Hello All and I would appreciate your thoughts/suggestions on my latest blood test results.
GP results at 8.30am
TSH 0.72 (0.27 - 4.2)
T4 18.7 (10.8 - 25.5)
Ferritin 65 (30- 400)
B12 550 (180 - 999)
Folate >20.0 (3.89) - 400)
Vit D 98 (50 - 174) in Jan 2024
Monitor My Health (same day & approx. same time as GP blood test)
TSH 0.79 (0.27 - 4.2)
T4 18.2 (12 - 22)
T3 4.2 (3.1 - 6.8)
Usual protocols followed, have been taking 75mcg levothyroxine since November 2023, GP prescribed FerroDose 210mg in January. Otherwise, Vit D&K2 spray, Vit B complex and magnesium supplements.
I am feeling 'out of sorts', having afternoon naps again and cold feet.
GP will not increase thyroxine dose because of TSH level. My T4 levels have increased however my T3 have not. Should they have done by now? been on thyroxine since June 2023. Is there anything I can do to increase T3 levels?
Thank you
Written by
Amtired
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Even with a TSH of .72 you still have a little room for an increase. Your FT4 is only 62% of range and FT3 needs to be 60-70% of range. Its much lower.
Have you asked several GPs at the same practice for a trial increase? This can seem less intimidating to some GPs and they may be more likely to let you have it on that basis.
You can email info@thyroiduk.org for a list of TS friendly Endo's. Make a new post asking for feedback on any who might be suitable. Messages will have to be by private message.
Its possible to get T3 prescribed on the NHS but can be a slow process. Its faster if you can go privately.
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).
Consider starting levothyroxine at a dosage of 1.6 micrograms per kilogram of body weight per day (rounded to the nearest 25 micrograms) for adults under 65 with primary hypothyroidism and no history of cardiovascular disease.
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