How soon to repeat thyroid blood test after initial prescription of Levothyroxine 50mcg?

[NortherlyRose]

I am 65 years old and I was prescribed 50mcg of Levothyroxine at the end of January after blood tests and symptoms suggested hypothyroidism. I had very helpful advice from you when I posted about this initially. Thank you!

My GP wrote in my notes that the thyroid blood test should be repeated in 4 weeks . From what I have read that seems a bit soon.

Would re-testing after 6-8 weeks make more sense or is it best to get it done sooner?

Here are my test results from 21/27 January. In addition to Levothyroxine 50mcg I have been prescribed a loading dose of Vitamin D (Colecalciferol 20,000 unit, 2 capsules once a week for 7 weeks):

Thyroid function test

Serum TSH level 9.37 mu/L [0.35-5.5]

Serum free T4 level 13 pmol/L [9.0-23.0]

Serum thyroid peroxidase antibody concentration >1300 Ku/L [0.0-59.0]

Vitamin D

Serum total 25 - hydroxy vitamin D level 27 nmol/L [50.0-99999.0]

Vitamin D levels of 25 - 50 nmol/L.

B12 / folate level

Serum vitamin B12 level 383 ng/L [190-910.0]

Serum folate level 5.7ng/mt [3.3-99999.0]

Ferritin

Serum ferritin level 80.1 ug/L [30.0-400.0]

Full blood count

Haemoglobin concentration 145 g/L [115-165]

MCV 95.1 fL [80.00-100]

Mean cell haemoglobin level 32.2 Pg [27.0-32.0]

[Obsdian]

6-8 weeks is standard for retesting for your first dose.

[NortherlyRose in reply to Obsdian]

That is what I thought. The other GP I see about HRT said to retest in 3 months and that seemed too long! Four weeks seems a bit quick! Perhaps it is because they want to titrate the dose up a bit, and they need to see the blood test result before doing this.

[Obsdian in reply to NortherlyRose]

Early on I found 6-8 weeks perfect.

On my last dose increase from 75-100 I found my body seemed to adjust really slowly and the 3 months wait feels appropriate at this point. It might nlt be the same for everyone but 6-8 weeks is standard. For some there can be a drop around 4 weeks which you'd miss testing at 4 weeks.

[NortherlyRose in reply to Obsdian]

Thank you. While I am keen to see what a dose increase does in terms of improving my well-being I have been convinced by what I have read on this forum that slow and steady is generally better.

Part of the problem is that well-meaning people keep asking if I feel better yet. I don’t feel much different to be honest, but it is still very early days. I think I need to manage their expectations!

[Obsdian in reply to NortherlyRose]

Yes! No one I know understands how thyroid medication works and I was getting asked that too. Their eyes glaze over if you try and explain.

[tattybogle in reply to NortherlyRose]

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A Helpful Quote from another members GP ,on what to expect when starting treatment for hypothyroidism.

"The way my new GP described it was ..."You know how your body is continually breaking down and rebuilding itself? Well, the thyroid controls the rebuilding, so if it isn't working you carry on breaking down but don't rebuild properly. Your body now has a lot of catching up to do, which will take a minimum of 12 months, probably a lot longer...." or words to that effect. He also said it would be a saw tooth recovery (get better, go backwards a bit, get better, go backwards a bit) and he's been right so far."

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[NortherlyRose]

I really like this quote.

Thank you.

Knowing that recovery doesn’t tend to be quick or without setbacks is important as it creates realistic expectations. It doesn’t help that a lot of people see hypothyroidism as a mild condition, and assume that it is quick and easy to treat.

[tattybogle in reply to NortherlyRose]

this one may help you explain some things in a way others can easily understand :

healthunlocked.com/thyroidu... the-shoe-size-analogy.

this one includes a link to ~ "when-your-family-member-or-friend-has-thyroid-disease-" which might be useful :

healthunlocked.com/thyroidu.... list-of-references-

(and both of them may come in handy when discussing the need for dose increases with GP in future)

[Insomania]

Have a read of advice advice on here on essential vitamins and minerals. Cannot emphasise enough how important they are for thyroid function. It takes time to titrate and low vits and minerals can muck up progress, as I found.

[NortherlyRose in reply to Insomania]

Thank you. This seemed overwhelmingly complicated to begin with but I am gradually getting to grips with it. Doing one thing at a time as recommended by a couple of people makes it more manageable!