Recent TSH results…: Hi again! I had my bloods... - Thyroid UK

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Recent TSH results…

Newtohashimotos2025 profile image

Hi again!

I had my bloods rechecked on Monday

So that would be exactly 4 weeks since starting 50mcg of Levo.

My TSH is now 2.16! That’s came down for 17.33. I forgot to ask for T4 and I don’t think they check T3.

I don’t know if the GP will even contact me to discuss? Or if I am just to continue on 50mcg.

I have been quite strictly gluten free since I started the Levo also so wonder if this has been why it’s been so effective.

Have also started sublingual b12 1000mcg and D3+K2. Plan to start Folate next week.

I guess my question is do we think I will be staying on 50mcg?

Thanks again!

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Newtohashimotos2025 profile image
Newtohashimotos2025
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6 Replies
greygoose profile image
greygoose

Not forever you won't - at least, I hope not. Four weeks was a bit soon to retest, your TSH could go up again.

Don't forget you need to take a B complex with B12, and magnesium with vit D. :)

SlowDragon profile image
SlowDragonAmbassador

Just testing TSH is totally inadequate

But often all NHS will do

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)

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 always be below 2 on levothyroxine

gponline.com/endocrinology-...

Graph showing median TSH in healthy population is 1-1.5

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

Comprehensive list of references for needing LOW TSH on levothyroxine

healthunlocked.com/thyroidu....

onlinelibrary.wiley.com/doi...

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).

sciencedirect.com/science/a...

The optimal daily dose in overt hypothyroidism is 1·5–1·8 μg per kg of bodyweight, rounded to the nearest 25 μg.

Newtohashimotos2025 profile image
Newtohashimotos2025 in reply toSlowDragon

Thanks for the replies.

I don’t know if the GP is going to call me regarding the results? As I just enquired myself about the latest test.

I weigh approx 58kg.

SlowDragon profile image
SlowDragonAmbassador in reply toNewtohashimotos2025

So you probably won’t need too many increases

Guidelines suggest approx 92mcg per day as eventual dose

some people need a bit less than guidelines some need a bit more

You could request small increase now to 62.5mcg daily (adding 12.5mcg to 50mcg tablet by cutting 25mcg tablet in half)

Newtohashimotos2025 profile image
Newtohashimotos2025 in reply toSlowDragon

Thank you I will try asking for an increase.

Thanks for the advice re. vitamins I have started b12 and d3. Will add in folate next week.

TheMudRunner profile image
TheMudRunner

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.

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