TSH level

[BRITT1DENMARK]

Hi, my daughter’s TSH is 3.7 and she’s on 125mg thyroxine. Although this is the “normal” range. I think it seems high and something isn’t right. Do you agree?

Many thanks

[Jaydee1507 Administrator]

Thats quite a high TSH for someone on 125mcgs Levo.

Does she always take her Levo on an empty stomach an hour before food or drinks other than water?

Has she had key vitamins tested - ferritin, folate, B12 & D3 and supplementing levels to OPTIMAL?

We need OPTIMAL vitamin levels for our thyroid hormone to work well.

Did you do the test as per the protocol recommended here? Recommended blood test protocol: Test at 9am (or as close as possible), fasting, last levo dose 24hrs before the blood draw, last T3 dose 8-12 hours before 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.

[BRITT1DENMARK in reply to Jaydee1507]

hi Jaydee1507, yes she does follow the quidelines when she has her bloods done. The doctors haven’t tested all her levels for a while. It’s very limited what you get on nhs

[Jaydee1507 Administrator in reply to BRITT1DENMARK]

So she due a dose increase and like thousands of members here she will need to either prsuade her GP to do the tests required or buy private tests. Its unfortunately the only way to feel well.

[BRITT1DENMARK in reply to Jaydee1507]

Thank you for your advice

[tattybogle]

yes .... GP's are advised to keep TSH below 2 /2.5 ish in all patients on levo :

healthunlocked.com/thyroidu.... -list-of-references-recommending-gps-keep-tsh-lower-in-range

[BRITT1DENMARK in reply to tattybogle]

Thank you, just need to convince nhs doctor

[SlowDragon Administrator]

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).

How much does she weigh in kilo

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.

Some people need a bit less than guidelines, some a bit more

Post all about what time of day to test

healthunlocked.com/thyroidu...

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

Testing options and includes money off codes for private testing

thyroiduk.org/testing/

Medichecks Thyroid plus BOTH TPO and TG antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes BOTH TPO and TG antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

Only do private testing early Monday or Tuesday morning.

Link about thyroid blood tests

thyroiduk.org/testing/thyro...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

Symptoms of hypothyroidism

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

Tips on how to do DIY finger prick test

support.medichecks.com/hc/e...

Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee

[BRITT1DENMARK in reply to SlowDragon]

Thank you so much for your reply and knowledge. I will have a good read