High thyroid reading

[lorrainewilson64]

Morning everyone just had my review at the dandruff they said my thyroid is high . I'm waiting for a doctors call to discuss what next . The reading is 7.82ml U/L . I'm on 75 strength thyroid. Just wondered what it means .

[lorrainewilson64]

Sorry should have said DOCTORS. Lol

[Bearcubs in reply to lorrainewilson64]

Sorry I giggled when I read that lol 😆

[Obsdian in reply to Bearcubs]

Me too. My phone does this to me all the time.

[Bearcubs in reply to Obsdian]

Mine does too lol 😆 😂

[Sparklingsunshine in reply to Obsdian]

Good ole predictive text haha.

[helvella Administrator in reply to lorrainewilson64]

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[Jazzw in reply to lorrainewilson64]

Ah, the doctor’s, those flakey people. 😂

[Obsdian]

A high tsh means you're not getting enough thyroid hormone and will need an increase.

[lorrainewilson64 in reply to Obsdian]

Thank you. I got confused as the nurse told me that the doctor would call me and most probably reduce my thyroxine as its too high . I said shouldn't it be increased and she said No , it's the opposite.

[Obsdian in reply to lorrainewilson64]

That nurse doesn't know what she's talking about. Above range means too little hormone, bellow range means too much (unless you're on t3 and its suppressed).

[Bearcubs in reply to Obsdian]

Yes, I used to get so confused about that but too high definitely means an increase x

[lorrainewilson64 in reply to Obsdian]

Not on T3 . They wouldn't ever give it to me .

[Sparklingsunshine in reply to lorrainewilson64]

Gordon Bennet, its scary that these ' health professionals' are alive and walking amongst us. If they dont understand this very basic thyroid information they honestly have no business being allowed anywhere near patients.

[Jingley in reply to Sparklingsunshine]

This is so true. I once had blood taken by a nurse who was also talking Levo. She seemed really shocked that I was on such a 'high dose' as she put it - 100mcg. She was taking 50mcg and said that was enough for her as her TSH was now just within range. She looked exhausted.

[Sparklingsunshine in reply to Jingley]

It never ceases to surprise me that people are so trusting and accepting of whatever a doctor tells them. They never question why they still feel rubbish. I'm a natural rebel, I challenge everything 😆

[SlowDragon Administrator]

You are legally entitled to printed copies of your blood test results and ranges.

important to see EXACTLY what’s been tested

The best way to get access to current and historic blood test results is to register for online access to your medical record and blood test results

UK GP practices are supposed to offer everyone online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.

This currently only applies in England, not across the whole of the UK. Nether Scotland nor N.Ireland have released an NHS app for patients. (Scotland supposedly due in December '24.) Wales has an app, but only for booking appointments, repeat prescriptions and amending personal details

In reality some GP surgeries still do not have blood test results online yet

Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up.

Was recent test early morning and last dose levothyroxine 24 hours before test

Is your hypothyroidism autoimmune

Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine

For full Thyroid evaluation you need TSH, FT4 and FT3 tested

Also both TPO and TG thyroid antibodies tested at least once to see if your hypothyroidism is autoimmune

What brand levothyroxine are you taking

Do you always get same brand at each prescription

What vitamin supplements are you taking

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

75mcg is only one step up from standard starter dose

Unless very petite likely in need of dose increase as shown by high TSH

[lorrainewilson64 in reply to SlowDragon]

Thank you for your reply. My brand has changed from Teva to Crescent for the past months. Wonder if this is why it's high.

[SlowDragon Administrator in reply to lorrainewilson64]

Are you lactose intolerant

On dairy free diet?

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 Vencamil or Teva

Vencamil is lactose free and mannitol free. originally only available as 100mcg only, but 25mcg, 50mcg and 75mcg tablets became available Sept 2024

Prior to March 2023 Vencamil was called Aristo

Vencamil often very well tolerated/best option for many people

How to get Vencamil stocked at your local pharmacy

healthunlocked.com/thyroidu...

Posts discussing Vencamil

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu....

Teva makes 12.5mcg 25mcg, 50mcg, 75mcg and 100mcg

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

For others Teva is by far the best

Teva is lactose free, but 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 

Helpful post about Teva

healthunlocked.com/thyroidu...

Posts that mention Teva

healthunlocked.com/search/p...

Teva poll

healthunlocked.com/thyroidu...

Relatively new ……Hillcross brand

This is a box, rather than a brand. 50mcg and 100mcg are Accord brand….but beware 25mcg is Teva brand

Helpful post about different brands

healthunlocked.com/thyroidu...

List of different brands available in U.K.

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

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...

[SlowDragon Administrator]

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 somewhere near full replacement dose (typically 1.6mcg levothyroxine per kilo of your weight per day)

cks.nice.org.uk/topics/hypo...

bnf.nice.org.uk/drugs/levot...

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.