thyroid results since changing from 200mcg to 225

[Thyroidmeg]

my tsh has come way form I’ve never been this low ?? My ft4 has gone way up ?

My antibodies are normal

[Thyroidmeg]

this was a few months ago

May results before change in levothyroxine

[Thyroidmeg in reply to Thyroidmeg]

results from dr which made him increase levo

NHS results

[greygoose]

Pretty certain that you have Hashi's even if your TPO antibodies are 'normal'. Perhaps your Tg antibodies are high? Or you're one of those people that have Hashi's without high antibodies.

Not surprising your TSH is low - although not that low - with that extremely high FT4. But it seems very unlikely that your FT4 would go that high just on a 25 mcg increase in dose. More likely to be a Hashi's 'hyper' swing, I would think.

[Thyroidmeg in reply to greygoose]

I’m finding it all a bit scary it is quite a difference from the recent test . The antibodies test said the same as you that just because I have normal

Antibodies doesn’t mean i don’t have hashis that 1 in ten with Hashi have normal

Antibodies .

[greygoose in reply to Thyroidmeg]

Well, there's really nothing to be scared of. Just makes it difficult to find the right dose.

But, how long was the gap between your last dose of levo and the blood draw for that test?

[Thyroidmeg in reply to greygoose]

Both times about ten hours . So that I could go to post office after taking test

[greygoose in reply to Thyroidmeg]

OK! Panic over! You have a false high FT4 there. You should leave 24 hours.

[Thyroidmeg in reply to greygoose]

Ok that’s good news then. The dr test will be 24 hours as I don’t take it til after bloods

[greygoose in reply to Thyroidmeg]

[Thyroidmeg in reply to greygoose]

recent antibody test has increased from 13 to 17 since may

Antibodies September

[Thyroidmeg in reply to Thyroidmeg]

normal explanation from September (same text as may)

[greygoose in reply to Thyroidmeg]

Whether they're negative or positive anybodies fluctuate all the time. It doesn't mean anything.

[Thyroidmeg in reply to greygoose]

could it be related to my high white blood count and haemoglobin. That’s getting tested again next week

[greygoose in reply to Thyroidmeg]

What? The increase in antibodies. No, no connection.

[Jaydee1507 Administrator]

Have you changed how you take your Levo? Your TSH was high for someone on 200mcg Levo before.

Were both tests taken under the exact same conditions - time of day and when you took last dose of Levo?

Did you take Levo just before this test?

Are you now supplementing vit D? With how much?

[Thyroidmeg in reply to Jaydee1507]

No I take it the same away from my other meds in the morning . Both tests same conditions yes

I was always taking vitamin d3 800iu from dr but even when I was insufficient the surgery just said are you taking them but didn’t increase dose. So I take 2000 myself now

[Jaydee1507 Administrator in reply to Thyroidmeg]

So you didnt take Levo just before the test? You allowed 24hrs from last dose & blood test.

Liely you need to try and get some T3 added rather than increasing Levo which is just taking you over range which isnt good.

You can email [e-mail] for a list of T3 friendly Endo's. Make a post asking for feedback on 1 or 2 of them with replies by personal message only.

[Thyroidmeg]

I’m getting the thyroid tests at dr st end of October again to see how increase in Levo has affected levels . They don’t test t3

[SlowDragon Administrator]

Significant minority of Hashimoto’s patients only have high TG antibodies (thyroglobulin)

NHS won’t test TG antibodies unless TPO are high

You need to test privately

20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis

Vitamin D - I take 2000 myself now

So you need to test

Even 2000iu may not be high enough dose

When were Vitamin D, folate, B12 and ferritin levels last tested

Are you taking any B vitamins?

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)

If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test

If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal

Do you always get same brand Levo at each prescription

[Thyroidmeg in reply to SlowDragon]

They refused to test b12 and nurse rolled her eyes when I said can you test b butane but I will ask dr again

My ferritin hasn’t been done for a few years it was very low . I went to dr snd said I was concerned about my hair and he looked and said nothing and did nothing .

Nurse said thyroglobin is fine no need.

I asked different nurse for ferritin and she ignored me. I asked for d and explained I was on pills for it and wanted it tested and she gave in and tested d last month and it was insufficient

My levo is different type every 2 months when I get it . Assuming the buy cheapest

Vit d levels

[SlowDragon Administrator in reply to Thyroidmeg]

so you will need to test yourself

It’s not fair, but NHS monitoring is useless

Exactly what vitamin supplements are you taking

Test after minimum 6-8 weeks on same dose and brand of Levo

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...

Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee

Only do private testing early Monday or Tuesday morning.

Tips on how to do DIY finger prick test

support.medichecks.com/hc/e...

[SlowDragon Administrator]

work out which brand of levothyroxine suits you best and request/politely insist GP specifies that brand on prescription

Many members don’t get on with Teva

For others it’s the best

Many people find Levothyroxine brands are not interchangeable.

Most easily available (and often most easily tolerated) are Mercury Pharma or Accord

Mercury Pharma make 25mcg, 50mcg and 100mcg tablets 

Mercury Pharma also boxed as Eltroxin. Both often listed by company name on pharmacy database - Advanz

Accord only make 50mcg and 100mcg tablets. Accord is also boxed as Almus via Boots, 

Wockhardt is very well tolerated, but only available in 25mcg tablets. Some people remain on Wockhardt, taking their daily dose as a number of tablets 

July 2024

Crescent levothyroxine. Dosages: 12.5, 25, 50, 75, 100

(Not yet known if all approved dosages are or will be available).

Excipients: lactose monohydrate, maize starch, croscarmellose sodium, gelatin and magnesium stearate.

Lactose free brands - currently Teva or Vencamil only

Teva makes 25mcg, 50mcg, 75mcg and 100mcg

Many patients do NOT get on well with Teva brand of Levothyroxine.

Teva is lactose free.But Teva contains mannitol as a filler instead of lactose, which seems to be possible cause of problems. Mannitol seems to upset many people, it changes gut biome 

Teva is the only brand that makes 75mcg tablet.

So if avoiding Teva for 75mcg dose ask for 25mcg to add to 50mcg or just extra 50mcg tablets to cut in half

But for some people (usually if lactose intolerant, Teva is by far the best option)

Vencamil is lactose free and mannitol free. originally only available as 100mcg only, but 25mcg and 50mcg tablets became available Sept 2024

March 2023 - Aristo now called Vencamil

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

How to get Vencamil stocked at your local pharmacy

healthunlocked.com/thyroidu...

Helpful post about different brands

healthunlocked.com/thyroidu...

List of different brands available in U.K.

thyroiduk.org/if-you-are-hy...

Posts that mention Teva

healthunlocked.com/search/p...

Teva poll

healthunlocked.com/thyroidu...

Once you find a brand that suits you, best to make sure to only get that one at each prescription.

Watch out for brand change when dose is increased or at repeat prescription.

Government guidelines for GP in support of patients if you find it difficult/impossible to change brands

gov.uk/drug-safety-update/l...

If a patient reports persistent symptoms when switching between different levothyroxine tablet formulations, consider consistently prescribing a specific product known to be well tolerated by the patient.

academic.oup.com/jcem/artic...

Physicians should: 1) alert patients that preparations may be switched at the pharmacy; 2) encourage patients to ask to remain on the same preparation at every pharmacy refill; and 3) make sure patients understand the need to have their TSH retested and the potential for dosing readjusted every time their LT4 preparation is switched (18).

And here

pharmacymagazine.co.uk/clin...

Discussed here too

healthunlocked.com/thyroidu...