latest results

[RoseStar]

hi all,

Thyroid results on 50mcg taken 29th Jan

TSH 4.37 (0.3-4.2)

T3 4.6 (3-5.4)

T4 13.8 (9-19)

Dose increased to 75mcg

Taken again yesterday

TSH 2.76 (0.3-4.2)

T3 4.2 (3-5.4)

T4 13.6 (9-19)

I still feel pretty crap to be honest - muscle aches, constipation, fatigue. I popped a note to the doctor’s surgery and said please can you ask the GP not to just mark these as normal as i want an increase on the basis of endo previously telling me TSH needs to be under 2.5 and I have personally felt best when mine is under 1. Advanced nurse practitioner just said I have to wait for the doctor to review results and they will decide. Well now i’m panicking because my GP previously told me as long as it’s “in range” (under 4.2), all is well.

I’m so exhausted fighting, i really am.

[Jaydee1507 Administrator]

Most people feel well when thir TSH is at or just under 1 so you do need an increase.

If doctor says no then don't take no for an answer. keep asking, try a different doctor and don't give up.

What supplements are you taking?

What are your latest vitamin results?

We need OPTIMAL levels of key vitamins for our thyroid hormone to work well.

[RoseStar in reply to Jaydee1507]

I have managed to get an increase to 100mcg 👏 I am on Thorne B complex, vitamin D, gentle iron and flaxseed capsules. I’ve seen a private endo yesterday as he’s not convinced I’m converting particularly well. He’s done bloods for my vitamin levels too, so I will find out in a couple of weeks

[SlowDragon Administrator]

Push for next increase

Have guidelines printed out and ready to quote

Guidelines of dose Levo by weight

approx how much do you weigh in kilo

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

pathlabs.rlbuht.nhs.uk/tft_...

Guiding Treatment with Thyroxine:

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

gponline.com/endocrinology-...

Graph showing median TSH in healthy population is 1-1.5

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

Comprehensive list of references for needing LOW TSH on levothyroxine

healthunlocked.com/thyroidu....

onlinelibrary.wiley.com/doi...

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).

Have tick sheet of remaining symptoms ready too

Symptoms of hypothyroidism

thyroiduk.org/signs-and-sym...

which brand of levothyroxine are you currently taking

[SlowDragon Administrator]

Presumably you have autoimmune thyroid disease also called Hashimoto’s

Have you had coeliac blood test done BEFORE trialing strictly gluten free diet

Vitamin levels need retesting particularly full iron panel

healthunlocked.com/thyroidu...

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

Stop iron supplements 5-7 days before testing

Medichecks iron panel test

medichecks.com/products/iro...

Look at increasing iron rich foods in diet

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

List of iron rich foods

dailyiron.net

Aiming for ferritin at least over 70