as they are so bad
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 red meat everyday, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption
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.
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).
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