I've been taking Levo 50mg per day for 3 months, and just had the first blood test result back. My TSH is at 2.85, and they are saying that I should stay on this dose and get tested again in a year.
The last test before I started medication (January) my TSH was 8.6, T4 12.8.
Both were done first thing in a fasted state, and I didn't take my Levo dose before the most recent one.
When I started taking Levo it was life-changing, I felt completely different, after 4 years of not really living.
I think I'm a bit overwhelmed by how much better I'm feeling, so it's hard to tell whether it's the right dose purely based on symptoms. I do still have 'off days' where I feel like I did before. Does 2.85 sound about right, and I should go back and get a blood test again only if I start to feel knackered? Or should I make an appt. with the GP to talk about whether I should be on a higher dose of Levo?
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tattiescone
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50mcg levo is just a starter dose...you are ready for an increase to 75mcg
You should be retested 6/8 weeks after starting levothyroxine and dose then increased/ adjusted....a year is FAR too long!
Initially after adding replacement hormone we can feel really improved but this doesn't last as the body indicates it needs more....symptoms return.
Your TSH is too high...when medicated it should be close to 1....indicates undermedication.
Your "off days" again are likely symptoms of undermedication
You shouldn't feel knackered if dose is correct....discuss increase to 75mcg .with your GP. If they refuse then complain to the Practice Manager and/ or consider a full thyroid test to include..
TSH, FT4, FT3, vit D, vit B12, folate, ferritin and thyroid antibodies TPO and Tg
Good you are seeing improvement and are tolerating the levo T4 well.
Are you autoimmune type - have they tested for antibodies. They do it once and it is useful to know going forward what might have caused it.
I am fairly new and your levels can move around quite a bit at the start, I think your thyroid if it is being attacked by immune system can release more hormone and throw your levels around.
Most people are fine it seems on levo, many on here are not and I found it scary to read. I think this group is mainly the poor converters of T4 to T3 and people with othe rcomplex issues.
Fingers crossed you do not need too much help but if you do they are amazingly kind, knowledgeable, passionate people here to help.
Hi I'm fairly new to this thyroid stuff. It might be that 2.85 is right for you did they do a T3&T4 this time? From what I've read on here your improvement might fade.
DippyDame is right that the aim seems to be to get TSH below 2, however if your feeling good who can say.
But there's no doubt that a single test can't indicate stability. You need to be tested every 6 to 8 weeks until it's determined that your improvement is maintained and your blood levels are stable. Fwiw you should have been tested 6 weeks after starting not 3 months.
Good idea to speak to your GP. The practice or the local hospital should have a protocol for management of hypothyroidism. I couldn't find recommended intervals on NICE, BNF or NHS websites. They do say 'regular tests' without defining regular.
You may be in a honeymoon period after starting treatment so be aware that your symptoms may return over the next few months. Most people need their TSH at or below 1 to feel well long term.
I'd suggest making that appointment and pushing for a trial of an extra 25mcgs Levo.
As the NHS has only tested TSH this time we really don't have any idea where your free hormone levels lie and if you are converting well. I'd recommend getting a private blood test run to show TSH, FT4 & FT3 to be able to make that assessment. While you're there you should also test key vitamin levels which I see that you have done in the past.
Are you supplementing your vitamin levels to OPTIMAL which is where they need to be for our thyroid hormone to work well? I see you posted some vitamin results a while back but didn't really get many comments. healthunlocked.com/thyroidu...
It's ideal if you can always get the same brand of levo at every prescription. You can do this by getting GP to write the brand you prefer in the first line of the prescription. Many people find that different brands are not interchangeable.
Always take Levo on an empty stomach an hour away from food or caffeine containing drinks & other meds. Many people find taking it at bedtime works well for them.
If you are feeling well a TSH of 2.85 is fine. You can ask to review it in three months, or sooner if you should start to go downhill. Generally there is a progressive decline of the thyroid so be prepared to jump on them if you should get worse.
The aims of treatment are to alleviate symptoms, align thyroid function tests within or close to the reference range, and to reduce the risk of long-term complications.
But even they put alleviate symptoms as the primary aim.
Their secondary aim, align thyroid function tests within or close to the reference range, really is only saying that is how the prescriber can tell the treatment is adequate. No numbers can show a person is feeling well and not suffering continuing symptoms. It shouldn't actually be an aim. But even they are allowing the test results to be out of the reference intervals (albeit close to them) if necessary to alleviate symptoms.
When you are feeling the your symptoms have been alleviated, and that has been so for some time (months or years), the test results can be useful. If in future you don't feel as well, those test results can help guide you what is wrong. But the values at which anyone feels their best can, and do, change over time for any reasons including laboratory variations.
Please can I just check that you don't take iron supplements for at least 2hrs after your levothyoxine in the morning. I heard a doctor mention this fact on a radio programme. I'd never heard this, so asked the pharmacist in Boots the chemist & she said I don't know, never heard it though. I just stood there smiling, after a brief pause she said,"you want me to check don't you?" I just nodded. 10 minutes later she came back saying,"We'll they say you learn something new everyday, thank you."
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