After being on 50mcg levothyroxine for 64 days which is about 8 weeks. In this time I have had 3 types of levothyroxine which the first 2 were hiilcross for 18 days then teva for 14 days which I reacted to them both. Now on vencamil which I seem to tolerate.
After getting my bloods repeated through the nhs, which they only Tested TSH my numbers as only dropped by 35 for my TSH
TSH was 4.40
Now TSH 4.05
So what I am trying to say is am I undermedicated. I also have bile salt malabsorption.
Thanks
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Leggits15
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With a TSH over 4, no matter how much it's dropped, you are under-medicated, yes. We expect it to come down to 1 or under. But, as you're only taking 50 mcg it's to be expected. It's time for an increase to 75 mcg.
Hi grey goose thanks for your reply, so they said my bloods were normal. So I am going to make an appointment to see if they will up my medication. What if they won’t 😊
When a doctor says 'normal', all he means is that it's somewhere within the range. And you don't have to go to med school for 7 years to work that out! You just look at the result! The problem is, in med school they are not taught how to interpret blood test results. It's a huge great mystery for doctors. They don't understand ranges, and they don't understand that you can't just look at one result and draw conclusions, and they don't understand that just being in-range is not the same as optimal - in fact, there's a whole heap of things they don't understand, especially when it comes to thyroid!
A truly 'normal' TSH (euthyroid) is around 1, never over 2 - that shows the thyroid is struggling - and when it reaches 3 you are technically hypo. So, looked at that way, you can see that over 4 is far from 'normal'.
So, now you know all that, you can see that you now know more than your doctor. So, you're going to have to stand up and fight for it. People on here often say that it's a good idea to ask for a 'trial' increase, or something pussy-footing like that. I'm afraid I'm not a pussy-footing kind of girl. I'm more of an I-want-it-and-I-want-it-now! type. You pays yer money and you takes yer choice. Or, you could try the nuisance method: keep badgering them until they give you what you want to get rid of you. Another approach is to say: if you don't give me an increase I'll buy my own levo on-line and give myself an increase! That sometimes works.
But, I honestly don't know. Depends on the individual doctor what is likely to work on them. Oh, and of course, there are the NICE guidelines. I believe it says somewhere in that document that they should be aiming for a TSH at least under 2. And yours is well over. So they would be in breach of their own guidelines.
See/contact GP for 25mcg dose increase in Levo to 75mcg per day
Vencamil make 25mcg tablets
50mcg is only standard STARTER dose Levo
GP should have tested vitamin D, folate, ferritin and B12 at diagnosis of Hashimoto’s
Did they?
Retest FULL thyroid and vitamin levels in 6-8 weeks
just testing TSH is totally inadequate
Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)
Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins
If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test
If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal
Hi Slowdragon , I got my blood tests done previously from medichecks. This time around my doctor done them but only TSH. So I am going to ask for an increase then go back to medichecks after 6 to 8 weeks😊
If a patient reports persistent symptoms when switching between different levothyroxine tablet formulations, consider consistently prescribing a specific product known to be well tolerated by the patient.
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).
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."
these may be helpful too : healthunlocked.com/thyroidu... explanation-of-what-*high-tsh-is-telling-us-when-our-ft4-level-is-normal-on-levothyroxine-the-shoe-size-analogy.-*-over-2.5-3-ish
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