TSH, blood tests, weight gain - I am in the dark

[TY_004]

Good morning fellow members!

I have hypothyroidism and have suffered with it for about 2 and a half years. Until April of this month I was not advised to have regular blood tests. Since my initial diagnosis and prescription of a daily dose of 75 micrograms levothyroxine, my weight has gained despite eating well and regularly exercising.

Grateful for advice on what questions I should be asking my GP, and if anyone is in a similar situation to me.

Are there other specific blood tests I should be asking for? Is 75 micrograms an average dose?

Thanks in advance.

[pennyannie]

Hello TY_004 and welcome to the forum :

So just reading your Profile page and found out that after treatment of head and neck cancer - chemo and RAI - your thyroid was found to be non functioning and collateral damage.

When was all this please - and are you now classed as primary hypothyroid ?

A fully functioning working thyroid would be supporting you on a daily basis with trace elements of T1. T2 and calcitonin + a measure of T3 at around 10 mcg + a measure of T4 at around 100 mcg. - with T3 said to be around 4 times more powerful than T4.

I'm guessing you have been discharged from the hospital -

did you ever see an endocrinologist and what was diagnosed -

Your named doctor in primary care and who is responsible for your prescription should at least be running the yearly thyroid function blood test - which can be just a TSH reading which doesn't really say anything and a waste of time - but that's where we are currently.

We need to see a full thyroid blood panel - to include a TSH + Free T3 + Free T4 + inflammation, antibodies and ideally ferritin, folate, B12 and vitamin D -

as in order for T4 - Levothyroxine to work well and convert into the active hormone T3 - that runs the body - we need optimal levels of the core strength vitamins and minerals as detailed.

So first off you can ask your doctor to run this comprehensive blood test - but you may need to get this run yourself - as many of us have been forced to do - and once with the results and the ranges simply start a new post and you will be talked through what it all means and what your next best steps back to better health can be.

There is a whole page dedicated to Private blood test companies on the Thyroid UK website - which is the charity that supports this patient to patient forum - where you'll read around all things thyroid including :-

how to take T4 - Levothyroxine - and when and how to run a fasting blood test :

Can I suggest you go back into your Profile page and word it so that your medical history is detailed in your summary -

at present it just details - blood tests and levothyroxine -

and we need to try and get ' tagged ' your previous medical diagnosis of head and neck cancer and the treatments given - as each case of hypothyroid is unique and not one size answer fits all the people dealing with hypothyroidism.

[TY_004 in reply to pennyannie]

Pennyannie - thank you so much for such a detailed reply.

I will attempt to answer all of the questions that you raised.

My Chemo and radiotherapy ended in November 2013, and since February 2019 I have been in full remission. No medical staff mentioned the likelihood of thyroid damage and it came as a shock to me. I have no idea if I am classed as primary hypothyroid, all that I know is that I have a diagnosis of hypothyroidism and will be on levothyroxine permanently.

I was discharged from hospital in December 2103 (after contracting neutropenic sepsis).

I have never seen or been referred to an endocrinologist.

I will enquire about a blood test to show a full thyroid blood panel - to include a TSH + Free T3 + Free T4 + inflammation, antibodies and ideally ferritin, folate, B12 and vitamin D.

I will look over my medical history and add detail to my profile, as you suggest.

Thank you and best regards

TY_004

[pennyannie in reply to TY_004]

OK then - we generally feel best when the T4 is up in the top quadrant of its range as this should then convert to a decent level of T3 at around a 1/4 ratio T3/T4.

If you are now ' classed as primary hypothyroid ' I am guessing you would likely do better adding in a little T3 - Liothyronine - at a similar dose to that which your thyroid once naturally supported you with - but that's some way down the tracks -

first off we need the full thyroid blood test and I think it's referred to as a thyroid ultra or an advanced thyroid panel by the Private blood companies - if you doctor isn't able to action this for you.

It's a fasting early morning by 9 am blood draw and you just take in water over night and do not take your daily T4 dose until after the blood draw - otherwise your results will show a false high as we will be measuring what you have just ingested.

If taking any supplements leave these off for around a week prior to the blood test so we measure what your body is holding rather than that just ingested and any supplements containing biotin can interfere with blood test assay measuring so these need to left off for the week prior to the blood test also.

Do you take your T4 on an empty stomach and wait around an hour before eating or drinking anything ?

Hopefully we will be able to turn a few lights on and take you out of the dark !!