Thyroxine increased from 100mcg by tiny amount recently due to increased TSH. (25mg over 4 days - quartered tablets). Managed to tolerate for about 6 weeks but felt increasingly unwell, anxious, over medicated. Would appreciate your input before appointment with NP/GP: also on Ferous numerate as was previously low, and take 1-2 Adcal D3 daily.
Blood results from Randox;
23rd Oct prior to increase
TSH 8.09 - optimal 0.35-5.5
Ft4 19.80- optimal 11.9-21.6
Ft3 3.96 - optimal 3.1-6.8
Anti TPO - 33.3 optimal < or =34.0
Anti - Tg - 21.6. optimal < or =115.0
Jan 3 - after 2 days of no dose and 5 days of dose reduced back to 100mcg
TSH 24.395
T4 20.52
FT3 2.47
Anti Tpo 20
Anti Tg 15.3
many thanks in advance
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rosie64
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You need to test Vitamin D, folate, ferritin and B12
What were most recent vitamin results and how long ago was test
Essential to take iron at least 4 hours away from Levo and 2 hours away from other supplements
Calcium and vitamin D should also be at least 4 hours away from taking Levo
Are you also taking magnesium supplement and/ or vitamin B complex and/or B12 injections or separate supplements
TSH 8.09 - optimal 0.35-5.5
Ft4 19.80- optimal 11.9-21.6
Ft3 3.96 - optimal 3.1-6.8
Was test done as recommended, 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)
Do you always get same brand levothyroxine at each prescription
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
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
Thank you for reply. I take thyroxine at night , prior to going to bed, as close to an empty stomach as possible, and away from supplements. I will maybe try taking in am and see if that makes a difference.
Tests were done in afternoon as had to travel to appointments & that was best appointment I could get. Did take thyroxine night before but it was about 14 hours.
I’m on daily adcal d3 & 8 weekly Vit B12 injections for pernicious anaemia.
Don’t take a B complex.
Will post last results if I can find them. I know, as is expected, B12 was high due to injections, and iron was bit low.
As you have B12 injections it’s recommended also to supplement a good quality daily vitamin B complex, one with folate in (not folic acid) may be beneficial.
This can help keep all B vitamins in balance and may help maintain B12 levels between injections
so I suggest you start a vitamin B complex now
Check your vitamin levels at next test
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 if last test result serum B12 was below 500 or active B12 (private test) under 70:
Post discussing how biotin can affect test results
Obviously your B12 will be good as on B12 injections
Folate will be good once on daily vitamin B complex
If once all vitamins optimal, and testing correctly, last dose levothyroxine 24 hours before test, giving result of Ft4 is at top 1/3rd of range …….if Ft3 remains low then look at seeing thyroid specialist for T3 prescribed alongside
Because of long wait on NHS, you would probably need initially to see privately
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 will prescribe T3
Ideally choose an endocrinologist to see privately initially and who also does NHS consultations so that might eventually transfer to getting T3 on NHS
Your TSH is rather high which indicates you haven’t enough in your system. Although your T4 result is good that seems odd. Your T3 is very low maybe this is why the TSH is higher than it should be. TSH should be around 1.00-2.00 to be symptom free. Which means adequate t4 and t3 levels. I think you need to add T3 liothyronine alongside your T4 levothyroxine medication. You must be having unwanted symptoms with those results.
I firstly thought the ferris fumerate might be stopping absorption as there’s a contraindication between it and levothyroxine but your t4 is more than adequate. You must always take ferris fumerate at least 4hrs away from levothyroxine.
Thanks McPammy. No I don’t feel great but that is an ongoing issue. I’m wondering if there is some sort of central issue going on here. Strangely though, for first time in 30 years sinsce starting Levo, my feet are not so swollen?????
Reduction in swollen feet might be de to now adding levothyroxine and reduction over all in water retention. I found I had piled on too much weight even though I ate healthy. It was mainly water retention due to my metabolic rate being so low due to lack of thyroxine. Adding T3 medication some years later, which I needed all along, gave me a real energy boost, which meant I had the energy to exercise. I then lost 4st without even trying really. All I did was walk briskly twice a day round my village. I still continue to do that. T3 is really important to keep your eye on. TSH or T4 tests are not enough. You need to check your t3 also.
Your ongoing issue will no doubt be down to thyroid disease. It can cause so many issues it’s untrue GP’s try to treat each issue when all they need to do is treat the thyroid condition well. Remember TSH of 1.00-2.00 is your aim for being symptom free I can’t stress this strong enough!
Thank you McPammy. The swollen feet started after I stared taking Levo, in 1996, which is one of the things that are so confusing to me. I can’t get Tsh down as I seem unable to tolerate any more than 100mcg of Levo. I have thought for a while about T3, but it’s getting it when there isn’t the GP support. I’m so glad you are doing well. It’s a wee beacon of light when you hear of someone actually feeling better x
You could try going private and get a 3 month trial on combined treatment T4 plus T3 medications. I went private eventually to find my help and wellbeing. Without going private I really don’t know where I’d be today.
Think about it. If you’d like my private endocrinologist information just private message me as can’t mention names on the open forum.
I can’t tolerate high doses of levothyroxine. So adding the t3 really helped me no end.
Thanks folk, I’ve already been looking into it. I keep putting it off in hope that GP will somehow come through & things will improve. I don’t know who I’m kidding.
Thanks Sleepman. That is one of the possibilities I have been thinking about. I’m grateful to have the private blood results at least, though hope Dr does not dismiss them.
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