Hi everyone! I’m new to the community and I’m really impressed by the support here. I’m looking for some guidance on adjusting my dosage.Here are my lab results from this week:
- TSH: 2.4 (0.4 - 4)
- FT4: 15.8 (12 - 22)
- FT3: 4.5 (2.5 - 6)
I’m currently taking 37.5 mcg of levothyroxine, but I’ve been struggling with symptoms like fatigue and hair loss which is driving me insane. I’ve had to take several days off work because I’ve been unable to function properly. My GP is not open to increasing the dose, and I’m feeling stuck, as the current situation is difficult to manage.
Has anyone else had a similar experience, and how did you handle adjusting your dosage? I’m looking for some advice on how to approach this.
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Glutenfreemonkey
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Hi PurpleNails, thanks for your reply. I was diagnosed 3 months back so no, I was never on a higher dose. Started at 25mcg and bought it up to 37.5 mcg. No other health issues and tested for all nutrients except folate, which are again optimal as I have been supplementing for over 8 months.
tested for all nutrients except folate, which are again optimal as I have been supplementing for over 8 months.
Please add actual results and ranges
Exactly what vitamin supplements are you taking
IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 3-5 days before ALL BLOOD TESTS , as biotin can falsely affect test results
In days before blood test, when you stop vitamin B complex, you might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg) and continue separate B12 if last test result serum B12 was below 500 or active B12 (private test) under 70
Hi Slowdragon, Roger that. I will add the results to my profile. I didnt stop B complex as I wasn't aware previously until I struck upon this forum. I will keep that in mind for the next one. Vit B12 was 'high' - 723 pmol/l.
Likely to need further increases over coming months
When adequately treated most people will have Ft4 at least 60-70% through range
ALWAYS test thyroid levels early morning, ideally before 9am, only drinking water between waking and test and last dose levothyroxine 24 hours before test
How old are you
How much do you weigh in kilo
Can you see different GP
Request/politely insist on testing of Full iron panel including ferritin for hair loss
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).
Glutenfreemonkey Suspect your GP is just looking at numbers and thinking everything is within the ranges! Not good enough. Should be listening to your symptoms. On here we normally see TSH below 2 and often below 1 for folks to feel well.
TSH is NOT a thyroid hormone but that's what most medics seem to fixate on. TSH is the message from your pituitary to tell your thyroid to produce more hormones. T4 is a storage hormone and your body converts it to T3 the active hormone which should reach every cell of your body.
Quite a lot of us on here are poor convertors of T4 to T3 and often have to have some T3 added totheir levothyroxine. To check % through range of your T3 and T4 go to thyroid.dopiaza.org
Hi Crimple, that's correct. He is only looking at TSH and sent me a report yesterday rejecting my suggestion of dose increase as TSH is normal. I'm now on a wait list to see someone else.
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