hi all, I posted last week… I had my results back today. Was on 50mcg in April to August, increased to 75mcg in August, 8 weeks later here are my results before and after:
August (50mcg)
TSH 2.83
T3 4.1
T4 13.8
today (75mcg)
TSH 2.52
T3 4.9
T4 15
so it’s definitely an improvement, but do we think a trail dose of 100 should be requested? Symptoms are improving but still extremely tired. X
Ask for next dose as a trial if necessary. TSH well over 1 where most people feel well.
Do include reference ranges for each test. These are not standrd so important to quote.
TSH 0.25 - 4.2
T3 3.1 - 6.8
T4 12 - 22
Free T4 (fT4) 15 pmol/L (12 - 22)
Ft4 (levothyroxine ) only 30.0% through range
Free T3 (fT3) 4.9 pmol/L (3.1 - 6.8) 48.6%
Definitely request next increase to 100mcg ….as a trial if necessary
which brand of Levo are you currently taking
when adequately treated likely to need Ft4 at least 60-70% through range
Keep working on vitamins as discussed in previous post
And consider trialing gluten free diet soon
It’s definitely increasing and improving since last time so I’m grateful for that! Just need the extra push to get to 100% x
Have these guidelines printed out and ready to quote
nhs.uk/medicines/levothyrox...
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
gponline.com/endocrinology-...
Graph showing median TSH in healthy population is 1-1.5
web.archive.org/web/2004060...
Comprehensive list of references for needing LOW TSH on levothyroxine
healthunlocked.com/thyroidu....
onlinelibrary.wiley.com/doi...
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).
sciencedirect.com/science/a...
The optimal daily dose in overt hypothyroidism is 1·5–1·8 μg per kg of bodyweight, rounded to the nearest 25 μg.
Thank you! How often do we need to re-test? X
Retest 6-10 weeks after increasing to 100mcg
As you get nearer your eventual dose…..you can leave longer between increase and testing
Retest again every 3 months until levels remain stable
And maintain optimal vitamin levels too
Managed to get an increase to 100mcg!!
Although I was told I was sub clinical hypothyroidism which I have no idea what it means!
'sub clinical' hypothyroid just means , at diagnosis( before taking any levo) , the TSH was over range , but the fT4 level was still within range . (the high TSH shows the pituitary is 'asking' your thyroid to try and make more T4 because the amount of T4 it is producing is not quite enough for your body's needs , but at this point it is still managing to produce just enough T4 to keep it within range)
if the situation has become worse and the TSH was over range AND the fT4 was below range, it would be called 'overt' hypothyroid. This means that even though the pituitary is asking the thyroid to try and make more T4 ,,, the thyroid cant manage to make enough to keep T4 within range.
These are rather arbitrary definitions , and they are not directly related to the level of symptoms people have .... a few people who are 'overtly' hypo will not notice any significant hypo symptoms just feel a bit below par , while others will be freeing cold zombies without the energy to string a sentence together . It's the same with 'subclinical' hypo.... some will feel basically ok and some will be really struggling to function normally.
As far as the NHS is concerned the difference is that for overt hypo GP's 'should' start treatment with levo even if symptoms are not a problem... while subclinical is a case of 'could consider treatment with levo IF symptoms are causing problems'
Help with results please..
New blood results 
"good' results?
Please can anyone help with my latest blood results
