Hi had blood test as recommended early in day & no levo for 24 hours, no biotin for a week etc.
I am wanting an increase in dose by 25mcg which will take me to 75mcg- for weight recommended dose is 100mcg! Still symptomatic! Also now on ppi plus change of Bp meds, an anti flam & Hrt!
Gp reluctant to look at HRT but possibly agreed to increase levo- brain fog means i cant work the figures in percentages of the vitamins either! Help!
Also take vit c, D with k2 and B complex(took B12 last year to get numbers up then B complex to maintain). Advice please re ferritin, folate, B12
Thank you
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Robinface
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So we can offer better advice, can you share blood test results (with ranges in brackets) for:
FT3
FT4
In addition to TSH supplied.
Plus any antibody and key vitamin tests (ferritin, folate, vitamins D and B12)
If your GP is unable to complete all the above (eg if TSH is within range, some surgeries may not be able to access FT4 and FT3 tests), you could look to do this privately, as many forum members do, for a better picture of your thyroid health:
The result above was GPs idea of thyroid testing! Tried to put photo of vitamin results but no joy hopefully showing now?? Will look at private but have done medichecks in past but price increased! Will have to wait for payday! I requested vitamins tested but again above is all they will do! I take 50 mcg of the same brand every day when i wake up!
Do you always get same brand levothyroxine at each prescription
Approx how old are you
PPI will often significantly lower vitamin levels.
Why PPI and how long have you been on them
Is your hypothyroidism autoimmune
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
Also both TPO and TG thyroid antibodies tested at least once to see if your hypothyroidism is autoimmune
Very important to test vitamin D, folate, ferritin and B12 at least once year minimum
Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease and when under medicated
Exactly what vitamin supplements are you taking
About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high TPO and/or high TG thyroid antibodies
Autoimmune thyroid disease with goitre is Hashimoto’s
Autoimmune thyroid disease without goitre is Ord’s thyroiditis.
Both are autoimmune and generally called Hashimoto’s.
Significant minority of Hashimoto’s patients only have high TG antibodies (thyroglobulin)
20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis
In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)
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)
Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins
Hi yes same brand, am early 50’s, been on levo 30+ years put on by a psych- no idea why at the time i was very unwell with severe depression- hospitalised! HLA-B27 positive, Ankylosing spondylitis issues plus osteoarthritis & rheumatoid arthritis, have had cocktails of Nsaids years ago which left me with stomach/gut/indigestion issues! Have a rheumatologist i see yearly!
Back on PPI since Feb due to joint swellings/pain/stiffness & back on etoricoxib! Have queried Lupus as sibling has SLE-told no! Was on 25mcg until last year i think when i kicked up fuss and finally wore GP down to increase it (plus gave them private results!!)
Supplements- vit c 200mg, vit B complex (Boots) vit D3000+K2 Better You oral spray.
Good diet, love green veg, liver, pate! weight gained in last 6 months struggling to shift despite increasing exercise etc am tired, fatigued, dry skin, red faced, cold feet & hands, brain fog, anxiety- the list goes on! 😩
Couldnt get blood test earlier than the one i had 10am! Had to wait 2 weeks for that one!
Will look at private tests when i can afford it but wish to feed back to GP request increase in levo and do i have a case for B12? Thanks for all your help, brain fog is just awful finding words is taking an age!!
Request GP test vitamin D and also test thyroid antibodies for autoimmune thyroid disease
Levothyroxine doesn’t “top up” failing thyroid. Because of TSH feedback, almost everyone who starts on levothyroxine is likely/should end up on full replacement dose
Typically dose levothyroxine is slowly increased up in 25mcg steps …..retesting 2-3 months after each increase
On average full replacement dose is approximately 1.6mcg levothyroxine per kilo of your weight per day. So likely to need at least two further increases over coming months
Which brand Levo are you currently taking
Ideally don’t change brand generally and definitely not when changing dose
Wockhardt brand levo- vitamins as above- couldnt see clear mg/mcg on packaging will look again in morning! Eyesight rubbish in eve! Gp wont increase much fought to get this far!! Thank you so much
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
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.
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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Advice on blood test result please
Further blood results - advice please
Blood test results and advice please 
Advice on vitamins please and blood results.
