I was wondering if anyone could explain why when I first started taking 50mcg of levothyroxine in August 2024 it brought my TSH right down to 0.54 by October 2024 but now on the same dose my last two blood tests are back up to 4.5 TSH?
I had another private test in November and had 1.17 TSH then.
I experienced an ectopic pregnancy that ended in January so I thought the high TSH in January might be due to the HCG hormone but it’s been over a month that I’m not pregnant now and my TSH has slightly increased even.
Could the pregnancy have affected my TSH and that’s why it’s still high? Or should I increase my dose?
The GP in January said my dose is fine unless I feel tired. I told her I want to conceive again soon so I need my TSH to be 2.5 or under.
I’m just feeling confused on what to do and why my TSH is increasing again even though I’m on the same dose.
For the record, not sure if it helps, but my T4 results have been:
- 18.1
- 16.2
- 16.7
- 15.9
Thanks!
Written by
RLG123
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This is quite normal for TSH to rise again but it can be a bit delayed, 50mcg is a starter dose and you should be monitored then as the TSH increases your T4 dose should be increased until you maintain a TSH around 1
It can often take 12 weeks for TSH to settle again so it looks like your low results was only 8 weeks after initial dose before it had started to rise again
If you could add the ranges for your results as they vary from lab to lab
Once you get your TSH around 1 then I'd suggest getting a private full thyroid panel to see how well you convert fT4 to the active fT3
I have not been TTC or pregnant & hypo at the same time but have done a lot of deep dive reading on it.
You might want to search this site for TTC, as there are blood measures discussed for best chance not to miscarry.
But what I just wanted to pipe in to say is regards to your FT4 when you do conceive.
It’s very important to keep your FT4 up… to have it definitely well over mid range, if not 75% through range, while TTC.
Because
Your baby won’t have the ability to make their own thyroid hormone until mid-gestation (20 weeks), so the baby will rely entirely on yours.
But most importantly, week 5-6 after conception the baby goes through the most important neurological development of the whole pregnancy. continuing through about week 10 or so, and this neurological development demands sufficient thyroid hormone.
Since most people might not even know they’re pregnant til a week or so before that, if your ft4 isn’t high enough already, you won’t be able to bring it up in time for the demands of week 5.
So while you manage your thyroid numbers to TTC, keep an eye on the time when you will actually be TTC, because you’ll want to keep your FT4 up. Also, about 85% of pregnant women need to increase their Levo regularly through the pregnancy. So just keep in mind as time flies : )
I am not in the age group for this. However I can’t imagine for one moment any GP would be capable of comprehending this (and so clearly described) and ensuring its application. Very succinct FIR. Great piece of work. Why’s and wherefores explained.
50mcgs levo is just a starter dose. We can work out a very approx amount that you need by body weight which is mentioned in the NICE guidelines. How much do you weigh in kilos?
Even though we test thyroid levels every 6-8 weeks when titrating Levo, levels will continus to settle many weeks after that as the body heals. So it looks like your body has done some further healing and now requires more levo.
Blood tests can be affected by a few things. Time of day, when you last took levo. For highest TSH always test at 9am or earlier. Take last dose of Levo 24hrs before the test. On day of test take it after the test.
Have you also now tested key vitamin levels and supplementing to optimal?
When hypo we get low stomach acid which means we cannot absorb vitamins well from our food, regardless of a great diet. For thyroid hormone to work well we need OPTIMAL levels of vitamins.
Have you recently or could you ask your GP to test levels of ferritin, folate, B12 & D3? Private tests are available, see link for companies offering private blood tests & discount codes, some offer a blood draw service at an extra cost. thyroiduk.org/testing/priva...
There is also a new company offering walk in& mail order blood tests in London, Kent, Sussex & Surrey areas. Check to see if there is a blood test company near you. onedaytests.com/products/ul...
Only do private tests on a Monday or Tuesday to avoid postal delays.
If you dont get the right answer from one GP then go back and keep trying different GPs. Do not give up. You are right your TSH needs to be under 2.5. On treatment with Levo TSH needs to be at or just under 1 for people to feel well.
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