I’m looking for a bit of advice as iv posted on here before and members/admin have always been very helpful.
I was diagnosed with an underactive thyroid over 10yrs ago. I have hashimotos so my levels don’t seem to stay normal for long. I assume that’s the hashis? Anyway, I was on 100mcg of Levo but still feeling tired/achy joints, they tested my TSH which I know those figures alone don’t tell an awful lot with all the other readings but my TSH was around 3.5. In the past when they upped my dosage to 125mg iv ended up going hyper very quickly so they suggested just doing 125 3 times a week and 100 on the other days. That’s what I have done the last 2-3 months but my latest test results show that I’m hyper again. My problem is that apart from a few night sweats I have felt so much better so really don’t want to drop back to 100. However my doctor has said that I must reduce the dose then retest in Feb. I’m baffled as when I’m just on 100 my levels are off but just 3 days a week on 125 my levels go into overdrive. I really don’t want to drop the dose as I do feel so much better…I have 1 pack of 25’s left and I’m tempted to just take one a week as a little boost. Any advice that might help with my little conundrum?
T3 is 5.3
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Henson1980
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Your TSH might be slightly below range but your results are not showing that you're hyper or over replaced.
Your FT4 is only 55% of range and no FT3 result. So long as free hormone results are within range then TSH doesnt matter, although most doctors dont understand this.
What time of day was your test taken? Highest TSH is at 9am or earlier.
Are you testing and supplementing low vitamin levels?
What are your latest results for ferritin, folate, B12 & D3?
Your GP needs to take your wishes and opinion about your results into consideration. Do show your GP this and you can take responsibility for your low TSH.
The first paragraph in the NICE (NHS) Thyroid Disease, Assessment and Management guidelines says :
nice.org.uk/guidance/ng145
"Your responsibility”
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian. “
Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)
is this how you did your test
Do you always get same brand levothyroxine at each prescription
Exactly what vitamin supplements are you taking
ESSENTIAL to test and maintain GOOD vitamin levels
Night sweats suggests low B12
joint pain low vitamin D
Testing options and includes money off codes for private testing
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
Monitor My Health (NHS private test service) offer thyroid and vitamin testing, plus cholesterol and HBA1C for £65
IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 5-7 days before ALL BLOOD TESTS , as biotin can falsely affect test results
In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg) and continue separate B12
Thanks slow dragon I tested before 9am on an empty stomach only water and stopped takin Levo 24hrs before. I made sure I stopped biotin a week before as I know this can affect results. I take vid d, but b complex and selenium xx
Wow that’s really interesting…I feel so let down by my doctor, since iv reduced back down to 100 I feel like my energy has been zapped! She wants to wait until Feb to review me which means a good two months of feeling like this! If my own doctor doesn’t understand my thyroid results then what hope do I have 😩
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).
If GP says " I have to reduce your dose because the guidelines say i can't let you have a below range TSH" .....
The first paragraph in the NICE (NHS) Thyroid Disease, Assessment and Management guidelines says :
nice.org.uk/guidance/ng145
"Your responsibility
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with themand their families and carers or guardian. "
Hi, sorry to throw a spanner in the works. Could you possibly be perimenopause with having night sweats and body aches. It also made me think, if your username is your birth year, then that about at the right age. It's so difficult when both thyroid and peri/ menopause can have similar symptoms
HRT frequently results in needing change in dose of levothyroxine. Usually an increase in dose
Here’s link for how to request Thyroid U.K.list of private Doctors emailed to you, but within the email a link to download list of recommended thyroid specialist endocrinologists who are aware TSH can be low and look at Ft4, Ft3 instead
Ideally choose an endocrinologist to see privately initially and who also does NHS consultations so that might eventually transfer to NHS
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