Hi Folks, Been dealing with getting on an even keel with newly experienced B12 deficiency since the middle of last year and with the ignorance of GP’s. I was diagnosed with hypothyroidism several years ago and am on 50mcg of levothyroxin. But I now want to get an up to date view of my thyroid health as I feel there is room for a change in dosage.
Male, 5’6”, 83kg! Age 73.
My results of a private blood test are above. If they could be interpreted for it would be very much appreciated. Any guidance/wisdom for future enhancement of ongoing thyroid health development would not go amiss. Very many thanks in advance.
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B12again
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Well you could certainly benefit from an increase as you are really aiming to get your TSH nearer 1, you seem to be converting reasonably well so that is good news, was this test done before 9am with your last dose 24 hours before?
Glad to hear you are getting to grips with your B12, have you had any results for folate, Vit D and ferritin?
Thanks for the response. Yes, test was done iaw the protocol recommended on here. My folate is 12.6mcg. I’ve not had D or ferritin done but I take vit D3+k 5700iu. I’m SI EOD for my B12 and take a high strength B Complex and Magnesium 300mg.
I was diagnosed with hypothyroidism several years ago and am on 50mcg of levothyroxin.
Very poor care from your GP
50mcg is only standard STARTER dose
likely to need at least 2 more increases over coming months
Request/insist on 25mcg increase to 75mcg
As you have been left woefully under treated for far too long you may need to increase more slowly. Perhaps initially cut 25mcg in half and only add 12.5mcg daily for first 6 weeks, before increasing again up to 75mcg
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
Post discussing how biotin can affect test results
Even if we frequently start on only 50mcg, most people need to increase levothyroxine dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until eventually on, or near full replacement dose
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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