Thyroid level dangerously low?

[littlerobot]

I was told end Nov that it is dangerously low given 50mg dose of thyroxine, tested again 7th dec and increased to 75mg - after test initially dismissed as no action as it was borderline? I am still experiencing lots of throat discomfort and a sore inner ear. I have no idea of test readings. Advice please?

[helvella Administrator]

Am afraid that you really will have to get hold of your test results in order for us to have a better idea of what might be happening. You are entitled to them - details about how to get hold of them here:

thyroiduk.org.uk/tuk/NHS_In...

Do you know anything else about your condition? Have you been tested for thyroid antibodies?

[littlerobot in reply to helvella]

I honestly don't know what was tested - originally my doctor though that I had glandular fever after having terrible cough, cold,sore throat since early October and two back to back nasty water infections just prior to this. They just look down my throat and say there is no inflammation and cant tell me why they feel uncomfortable and itchy/sore feeling all the time. Guess that I will have to chase the doctor up - haven't been given any info other than being told my immune system is under attack and I will get free prescriptions

[littlerobot in reply to helvella]

Right now I have my results

test results 30 nov explains TSH 45.7 T4 - 10.1

test results 19th December TSH 13.5 T4 - 11.8

Still don't know what this means though - am I now in 'normal range' after the Dec test my throxin was increased from 50mg to 75mg although doctor said I was showing as borderline >

any advice please? also just found out high cholestrol runs in my family so perhaps should get this tested too

[Clarebear in reply to littlerobot]

Hi tweedy67 - there is nothing borderline about those test results - they show you are still very hypo It would help to have the range to go with the fT4 result - please could you ask your surgery for this too?

It might be worth investing in Dr Toft's little book "Understanding Thyroid Disorders" - it costs about £5.00 and is available in most chemists. In it on page 88 in my copy he says:

"Judging the correct dose of thyroxine

Your GP or thyroid specialist will usually prescribe a dose of thyroxine that raises the fT4 to the upper part of the normal range and reduces the TSH level in the blood to the lower part of the normal range.

Typical results would be a fT4 of 24pmol/l and a TSH of 0.2mU/l. In some patients a sense of well being is achieved only when fT4 is raised, for example 30pmol/l, and TSH low or undetectable. In this circumstance it is essential that the T3 level in the blood is unequivocally normal in order to avoid hyperthyroidsm."

Your results still have a long way to go and I suspect you will need several more increases. xx

[littlerobot in reply to Clarebear]

Hi Clarebear, thank you - I am not going mad then .. Do these that I copied from my results answer the questions. Confused.com! probably good idea for me to get the book then many thanks

TEST 1

Immunoassay tests

Specimen: SERUM

Collected: 29 Nov 2012 08:27

Investigation

Normality

Result

Immunoassay tests

Hypothyroid state.

Serum TSH level (XaELV)

Above range

45.7 mu/L (0.4 - 5.5) - Outside reference range

Serum free T4 level (XaERr)

Below range

10.1 pmol/L (11.5 - 22.7) - Outside reference range

Immunoassay tests

TEST 2

Specimen: SERUM

Collected: 19 Dec 2012 09:24

Investigation

Normality

Result

Immunoassay tests

If on stable dose of thyroxine >6-8 weeks, ?dose, ?compliance

Serum TSH level (XaELV)

Above range

13.5 mu/L (0.4 - 5.5) - Outside reference range

Serum free T4 level (XaERr)

11.8 pmol/L (11.5 - 22.7)

[Hidden]

As Rob has said, its difficult without actual results (and test ranges) to make a comment, however, if your TSH(thyroid stimulating hormone) was very high or T4 (thyroid hormone) to a point of being dangerous, you would have been hospitalised, so please don't worry yourself about the terms used by the GP. I think what they try to get across is that it would be dangerous to be left untreated. (My TSH was at one point rec0rded at 156 with a FT4 of 0 and I'm pretty sure it had been worse in the past and although I possibly should have been send to hospital I wasn't).

It does sound like your thyroid is under an auto immune attack, but again thyroid antibodies would have to be checked for this to be confirmed - (hashimotos is the usual autoimune hypothyroidism in which your thyroid goes in cycles of attack/ remission until it burns out)

The info you have been given by the GP is about as much as they ever tell you, its certainly all I got told, you can find out far more by reading the main website

thyroiduk.org.uk/tuk/index....

and there are always people on here happy to answer any questions you have

[Hidden in reply to Hidden]

Edit sorry Rod! was a typo

[shaws Administrator]

Welcome Tweedy,

You didn't fill in your profile so we don't know about your thyroid background.

As said above we cannot assist till you get a copy of your blood test results. I myself had never asked for a copy of my blood tests before I became Hypothyroid but It is very easy to get a copy of thyroid your blood test results. You ask your surgery for a copy and it also includes the ranges which are necessary for someone to comment, they may say they'll ask the doctor but you are entitled. You should keep a copy of all your blood tests so that you can keep an eye on how you are doing.

You will now find that, in order to get well, you will have to read as much as possible and Thyroiduk.org have a selection of books and can loan for the cost of the postage. Did you visit an Endocrinologist or is the GP treating you?

thyroiduk.org.uk/tuk/suppor...

[littlerobot]

Right now I have my results

test results 30 nov explains TSH 45.7 T4 - 10.1

test results 19th December TSH 13.5 T4 - 11.8

Still don't know what this means though - am I now in 'normal range' after the Dec test my throxin was increased from 50mg to 75mg although doctor said I was showing as borderline >

[helvella Administrator in reply to littlerobot]

The only way that the word "borderline" could make sense is that your FT4 is not very far from the extreme bottom of the reference range.

Your TSH is way too high - which is strongly suggesting you very much need more levothyroxine.

The most report on levothyroxine from the MHRA says:

Once diagnosed, patients normally start the estimated full or just below the full replacement dose immediately unless they are over 50, have severe hypothyroidism or have cardiac problems, in which case, the levothyroxine dose is gradually increased from an initial daily dose of 25 - 50 mcg levothyroxine. This is then increased by 25 – 50 mcg/day at 3-4 weekly intervals until a normal metabolic state is attained.

Thyroid stimulating hormone (TSH) secreted by the anterior pituitary gland, plays a pivotal role in the control of the thyroid axis and serves as the most useful marker of thyroid status. Careful monitoring of serum levels of TSH is necessary until an appropriate dose of levothyroxine is reached. The treatment target is a TSH level within the normal range (0.4 - 4.5 mU/L). TSH is monitored during chronic treatment, usually on an annual basis as chronic under-treatment or over-treatment may be associated with adverse symptoms and undesirable clinical outcomes.

mhra.gov.uk/home/groups/pl-...

Many here feel even that guidance is inadequate - but it does, basically, say that a TSH of 13.5 is a long way above the 4.5 they suggest as a typical top of range. And that the aim is for you to be within that range. And you doctor should be increasing your dose every 3 to 4 weeks until you ARE in range.

Very likely, at that point, your FT4 will be quite near to the top of the range. Which is fine.

Rod