High TSH result… my fault?

[Wagamama]

Hey guys,

just had my routine results back today and my TSH is high (but T3 ok…) but wondering if that is my fault…?

Serum TSH level 5.71 mIU/L [0.27 - 4.2]; Above high reference limit

Serum free T4 level 15.0 pmol/L [12.0 - 22.0]

I think the day before I went for my test I forgot to take my Levo completely (didn’t even think about it before I went for the test)…. Would that affect the results THAT much?

Wondering if I should go back and repeat the test before the dr starts suggesting I up my dose…?

What do you think..? 🤔

Thanks all x

[Cake-Maker]

I think you should do just that! 😉

[Sparklingsunshine]

In all honesty I doubt forgetting one dose of Levo would affect your TSH. TSH is pretty slow to move, and can take weeks or months to shift, unlike FT4 and FT3. If your TSH is that high it indicates you are undermedicated and need an increase.

[Jazzw]

What was your FT3 result? You’ve given FT4 which is on the lower side…

[Wagamama in reply to Jazzw]

They didn’t/don’t test for that unfortunately…. X

[Jazzw in reply to Wagamama]

The chances are you are undermedicated—it certainly looks that way.

[Wagamama in reply to Jazzw]

That’s a shame. I’ve been on the same dose for years… strange how it’s suddenly changed… 🤔

[BB001 in reply to Wagamama]

My need for thyroid hormone increases in the winter. I used to need 25mcg extra levothyroxine. To put your mind at rest, you could come clean to your GP about possibly forgetting a dose the day before and ask for a retest to verify. However, i too think TSH wouldn't have changed that quickly, it is usually recommended that you wait 6-8 weeks after a dose change before re-testing, so a day is not significant.

[Anthea55]

Make sure you don't take biotin near a blood test; it is often used in the testing process and can produce false results.

[Wagamama in reply to Anthea55]

Thanks, yeah I don’t take that… (had to look it up to see what it was… 😁)

[SlowDragon Administrator]

no forgetting one dose Levo won’t affect TSH

How much levothyroxine are you taking

Free T4 (fT4) 15 pmol/L (12 - 22)

Ft4 only  30.0% through range

Suggests you are ready for next dose increase

[Wagamama in reply to SlowDragon]

I’m taking 100 and 125 on alternate days

[SlowDragon Administrator in reply to Wagamama]

Which brand of Levo

Approx how much do you weigh in kilo

And what vitamin supplements

[Wagamama in reply to SlowDragon]

Hi, I’m about 65kg At the moment (5ft 8…. )

The 25mg is brand called Murcury pharma

The 100mg is different - Almus

Does it make a difference what brand you take?

I take folic acid, B12… not taking but D At the moment as run out and realise I need to take k with it so need to find the right one…

X

[SlowDragon Administrator in reply to Wagamama]

The 25mg is brand called Murcury pharma

The 100mg is different - Almus

Does it make a difference what brand you take?

Yes can make a difference to some people

You’re on roughly right dose for your weight …..but some people need higher dose than guidelines

Generally looking to maintain TSH below 2 and Ft3 at least 50-60% through range

Are you careful how and when you take your Levo

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

verywellhealth.com/best-tim...

markvanderpump.co.uk/blog/p...

markvanderpump.co.uk/blog/p...

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

[CharlieChan1]

My tsh goes up when I take Pepcid or an antacid for a few weeks. I guess it interferes with the absorption…..