Subclinicical-hypothyroidism?

[On_Point]

Ok new results in, opinions please do I contact the doctors yet or not as the results page say subclinical-hypothyroidism. Would the doctor bother with these numbers and can I push to start treatment to combat symptoms of weight gain, dry skin and muscle fatigue.

TSH 9.2 high TSH levels high (normal range 0.27 - 4.2 mU/L) ……… July 2024 they were 3.9

FT4 15.2 normal FT4 levels normal (normal range 12 - 22 pmol/L)

FT3 4.4 normal FT3 levels normal (normal range 3.1 - 6.8 pmol/L)

TPO 106 high ………. July 2024 they were 90.6

TPO antibodies of 35 or above:You have raised levels of TPO antibodies

I don’t have my ferritin levels etc as the test haemolysis so I need to repeat it 😢

[SlowDragon Ambassador]

Absolutely yes

Is this a private test?

Was test early morning

Can you add folate, B12 and vitamin D results if you have any

Have you had any tests via NHS

With two NHS tests with TSH over 5, and high thyroid antibodies and symptoms you should be offered “trial” on levothyroxine

Starting levothyroxine - flow chart

gps.northcentrallondonccg.n...

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)

cks.nice.org.uk/topics/hypo...

bnf.nice.org.uk/drugs/levot...

nhs.uk/medicines/levothyrox...

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

gponline.com/endocrinology-...

Graph showing median TSH in healthy population is 1-1.5

web.archive.org/web/2004060...

Autoimmune disease

you also need coeliac blood test at diagnosis of autoimmune thyroid disease

Request GP does this too

And although its technically subclinical if TSH under 10 it’s not “subclinical “ if you have symptoms

[On_Point in reply to SlowDragon]

Vitamin D was 53 adequate

I’ve got to redo my ,HB, Ferritin, TSAT, Active B12, Folate as the test as the blood haemolysis. I did the test first thing in the morning. I did the test with monitor my health which is linked to NHS testing. My Mum, Nan, Aunt and younger sister all have Hypothyroidism. I’ll fill out a e-consult Monday.

[SlowDragon Ambassador in reply to On_Point]

Vitamin D was 53 adequate

GP will often only prescribe to bring vitamin D levels to 50nmol.

Some areas will prescribe to bring levels to 75nmol or even 80nmol

leedsformulary.nhs.uk/docs/...

GP should advise on self supplementing if over 50nmol, but under 75nmol (but they rarely do)

mm.wirral.nhs.uk/document_u...

But with Hashimoto’s, improving to around 80nmol or 100nmol by self supplementing may be better

pubmed.ncbi.nlm.nih.gov/218...

vitamindsociety.org/pdf/Vit...

Once you Improve level, very likely you will need on going maintenance dose to keep it there.

Test twice yearly when supplementing

Can test via NHS private testing service

vitamindtest.org.uk

Vitamin D mouth spray by Better You is very effective as it avoids poor gut function.

There’s a version made that also contains vitamin K2 Mk7.

One spray = 1000iu

amazon.co.uk/BetterYou-Dlux...

It’s trial and error what dose we need, with thyroid issues we frequently need higher dose than average

Vitamin D may prevent Autoimmune disease

newscientist.com/article/23...

Web links about taking important cofactors - magnesium and Vit K2-MK7

Magnesium best taken in the afternoon or evening, but must be four hours away from levothyroxine

betterbones.com/bone-nutrit...

medicalnewstoday.com/articl...

livescience.com/61866-magne...

sciencedaily.com/releases/2...

Recipe ideas

bbc.co.uk/food/articles/mag...

Interesting article by Dr Malcolm Kendrick on magnesium

drmalcolmkendrick.org/categ...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

[On_Point in reply to SlowDragon]

Thank you that’s all very helpful. Lots to research and get my head around !

[tattybogle]

yes . let GP know of these latest results . they are likely to want to do their own test even though MMH is NHS lab, so preferably get an early am apt for GP blood draw. ( TSH falls over the morning until it's lowest around 1-3pm then slowly rises again)

they will also (usually) need to do a second test (to rule out a transient rise in TSH due to some other temporary cause) . NHS guidelines currently say this should be 3 mths after the first over range TSH result ... but since your TSh is so close to 10 already they may be prepared to reduce this to 6 wks , it's also possible they would start you on levo straight away , but this is not good practice ,,, and can cause problems later on , if a confirmatory 2nd test isn't done it can lead to doctors in future questioning the original diagnosis and being difficult about prescribing enough levo .