Increase

[Baileyleigh123]

so I was on 200 mg of thyroxine then reduced to 150 mg six weeks ago the doctor rang me this morning and told me my tsh level is 3.1 so she advised to put my thyroxine back up to 200 does this sound right to anyone in the know thankyou x

[helvella Administrator]

No.

In my view, your dose should be increased more slowly. I suggest to 175, pause and re-test, then stick there, or 187.5 or 200 if needed. And re-test.

Levothyroxine dosing seems to be based almost entirely on tablet dosages. So they are very frequently adjusted by 25, 50 or 100 simply because those dosages have long been available. And there appears to be a reluctance to prescribe more than two (e.g. 100 and 50, or 100 and 25, but not 100 and 50 and 25).

We have 12.5 and 75 now which makes finer adjustment feasible even without splitting tablets. But prescribing habits remain.

It is silly to see your dose is too low and prescribe again a dose which, recently, appeared too high. (Despite there being other factors.) Seems better to see if half-way is better, and re-assess in a few weeks.

[Baileyleigh123 in reply to helvella]

She said doctor only lowered it because I was having skin problems lol x

[Jaydee1507 Administrator]

How do you feel?

Ideally we need to see a full thyroid panel of TSH, FT4 & FT3 for a full assessment of thyroid function. The NHS often only offer a TSH which is useless.

Have you had a full panel run fairly recently, if not suggest you get one run.

A reduction of 50mcg is a large one and was heavy handed. What were the results that reduction was based on?

Are all vitamins at optimal levels? What are you supplementing with?

Do you do tests as per the protocol recommended here?

Recommended blood test protocol: Test at 9am (or as close as possible), fasting, last levo dose 24hrs before the blood draw, last T3 dose 8-12 hours before blood draw & no biotin containing supplements for 3-7 days (Biotin can interfere with thyroid blood results as it is used in the testing process).

Testing like this gives consistency in your results and will show stable blood levels of hormone and highest TSH which varies throughout the day. Taking Levo/T3 just prior to blood draw can show a falsely elevated result and your GP/Endo might change your dose incorrectly as a result.

[Baileyleigh123 in reply to Jaydee1507]

she just said doctor lowered it because I was having skin problems but I was shivering and tired again staying in bed till 9 in morning where previously I’d be up at 6 x

[Jaydee1507 Administrator in reply to Baileyleigh123]

Lowering dose by 50mcgs is drastic for skin problems. Suggest you get some full blood results and share them.

[Baileyleigh123 in reply to Jaydee1507]

Is it really id never had dermatitis in my life suddenly it was on my hand then last week all over my chest x

[SlowDragon Administrator]

Increase to 175mcg. Retest in 8-10 weeks

Meanwhile get iron and vitamin D tested and optimum

previous post discussing low iron and getting full iron panel test

healthunlocked.com/thyroidu...

[Baileyleigh123 in reply to SlowDragon]

Hi slow dragon yes i asked about my iron levels and they said they were fine all there interested in is my cholesterol level being high x

[SlowDragon Administrator in reply to Baileyleigh123]

High cholesterol indicates being under medicated for thyroid and/or low Ft3

You will need to do full iron panel yourself

Never supplement iron without doing full iron panel test for anaemia first and retest 3-4 times a year if self supplementing.

It’s possible to have low ferritin but high iron

Test early morning, only water to drink between waking and test. Avoid high iron rich dinner night before test

If taking any iron supplements stop 5-7 days before testing

Medichecks iron panel test

medichecks.com/products/iro...

Look at increasing iron rich foods in diet

Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption

List of iron rich foods

dailyiron.net

Ferritin over 100 to alleviate symptoms

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Great research article discussing similar…..ferritin over 100 often necessary

ncbi.nlm.nih.gov/pmc/articl...

[Baileyleigh123 in reply to SlowDragon]

Aww thankyou I thought you said that before if the thyroxine went down the cholesterol goes up and I mentioned this to her and she said no that’s nothing to do with lol x

[SlowDragon Administrator in reply to Baileyleigh123]

She needs to read NHS guidelines

nhs.uk/conditions/statins/c...

If you have an underactive thyroid (hypothyroidism), treatment may be delayed until this problem is treated. This is because having an underactive thyroid can lead to an increased cholesterol level, and treating hypothyroidism may cause your cholesterol level to decrease, without the need for statins. Statins are also more likely to cause muscle damage in people with an underactive thyroid.

Aiming for Ft3 at least 60-70% through range

Often on just levothyroxine Ft4 will need to be higher at 70-80% through range or higher

For good conversion of Ft4 (levothyroxine) to Ft3 (active hormone) you need to maintain optimal vitamin levels

[Baileyleigh123 in reply to SlowDragon]

There really don’t have a clue do they lol do vitamin c tablets work as well are they ok to take x

[SlowDragon Administrator in reply to Baileyleigh123]

Taking vitamin C alongside iron, or an orange juice can help improve iron absorption

[Sparklingsunshine in reply to Baileyleigh123]

There's a big push and dare I say financial incentives for GP's to prescribe statins. And never take GP's word for it that your iron levels or any other test is " fine". Anywhere is range is good as far as NHS is concerned, but as we are all individuals and have differing requirements.

So your fine might not work for me. Its always worth getting hold of actual written results yourself, not relying on word of mouth.

[Baileyleigh123 in reply to Sparklingsunshine]

Yes well I know my hair was going thin and I know this can be a sign of low iron I’ve to retest blood end of February so I will get the results printed off and put on here thanks x

[Stourie in reply to Baileyleigh123]

A long time ago , high cholesterol was one of the symptoms that doctors used when diagnosing hypothyroidism. Jo xx

[Baileyleigh123 in reply to Stourie]

Really wow surprising that wonder if my cholesterol goes down now then since they’ve increased my thyroxine again c

[Stourie in reply to Baileyleigh123]

When l was diagnosed hypo my cholesterol was 14.85 and within 5 or 6 months it was 4.5 roughly. The only thing that l did differently was take my thyroxine. I suppose I must have had good doctors because statins was never mentioned. Jo xx

[Baileyleigh123 in reply to Stourie]

That’s a massive drop think mine is 6 well we will see if it drops end of February when I have my blood took I am not going on statins that’s all they took about took them once and made me ill never again xx

[Stourie in reply to Baileyleigh123]

I think 6 is absolutely fine. Don’t worry about it. Jo xx

[Stourie in reply to Baileyleigh123]

l meant to say that Dr Malcolm Kendrick has a good book called. The Great Cholesterol Con. well worth a read. Jo xx

[Baileyleigh123 in reply to Stourie]

Thankyou xx