I am 51 and take 50mg levothyroxine daily and have been since July last year. I was feeling tired and sluggish and my bloods were tested and had TSH above 5. I was put on 50mg last year. I have had a private blood test done last week and the results are in the photo. My TSH is now 3.76 and I have elevated thyroid peroxidase antibodies(I hadn’t been tested for those before). I’m still feeling tired in the mornings and have a GP appointment today.
My questions are:
Do you think I should ask for an increase in my medication?
Do I have Hashimoto’s disease and do the NHS do anything about it?
Thank you for any advice. I’m new on here and I hope I’ve included enough data ☺️
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I have gone gluten free since February and that has eased a lot of other gut symptoms (which has made my insides feel a lot better!). I have also been taking an oral spray of vit D (BetterYou Vit D with K3 three sprays a day) since February too.
I will have a chat with the GP later today and see what she says as feeling this tired is not good in the mornings.
I am taking Teva levothyroxine 50mcg. The doctor today would not increase my dose saying my results were ‘within range’ and would not entertain that the tsh should be nearer 1.
I did my other test as you suggested to get a more accurate reading.
Doctor wanted to test for celiac disease but I’d have to go back to eating gluten for 6-8 weeks before they can test they said.
I am going to try going dairy free too. One thing to change at a time so I know what’s working or not.
They are going to do a full blood test too to see if anything else is going on.
When adequately treated most people will need Ft3 at least 60% through range, usually Ft4 (Levo) will be higher at 70-80% through range
see different GP or see thyroid specialist endocrinologist
If seeing different GP, take long list of current hypo symptoms
Request “trial” increase in dose Levo to 75mcg daily……or initially 50mcg and 75mcg on alternate days
And if they still refuse say you request referral to endocrinologist
Print these guidelines out and be ready to quote verbatim
Guidelines of dose Levo by weight
approx how much do you weigh in kilo
Even if we frequently start on only 50mcg, most people need to increase levothyroxine dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until eventually on, or near full replacement dose (typically 1.6mcg levothyroxine per kilo of your weight per day)
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
TSH should be under 2 as an absolute maximum when on levothyroxine
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).
Here’s link for how to request Thyroid U.K.list of private Doctors emailed to you, but within the email a link to download list of recommended thyroid specialist endocrinologists
Ideally choose an endocrinologist to see privately initially and who also does NHS consultations
Thank you SlowDragon. I am 86kg at the mo but am consciously losing weight to be at my personal optimum weight. Everything helps.
I have booked another appointment with the doctor after a fresh full blood count and then if that shows up with nothing else making me tired I’ll request a trial at 75mcg.
I’ll also have a look at the private doctors too as need this sorting asap.
Thank you so far for all your suggestions. This is why I love this site. ☺️
Elevated antibodies indicates the auto immune Hashimotos. I needed more than 50mcgs, as others say, it's a very minimal dose. I went up gradually to 125mcgs but the best thing for my symptoms - fatigue, pain, brain fog, weight gain etc., was going gluten free. I haven't managed dairy free as I don't eat meat or fish and it was difficult. My TSH went right down and I have reduced Levothyroxine to 100mcgs for a start (to be rechecked soon) I have even lost weight. 😊,
Hi trisha7. Thank you for those helpful suggestions. I have gone gluten free since October last year and a lot of my symptoms eased. They want to test me for ceoliac but I’ll have to eat gluten again for 6-8 weeks prior to a blood test and I’m not looking forward to doing that if I decide to do it!
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Elevated antibodies? Thyroid peroxidase antibodies 808.5 IU/mL (<34)
