Have an appointment for my daughter aged 19 who has thyroiditis/hashimotos and is on 75mg levothyroxin, but still is exhausted, light headed, hair falling out, dry skin, aching limbs sometimes, feels down/anxious...
Blood test last week
Serum free T4 17.3 pmol/L ( 10-19.8)
Serum TSH 1.7mu/L ( 0.3-5.5) was 2.3 in Nov and does of T4 went from 50 to 75 mg
Serum free T3 5.2 pmol/L (3.5-6.7)
No recent Vit D/iron but she is taking supplements
Last Vit D test 7th Nov showed she had gone up 48 nmol/L ( 24-167) vit D insufficiency so none prescribed. She is taking 1000iu daily
calcium 2.38mmol/L( 2.2-2.6)
Does she need to stop taking anything prior to this visit?
Is there any questions that I should be asking.. as she is still not well
Written by
bensons76a
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If she takes levo in the morning, take the dose after the appointment. in case they take a blood test. If is very late in the afternoon she can miss that day's dose.
If she takes it at night, miss the p.m. dose the day before the appointment.
It is most unlikely that your daughter should stop taking anything as the consultant will want to run blood tests and stopping taking anything will only distort results and might result in inappropriate assessments. Perhaps the person to ask really is your GP so you can be confident about the answer to your question.
Were I you/your daughter I would ask about the relatively high TSH as most people on treatment for hypothyroidism which Hashimoto's results in, aim for a TSH of under 1, but there may well be a reason known to the consultant which you will find out by asking such a question. Also, it is usual to start people on 50 mcg levo then recall them in 4-5 weeks, run blood test, then raise the levo dose, recall in 4-5 weeks, re-assesss by blood test and increase the dose as necessary. It does seem rather surprising that your daughter has been on only 75mcg levothyroxine since November as this is a rather small dose and it is not surprising that she does not feel well, but again, there may be a reason for this slow titration. She is fortunate in being looked after by a consultant, and must describe to him exactly how she feels in detail, they need accurate information to act on as well as blood test results.
You can find details of the various thyroid tests, etc., on the main Thyroid UK site, start on:
and you will find much information on the site, including a symptom list which your daughter might find makes it easier to tell the consultant what symtoms she has.
It would be good if the consultant would run tests for Vitamin B12, Folate, and Ferritin and the other iron tests if you ask for them. For detailed info, see:
Do please buy "Understanding Thyroid Disorders" by Dr Anthony Toft, £5 from chemists/Amazon. In it he deals with hypothyroidism very clearly and in a way which might prompt you to ask further questions in the future when the optimal levothyroxine dose is achieved.
I trust all goes well at your daughter's appointment, she is very lucky to have your support and concern for her welfare at a time when she is under the strain of feeling unwell.
Your daughter has a right to have copies of all blood tests once the GP has seen them, she just asks him/her. It is always a good idea to begin a file to keep blood tests and notes of symptoms, dates of dose changes.
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Will I need medication?
Should I stop T4 and take T3 only medication?
Do I need supplements?
Do I need to adjust my medication?
Advice need re T3 before hospital appointment 
