Testing should be minimum 6-8 weeks after each dose change
Retest again in another 4 weeks
Getting full thyroid and vitamin levels privately if GP won’t test
ALWAYS test early morning, ideally before 9am, only drinking water between waking and test and last dose levothyroxine 24 hours before test
50mcg is only the standard STARTER dose
Guidelines of dose Levo by weight
approx how much do you weigh in kilo
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)
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
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).
just to add, I started on 50mg. Felt better for 4 weeks or there abouts and the. Felt worse than I had pre-treatment until I had bloods done and saw my (private) GP again (at week 6 & 7). He increased my dose to 100mg, which has been great for about 6 months. I am starting to wonder if my does needs increasing slightly again now, but that’s a concern from the last 3-4 weeks.
So, it’s a bit early to tell I’d suggest. Private blood test to include T3 is a great plan, in about 2-3 weeks time. Book an appointment with your GP for around then if you’re able to. If you have an issue converting T4 to T3, your GP will hopefully agree to add this to your standard annual testing cycle. After all the not great things my NHS GP did, they did adopt me back to the NHS is September, and are testing TSH, T4 & T3 a they even offered up a medical exemption certificate without prompting.
I was left on 50mcg Levo for nine months before I pushed for an increase and I don’t think my experience was uncommon. Be sure to request further testing; keep a diary of symptoms and don’t rely on the GP to manage your condition or to have any idea of the correct dose for you!
How do you feel now that your dose has been increased? I am still waiting to speak to a GP about a dose increase. I am fully expecting to be told that as my TSH is ‘in range’ that I don’t need an increase. I don’t feel any better then what I did when I started so I will be pushing for an increase.
I tested privately (finger prick test kit posted back to Monitor My Health) so that I could see where my FT4 and FT3 were sitting and persuaded the GP there was room in the range for an increase. But once you get past 75mcg it’s better to increase more gradually in case you miss your sweet spot.
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