I began Levothyroxine in May 2024 and started on 25mcg. This increased to 50 mcg (June 2024) and then more recently 75mcg (September 2024).
My TSH results are below:
Lab range 0.2-4.0
November 2024 3.9
September 2024 5.3
June 2024 5.1
May 2024 7.2 & 8.1
Note on lab range does say if on levothyroxine adequate replacement therapy indicated by TSH 0.2-2.
My doctor has messaged that my most recent test is normal and to stay on current dose of 75mcg. I think they have just looked at normal no further action on the header of the result and not at the note regarding adequate replacement indicates at 0.2-2.0.
Although my symptoms have improved I'm still not 100%. I still feel occasionally dizzy fatigued and some joint pain. However horrendously heavy periods have improved and can stay awake after work!
Should I be insisting the dose is raised to get TSH closer to 2.0 or is the GP right to be cautious as not to over medicate?
GP surgery previously refused to retest ferritin as was 17 (above the low of 15 on the lab range) and said to try iron supplements if I wanted to after this last blood test. Previous blood tests also showed am borderline perimenopause as FSH was 26. I am 47 years old. Vitamin D test refused also. However, I'm awaiting the results of a coeliac test.
Previous blood tests show high TPO and was started on levothyroxine due to strong family history of autoimmune disease (dad was type 1 diabetic).
Many thanks
Written by
Greyhound92
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Like you, I’ve had dreadful support with low iron from GPs. I couldn’t tolerate iron tabs so I was (eventually, encouraged by this forum) referred to nhs haemotology. Yeah they do take it seriously! I’ve had gastro investigations and I just had another nhs iron infusion when ferritin lowered to 46 because it’s impacted my thyroid hormones. You need good iron for thyroid meds to work.
Heavy periods, even if yours are now moderate, Tranexamic acid is a fantastic cheap treatment from GP that helps our iron. I just use it for first 48h. So good.
Yes, the GP referred me, because I couldn’t take iron tablets (made gut issues worse).
while I waited for the NHS haemotology appt, i had my first iron infusion privately because I felt so unwell. By the time I saw consultant 3 months later, my ferritin was dropping again. I have iron deficiency anaemia.
My doctor has messaged that my most recent test is normal and to stay on current dose of 75mcg. I think they have just looked at normal no further action on the header of the result and not at the note regarding adequate replacement indicates at 0.2-2.0.
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).
I had stopped any supplements for the latest blood test, but aim to reintroduce the Better You sprays I have for B12 and Vitamin D. I'm also going to start taking Feroglobin liquid again.
I'm going to reply to the GPs message tomorrow and request a further increase.
Last levothyroxine meds were Teva brand and I have been OK with them.
I may look into private testing for ferritin and vitamin d if I don't improve further.
I do feel much better than I did in April/ May but am not yet back to running or going to the gym.
aim to reintroduce the Better You sprays I have for B12 and Vitamin D
With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a separate B12 supplement
A week later add a separate vitamin B Complex
Then once your serum B12 is over 500 (or Active B12 level has reached 70), you may be able to reduce then stop the B12 and just carry on with the B Complex.
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