looking for advice on my diagnosis and meds

[Ailes99]

I am a 73 year old British female resident in Spain. I was diagnosed with hypothyroidism in February 2024 , when my TSH was 6.386 ( range 0.35 - 5.5). I was prescribed 25mcg Euthyrox daily. I was also prescribed Atorvastatin 20mg ( which I did not take).

my next blood labs in May showed

FT4 1.33 ( range 0.8 - 1.9)

FT3 3.28 ( range 1.4 - 4.4)

That was all that was tested.

I then changed doctors ( my choice).

My new Doctor agreed to my request for full blood labs for everything related to the thyroid, including antibody tests.

in September 2024my results were as follows,

TSH 5.10 ( range 0.27 - 4.20)

FT4 1.49. ( range 0.58. - 1.64)

FT3 was not tested by the lab this time, although requested by the doctor. When I asked why, she said it was probably because my FT4 was in range, so not necessary !!

vit D 55 ( range 20 - 99)

Folic acid 4.5 ( range 3.5 - 20)

B12 602 ( range 197 - 771)

Ferritin 263 ( range 15 - 150)

TPO 9 ( range <34 )

TG 13.6 ( range < 115)

Total cholesterol 224 (range 50 - 200)

Triglycerides 124 ( no range given)

Ferritin 263 ( range 15 - 150)

My doctor was ok with me not taking a statin. She said to continue with 25 mcg Euthyrox with next blood labs in 6 months.

Euthyrox is the only pharmaceutical I am taking currently, however I supplement with magnesium, turmeric, co q 10, red rice yeast , Danacol, stinging nettle extract, lutein, vit D k2mk7, 1 spoon evo.

My medical history is , high-ish cholesterol and osteoporosis. I have refused all bone meds and have had no fragility fractures.

I had no knowledge of hypothyroid symptoms till I was diagnosed, and have since learned much from Health Unlocked. The only symptoms ( minor), I have are brittle hair, brittle & ridged nails, digestive issues, and a protruding belly.

I was expecting my euthyroid to be increased, as I have been on 25 mcg since February. Since it hasn’t been increased I am wondering if I need it at all , as I understand it does not supplement the thyroxine the thyroid produces, but rather, makes it lazy ? Any comments or advice on my results would be much appreciated. I apologise for the very long post.

All blood labs were done before 9 am on an empty stomach and over 24 hours since the last dose of Euthyrox. Thank you for your patience.

[SlowDragon Administrator]

TSH 5.10 ( range 0.27 - 4.20)

FT4 1.49. ( range 0.58. - 1.64)

High TSH …..definitely suggests you need next dose increase in levothyroxine

Assuming you have ongoing hypo symptoms?

Request GP increase to 37.5mcg initially

Retest in a further 6-8 weeks

Folate is low

supplementing a good quality daily vitamin B complex, one with folate in (not folic acid)

This can help keep all B vitamins in balance and will help maintain B12 levels too

Difference between folate and folic acid

healthline.com/nutrition/fo...

B vitamins best taken after breakfast

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

Post discussing different B complex

healthunlocked.com/thyroidu...

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

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

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

healthunlocked.com/thyroidu...

helvella.blogspot.com/p/hel...

[Ailes99 in reply to SlowDragon]

Thank you, SlowDragon for your comprehensive and speedy reply. I will take time to digest your recommendations, and act on them. I live in Spain, so will have to research sources for your recommended supplements. The only symptoms I have ( high cholesterol, osteoporosis, brittle hair /nails, digestive problems etc), i have had for years, and don’t really know if they are thyroid related? The diagnosis came completely out the blue, and I don’t feel my symptoms are bad compared to others, but I thank you for your input.

[crimple]

Ailes99 in the past hypothyroidism was diagnosed when cholesterol was raised. Being on the correct dose of levothyroxine should result in lower cholesterol level. Your TSH shows you are not on a high enough dose of Levothyroxine. When hypothyroid we expect to have a TSH of around 1 if we are sufficiently treated.

[Ailes99 in reply to crimple]

Thank for your reply. That was why I refused statins. Just need to work on explaining to my doctor why my Levothyroxine should be increased .