I was diagnosed with hypothyroidism (autoimmune) April 2024.
I have been back to the GP 8 times with continued and continued symptoms mainly severe fatigue, debilitating brain fog, anxiety , depression and just off balance.
July blood panel showed:
TSH 1.50
FREE T4 13.8 (12-22)
T3 4.1 (3.1-6.8)
the GP has brushed me off numerous times and said it is all in my head I just have mental health issues. After months of research I think I need to try adding some T3 to my levothyroxine (currently on 75mcg)
can anyone recommend how to self source?
thank you
Written by
CAB123x
To view profiles and participate in discussions please or .
I’m not sure that you need T3. An increase in dose of levothyroxine would probably do the job. I take it your doctor is resistant to raising your dosage?
It'll be down to your TSH. Unfortunately happens to alot of us. I waited and waited, getting more and more unwell and decided to go private to get more Levo. Hopefully once I prove I'm better on a higher dose my GP will agree to prescribe it.
What time did you have your blood test? Are you taking any biotin?
Sorry I’m new to this but does taking levothyroxine raise T4 and lower TSH?
I think I’ll have to go private. I had my bloods fasted at 9am don’t take biotin. However I’m thinking of changing to taking it at night purely to make sure I stay away from food and drink. I suffer really bad with anxiety so it doesn’t help that either! X
That's okay, yes levo is T4, so it rases your T4 and lowers your TSH. You may find over the coming months your TSH raises again but GPs are so scared of TSH that if it's in the range they don't like to agree to an increase. My private Thyroid specialist GP said she finds people often don't feel better until their TSH is 0. Something. So under 1.
I am a long way off being well but I'll still need another few increases I think. My anxiety has improved alot since getting to 100mcg however.
Hey there,.looking at your bloods, your T4 is still very low in range and 75mcg is a very low dose, so probably an increase in levo is the first step. Your need your T4 higher in the range and that should bring your T3 up also.
If your GP isn't forthcoming with an increase then maybe look at going private (if you can) to a specialist GP/clinic
Hi CAB123x I'm really sorry to hear about the symptoms you're experiencing—they sound incredibly tough, and you deserve to feel better. I strongly recommend discussing an increase in your levothyroxine with your doctor. Since you started it recently, and both your results and symptoms indicate room for improvement, it’s worth exploring a higher dose. Many people with hypothyroidism find relief with just levothyroxine, and at 75mcg, there's definitely potential for adjustment without concern.
If your current GP isn't responsive to your needs, it might be time to consider finding a new one. Hypothyroidism is a lifelong condition, and you deserve and need a healthcare professional who listens and supports you, rather than dismissing your concerns.
Regarding T3, it's something to consider only after you've given levothyroxine a proper trial, potentially up to a year at the appropriate dose. Best of luck .
Thank you I really appreciate it. Do you know if there’s a link between running and thyroid disease? I was diagnosed just after I ran the London marathon so I’m thinking maybe my body had just had enough of the over exertion!
There is a study about mice and T3 depletion. I think @ tattybogle has it. (I'm on my phone so can't find where I saved it!)
But I was diagnosed after running a half marathon and I am firmly convinced that the training and race was what tipped me over the edge into total thyroid failure.
I can trace symptoms and flares all the way back into childhood but I managed and was functional until the race.
I have removed your private email. There is chat facility on forum which can be used. We don’t recommend recommending posting identifiable information.
Gosh that’s so similar to me! I’ve ran 2 or 3 half’s and a full marathon and after the London marathon April was when it really started to go downhill! Do you still run?
I think I’ve run a dozen half’s or more… two full, I ran/walked another full (after diagnosis… a great day, BIG mistake Im pretty sure I paid for for about 5 months after), and ran about 5+ 5ks a year for a decade, and some 10ks (my favorite training distance) too.
All the while my Hashis was killing my thyroid and my adrenal system was going completely out of whack.
Years and years and years of damage and imbalance to dig out of.
The month I was diagnosed was summer 2 years ago. I distinctly remembering trying to run the track and having to stop so much, I thought it was the heat. You know those wonderfully hot and sweaty and sunny runs… but this one I kept doing sprints as I just had to walk.
When I got the diagnosis, the first thing I googled was what my outlook for running would be.
I read an article by a woman that said she just had to give up on running and switch to yoga and other similar things. I was crushed.
Now, 2 years later. And I’m finally at very close to optimal dosing, in the past couple months I’ve been living a normal active life working and going places and stuff.
I am just now contemplating the idea of regaining my old self back - making moves towards my old running self.
Right now I am just thinking about it : )
I have no expectations. I’d be happy with a daily 35-40 min 5k : ) ha!!!! I’m thinking about that and I think I actually would accept that forever if I could have it.
But now that I am functioning , brain fog gone, active and by all appearances living a normal life , just wondering what platform of health/hormones I have and just how slowly I can move to the next level.
I’ve often wanted to make a list of runners on this board. Get us all together and share how long we were sick before diagnosis, how long it took to get back to some level of functioning, and who is running. Maybe soon.
For me personally I’m looking for those who really hit bottom before diagnosis and treatment. I have a feeling some here run, but I too am trying too see experience for those that fell far down and were able to work back up.
That sounds very similar to my experience. So I’ve ran for around 15 years now, had 2 breaks in that time
To have my two babies who are now 4 and 2, around 1 year ago was when I began to feel extremely tired but just assumed it was due to having two little ones, then just before the London marathon I had some bloods and an ECG done and that’s when they picked up low iron and hypothyroid. Started on 50mcg levothyroxine and sent me on my way. Did the marathon one week later and honestly haven’t felt the same since. That was 6 months ago to the day. I’ve honestly been back to the GP 10 times in the past few months with symptoms of anxiety, debilitating brain fog and just exhaustion and each time they’ve said your levels are in range it’s anxiety - I have managed to continue 5k’s probably twice or 3 times a week but I struggle with them a lot. It makes me question how I ever ran further than 5k before!! I think now is the time I need to stop running all together and have a few months break until I start to feel a little bit more normal because right now it’s super hard to function. The funny thing is, the reason I run is to help the anxiety! I’ve also started gluten free (only 2 days in to that) and began eating better, more veg and more regular. I am so pleased you’re feeling better and like your old self!! It must be such a relief 🥲
Definitely a good idea to gather some runners/gym lovers with hashi’s/hypo and hear everyone’s stories! X
Here’s me just telling you to listen to your body.
To share my experience - for as long as your thyroid hormones are so low, they are not enough for basic exertion much less a 5k.
Long story short - when we run as healthy people, our thyroid hums along like a warm engine, powering us forward as it gives us energy.
We all understand how food gives us energy. I’m sure you’ve calculated how many calories per 15 minutes you need to get through a marathon : ) Our thyroid is responsible for that metabolism.
But it’s misleading because metabolism is not only the process of how our body breaks down food and converts it to energy. But also how our body converts that food into energy TO RUN CELLULAR PROCESSES, from head to toe.
The reason that is important for hypo folks and especially looking at your low results, is that when your engine isn’t warmed up and working… then when you run and need a burst of energy, your adrenaline/cortisol adrenal system kicks in to compensate.
That’s like always having your turbo boosters on, and that will burn the whole system out.
As I noted above, I am fairly certain if I hadn’t run so much on my turbo boosters I would not have such a hole to dig out of.
Just sharing my experience. I’ve done a lot of walking and very little running/jogging for the past / years. This will soon be my next priority to tackle.
Gosh I wish I would have spoken to you months ago, because the ‘burn out’ feeling, the daily symptoms of detachment, fatigue, brain fog and anxiety are also symptoms of adrenal fatigue! Very interesting. From this day forward I’m going to stop running entirely, and just continue walking at least until my results are stable, I don’t even care if that takes me a year as long as I start to feel better! I can’t thank you enough for sharing your experience and I’m so pleased you’re feeling better these days. I hope you get to do your first 5k soon!!! Xxx
You need to stop running. Not for a few months. You need to stop. Maybe in the future when you are fully well again you can consider starting back slowly. You are currently killing your adrenal glands trying to run on such poor thyroid function and inadequate medication.
The emphasis now is to get better. And that takes time. If we try to rush it, or we self treat and rush it/get it wrong, it can take years to sort out. You will just make the whole thing worse by over exercising now. Sorry to be the bearer of bad news. But this is serious.
I know, I have made the decision to totally stop running. I’m absolutely gutted but I feel to unwell to continue. Please give me hope that once my meds are right and I’m on the right dose for optimal levels I’ll feel better? Because right now I feel so depressed 😔
It's a very depressing condition. Being under active and not optimally medicated makes us more depressed. It's a symptom. Try not to feel gutted. Go for a nice walk instead. Walking is a much better replacement. And we get fresh air and light.
Many people make a full recovery on the right meds. But it takes time and you also have to wait for the increases in recovery to help your adrenals recover too.
I was a hoop dancer. I exercised every day with hoops and music, often more than once a day. I also swam a lot. I rode a bike. Then one day I decided that the weight loss I had been doing using a low carb diet had stalled. So I looked into it and decided to try Keto diet. HUGE mistake. People in that world said I would feel like I had flu for 2 weeks. I felt like I was dying! And when several weeks in, exhausted, broken and so ill feeling I decided to stop it and go back to a sensible diet, it was too late. I was broken.
I recovered a bit, but not enough. Weight piled back on. No energy. I was diagnosed with hypothyroidism soon after. For me that was something like 8 years ago and I'm functional, slowly, but I'm far from well. I have taken my care into my own hands and with the help of this group of people and my private endo. I pretty much self treat and self test. I get 50 mcg of Levo a month off the GP now (I was on 125 mcg) and I mix that with natural desiccated thyroid. I'm trying to find a better dose, but I suffer when I increase.
My endo says I was sick a long time before I realised it. So I have a triangle of hormone disregulation going on now and it's hard to fix because it all needs to be fixed at the same time. I have insulin resistance, hypothyroid and high levels of cortisol. I'm also menopausal so need HRT, but thankfully that works well. I have permanent atrial fibrillation. I inherited it from my dad, but it will have been exacerbated by the hormonal chaos. This is why I advised you to stop running. You don't want to get into this mess because it's hard to get out of.
But I'm a bit extreme. I have also inherited a common gene defect from one parent that stops my body converting T4 into T3 reliably. You have good conversion. For now you need to focus on getting your Levo dose increased until your FT4 is around 70% of the reference range and your FT3 is nice and high in range, and if you can't do that through your GP go privately. Levo is cheap to buy so once you have the help of a private doctor or endo to get you on the right dose you won't need to see them very often.
Good luck. Allow yourself room to feel sorry for yourself. God knows how anyone manages this with small children. You are a heroine.
Thank you so much for your reply. I am so sorry you’ve had to suffer for so long. I’m quite hopeful that if I stop running, get my dose increased and am steady on the correct dose I will make a full recovery. My mum also has it and is absolutely fine. I’m only 32 so hopefully it’s been caught early enough to treat x
Yes, you have a lot in your favour. I burnt the candle at both ends I'm afraid. Along with the exercise I loved I also ran a theatre and stage managed several productions a year as well as running a business. That meant long, long busy days. Getting home gone midnight far too many times a year. I loved it all though. But when menopause came it was just a straw too many for the camel and it all crashed down.
It's a bit of an all encompassing mistress is theatre. I thought I could not live without it from the age of 14 until around 2018 when something happened with the theatre company and I had to step back. And then when we went through lockdowns I got used to not being out every evening for weeks at a time.
Since the end of lockdowns my hypo state has been worse and now I don't have the energy for running shows and I've not set foot inside one as audience either. It feels odd when I think about it. But it feels right for me at this point in time. Never say never. I never give up trying to find the key to better energy.
My endo thinks my insulin resistance is a big problem. So he put me on a medication used by diabetics to control that. An injection medication. My GP was happy to prescribe and it worked. I had more energy and I lost weight. I decorated! But then dad died and mum didn't want to handle any of it so I had to take over and the moment I'd finished sorting out the money side for mum and transferring the house etc. lockdown happened. I think the stress of all that knocked me back. I have not been able to get that medication for well over a year now due to skinny celebs who have made it fashionable to be even skinnier and brag about the "skinny jab". Diabetics relied on that drug. They can't get it now either. Sometimes social media is a right pain in the bum. I am hoping I might be able to get a different type of the same sort of medicine soon. Endo is recommending it, but not sure if GP will prescribe. My adrenal issues will sort themselves out more quickly if my insulin resistance is reduced.
On levothyroxine dose should be slowly increased until Ft4 is at least 60-70% through range
Approximately how much do you weigh in kilo
75mcg is only one step up from standard STARTER dose
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 somewhere near full replacement dose (typically 1.6mcg levothyroxine per kilo of your weight per day)
Adults usually start with a dose between 50 micrograms and 100 micrograms taken once a day. This may be increased gradually over a few weeks to between 100 micrograms and 200 micrograms taken once a day.
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).
The optimal daily dose in overt hypothyroidism is 1·5–1·8 μg per kg of bodyweight, rounded to the nearest 25 μg.
Your GP is INCORRECT not to increase your dose
Write to GP with results including percentages through range
And include copies of guidelines (assuming your weight suggests you need next increase to 100mcg )
Have you tested vitamin D, folate, B12 and ferritin
ESSENTIAL to test these at least annually minimum
Exactly what vitamin supplements are you taking
Is your hypothyroidism autoimmune
If GP still refuses to increase your dose levothyroxine
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 so that might eventually transfer to NHS
Vitamin D, ferritin and b12 were all ok. I take selenium and iron supplements only.
I’ve been on 75mcg for 7 weeks, have another blood test on Wednesday but I know they will refuse to increase it. I think private is the only option unfortunately 😞
Serum ferritin level is the biochemical test, which most reliably correlates with relative total body iron stores. In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency
Never supplement iron without doing full iron panel test for anaemia first and retest 3-4 times a year if self supplementing.
It’s possible to have low ferritin but high iron
Test early morning, only water to drink between waking and test. Avoid high iron rich dinner night before test
If taking any iron supplements stop 5-7 days before testing
This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.
Post discussing just how long it can take to raise low ferritin
A trial of strictly gluten free diet is always worth doing
Only 5% of Hashimoto’s patients test positive for coeliac but a further 81% of Hashimoto’s patients who try gluten free diet find noticeable or significant improvement or find it’s essential
Gluten Free often improves anxiety
A strictly gluten free diet helps or is essential due to gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)
Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and may slowly lower TPO antibodies
While still eating high gluten diet ask GP for coeliac blood test first as per NICE Guidelines
The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported
In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned
Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.
Similarly few months later consider trying dairy free too. Approx 50-60% find dairy free beneficial
With loads of vegan dairy alternatives these days it’s not as difficult as in the past
Igennus B complex popular option. Nice small tablets. Most people only find they need one per day. But a few people find it’s not high enough dose and may need separate methyl folate couple times a week
Thorne Basic B recommended vitamin B complex that contains folate, but they are large capsules. (You can tip powder out if can’t swallow capsule) Thorne can be difficult to find at reasonable price, should be around £20-£25. iherb.com often have in stock. Or try ebay
IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 5-7 days before ALL BLOOD TESTS , as biotin can falsely affect test results
In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg)
Post discussing how biotin can affect test results
As a rule of thumb, levothyroxine replacement should be around 1.6 mcg per kg of weight. I have attached the official NICE clinical guidelines, which clearly state this and that you could show your physician:
So if you weigh 60 kg, your replacement level should be 96mcg, rounded up to the nearest dose, that would be 100 mcg. This would also ensure that your T4 goes a bit higher and your T3 as well, as they are not very high. Most people feel well when the TSH is around 1 or less, and T4 & T3 are between 60 and 75% through the range, so you still have room to improve.
This calculation of 1.6 mcg/kg is just a rough guide, some people will need more, some are okay with less - but as you have hypothyroid symptoms, you should definitely be given another 25 mcg increase.
If your GP is still not budging after showing him the NICE guidance, I would really be thinking of changing GP. It is no good, if you are fobbed off and at the end of the day it is your health they are playing with and you will have to suffer their ignorance.
A clued up medic should look at your situation and increase your levo by 25mcg straight away
Instead they have looked at your TSH and decided that's fine, which is complete rubbish. They must consider FT4 as well and ideally FT3
Your FT4 13.8 (12-22) is 18% through the reference range
Your FT3 4.1 (3.1-6.8) Is 27.3% ditto
We aim to have both Frees approaching 75% ditto
So you can see immediately that these labs are abysmally low, you are undermedicated and need an increase to 100mcg levo/T4
Test again after 6/8 weeks and review the dose
It is vital to optimise vit D, vit B12, folate and ferritin to support thyroid function
Have these been tested?
Fortunately your T4 to T3 conversion is fine so no need to add T3
You will likely need at least 2 further increases of 25mcg levo ie 125mcg levo
Your symptoms are text book examples of hypothyroidism/ undermedication. Tick off ALL your symptoms on the list below and stick it under this medic's nose and ask him on that evidence to give you a trial increase of 25mcg........they like "trial" it leaves them thinking they are in charge!!!
If s/he still refuses an increase then complain to the Practice Manager that this GP isn't listening to you and is refusing to let you trial an increase. Any decision about treatment is supposed to be made jointly with medic AND patient.
Don't accept this poor treatment and the poor knowledge from this medic.....all too common these days
Honestly thank you so much. You’ve made me feel listened to. The GP I saw last time made me cry, I begged him to let me increase due to feeling so unwell and he told me to get out of his surgery and it’s all in my head. I have an appointment first week of November so I will see how that goes, if not I will definitely be self funding privately (which should never have to happen!!!)
if not I will definitely be self funding privately (which should never have to happen!!!)
You will find many U.K. medics have extremely limited understanding of autoimmune thyroid disease
This is by far the most busy forum on HealthUnlocked
Over 140,000 members, vast majority are U.K. based
There’s at least 2 million people in U.K. on levothyroxine. Approx 90% is autoimmune
This is not a rare disease…..but it can be difficult to get treated correctly
Levothyroxine does not “top up” failing thyroid…..it replaces it
It’s important to increase levothyroxine SLOWLY up
You may see TSH has increased at next test 🤞
Initially TSH drops after each dose increase, then as your body gets use to increase in metabolism then TSH (should) slowly rise
However ….many many Hashimoto’s patients have sluggish TSH…..then most important results are always Ft3 and Ft4…..plus OPTIMAL vitamin levels
Low vitamin levels tend to lower TSH
Levothyroxine is an extremely fussy hormone and should always be taken on an empty stomach and then nothing apart from water for at least an hour after
Many people take Levothyroxine soon after waking, but it may be more convenient and perhaps more effective taken at bedtime
No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap.
Some like iron, calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away
(Time gap doesn't apply to Vitamin D mouth spray)
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
I'm so sorry about your situation, frankly this " doctor" has no business being anywhere near patients, he should retrain as a pathologist, the dead dont complain and he can be as much of an arse as he pleases.
I think a complaint is in order, even if he does think you have MH issues that is no way to speak to someone in a vulnerable state. Its absolutely shocking. is there another GP you can see?
Your "doctor" sounds like a sociopath. You are clearly unwell and you should be dosing to symptom suppression with one eye on the bloods to check they are OK. Instead he's dosing to the tsh which is not the best nor only metric and ignoring the patient.
Most people would get another doctor or take things into their own hands.
I'm not qualified to advise but would have thought trialling higher doses of t4 would be the next step to discuss with a doctor before considering t3.
Oh it makes me so mad , he shouldn’t be a doctor,I hope you get sorted soon , my dr told me we don’t take any interest in t3 , I said I think if you had a thyroid disorder you’d take notice then , good luck and a big hug
Time to go head to head with your GP....and the surgery. Don't accept any excuses....there are none!
I don't think you should be pushed into private treatment because of an incompetent GP, when your condition could be readily treated on the NHS with more levo.
If this GP doesn't help can you see another in the Practice? Or complain. They are not fulfilling their role by leaving you undertreated.
If you do decide to go private there is a list of more helpful doctors available via thyroid uk website. It isnot a good idea to see just any endo, some are as bad as the GPs when it come to thyroid care.
You may yet be one of the lucky ones CAB. You are clearly not on enough Levo and your T3 still manages to make a reasonable showing.
I found 75 mcg a particularly ‘difficult’ dose. I was prepared to put up with symptoms on 25 and 50 because I thought I was getting somewhere. It was quite different on 75 mcg. I was expecting things to settle down. My GP put me on to 75 under a little duress, I thought. In fact I acquired a brand new symptom, which is still with me three years later!
Your GP is obviously terribly ignorant and stuck in their limited thinking. You appear to be in a reasonable place. You just need your next increase in Levo.
Yes agreed, me too. 25/50i was doing okay. 75 and my anxiety was awful, like nervous breakdown awful. It was like my nervous system went haywire. It makes you question if increasing is the right thing but I can safely say that now I'm up to 112.5 my anxiety is alot better in general. Still not well though 😕
Yes I’m exactly the same! How strange! The GP even increased my antidepressants because of the feelings of heightened anxiety!!! I can’t believe we have such incompetent GPs honestly it’s scary!!! X
Ah I'm sorry you've had a rough ride, too. This forum has been a god send, I think I'd have come off levo all together without it. My cortisol is low and I think that may have been contributing to my issues tolerating an Increase. I now increase very slowly!
It’s also helping me that knowing it’s a common thing, when I was first diagnosed I was so anxious and worried about my future and felt like the only one in the world with it! X
Yes I know, it's very scary to feel SO unwell. I hope you can get an increase (maybe ask for 100/75 alternative) and that make you feel a but better xx
Yes I get symptoms (as do many people) and when I tried to increase from 75- 100 they were quite bad. Increased anxiety, chest pain, palpitations etc awful. So I now go slower, max of 12.5mcg a day increase, rather than 25mcg. For 6- 8 weeks then retest.
Not everyone has such a bad reaction, but some find weeks 3/4 can be a bit of a rollercoaster.
I suspect as I have low cortisol this is part of the reason
Me too arTistapple , 75mcg was a horrible dose. I think it fully suppressed my own hormone production but wasn't close enough to replacement. I used to feel terrible all day until about 5:30 and then rally. I assume the dose wore off a bit by that time and my own gland kicked in for a bit.
Remember to not have anything to eat or drink other than water before the blood test and don't take your daily dose until after the draw. Hopefully it's early in the morning?
Drat! You should leave 24 hours between last Levo and blood draw. You actually could do with your blood test revealing a higher TSH test, so although it will mean a longer gap between last meds and appointment if you skip tonight's dose, it could very well play into your favour. So next time adjust meds the day before so that you have a 24hr gap, but this time skip tonight's dose and let's hope it gives you a bit higher TSH to convince the GP to increase your dose. We have to cheat this system. But TSH is slow to rise so it might not help much. It won't hinder though. Take tonight's dose after your test and then take tomorrow's dose at bedtime as normal.
Do you know how long it takes for TSH to rise and to know if it’s the right dose? I’ve been on 75 for 8 weeks now and no improvement. Hoping if I do increase to 100, I can maybe start to feel better sooner rather than later if it’s the right dose for me x
TSH is different in different people because it's a pituitary hormone so it depends on the state of your pituitary. But it is a slower rise than thyroid hormone itself. But don't get hung up on that.
As many people have said here for you, 75 is a weird dose and many of us had a hard time with it. 100 mcg is still quite a low dose and many need more. So expect to feel a little better at first on an increase but then it tends to slip back and that is a good indicator that after your 8 week blood test you may need a further increase. I was on 125. But my poor conversion meant I needed to try a different approach. It's normal to feel a bit better at the start of a dose increase. Then we think "hey! I feel good, I'm going running/dancing/drinking/decorating/gardening etc. whatever you love, and you exhaust the new supply and slip back. It takes months of work to get to the right dose if you go slow. But going slow is the very best way.
I found asking to trial a small increase landed better with my GP than a direct approach for an increase. A trial acknowledges that there will be another blood test to check TSH and I know my practice would push back if my TSH fell out of the bottom off the range. However adding 25 every other day only reduced my TSH by 0.6, so they accepted it ongoing,
I’ve still got some symptoms so I’m thinking about another trial adding a little more
The NICE guidance does support this approach, but most GPs struggle to understand how TSH, T4 and T3 work together
hi, you’ve had lots of excellent advice already, but I just want to echo previous comments about Ferritin. It’s definitely lower than you’d ideally want and if you’re still menstruating and running it’s likely to deplete further. Low Ferritin can cause anxiety / brain fog etc too. It’s common for an endurance athlete to have low Ferritin (as a cyclist I’ve battled it too). I’d work on getting that up alongside your Levo increase. Good luck - you will get well again!
Hi, yes I was same, haemoglobin at v top of range in my case but ferritin very low. Years of heavy periods/childbirth twice/endurance training. I had an infusion as my ferritin was 7 but as your levels are not as low, I’d try taking one over-the-counter Ferrous fumarate (can get from your pharmacist) every other day and check all levels again in a few weeks. This was advice I got from my Consultant for keeping my levels up post infusion if they started dropping again.
n.b I had 2 infusions in the end and my ferritin went up to around 90 and my Haemoglobin dropped slightly.
Edited to add: I was already eating plenty of iron rich food / have never been veggie / but I wasn’t absorbing enough from food alone.
You can and I was assured that wouldn’t happen as ferritin would be topped up first (and it didn’t - my haemoglobin if anything fell slightly), but you would be advised on that as part of the procedure. I went to the Iron Clnic in London Harley St but there may be other providers near you.
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
Any endos prescribing/recommending T3?
Starting T3
T3 of 8.3
T3
Weaning off T3
