Change dosage?

[Tigertummy]

I’m currently taking levothyroxine - 75 4 days a week and 100 3 days a week. Latest test results are T4 17.3 (range 11-21.2) and TSH 2.43 (range 0.27-4.2). These numbers seem much more in line with similar numbers this time last year and I’m having all the same symptoms. Last year my dose was increased. Does it sound like that needs to happen again? Thanks!

[greygoose]

Yes, you need another increase in dose. Your TSH is far too high for someone on thyroid hormone replacement. It should come down to 1 or under. And your dose is pretty small. I would insist on an increase if it were me.

[Tigertummy in reply to greygoose]

Thank you!

[greygoose in reply to Tigertummy]

You're welcome.

[SlowDragon Administrator]

Do you always get same brand levothyroxine at each prescription

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

Post all about what time of day to test

healthunlocked.com/thyroidu...

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

Just TSH, Ft4 and Ft3 test - £32

monitormyhealth.org.uk/thyr...

10% off code here

thyroiduk.org/testing/priva...

Monitor My Health also now offer thyroid and vitamin testing, plus cholesterol and HBA1C for £65

(Doesn’t include thyroid antibodies)

monitormyhealth.org.uk/full...

10% off code here

thyroiduk.org/testing/priva...

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).

[Tigertummy in reply to SlowDragon]

Yep, same brand every time. Blood test was first thing in the morning before taking my meds.

[SlowDragon Administrator in reply to Tigertummy]

Free T4 (fT4) 17.3 pmol/L (11 - 21.2) 

Ft4 61.8% through range

Plenty of room to increase dose

Suggest initially increase 100mcg to 5 days per week

Retest in 6-8 weeks