Blood Test Results 4 Months On

[NiaJayne]

Hi everyone,

I posted a few months ago about the results of a thyroid blood test after I had a partial thyroidectomy back in July 2022.

I’m currently on 25mcg of levothyroxine a day and had another blood test last month.

I just wanted to see what your opinions are? Are these results looking good or should I see if I can get a higher dose?

I’ll post the March blood results too so you can see the difference.

Thanks for the help!

Antonia

[Jaydee1507 Administrator]

Can you also include the reference range for FT4? Ranges vary from lab to lab but it does look terribly low.

[SlowDragon Administrator]

previous post shows virtually deficient ferritin

Are you now on iron supplements?

Did you get vitamin D, folate and B12 levels tested yet

healthunlocked.com/thyroidu...

Assuming same range as previous post for Ft4 (9-19)

FT4: 10 pmol/l (Range 9 - 19)

Ft4 is only a dismal 10.00% through range

Most people on just levothyroxine will need Ft4 at least 60-70% through range

Insist on 25mcg dose increase in levothyroxine and retest in 6-8 weeks

Likely to need several further increases in levothyroxine over coming months

Standard STARTER dose levothyroxine is 50mcg unless over 65 years old

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)

Is this how you did test

Important to also test vitamin D, folate, B12 and ferritin

Exactly What vitamin supplements are you currently taking

You need to retest vitamin D twice year when supplementing

And retest folate and B12 at least annually

If on iron supplements GP should do full iron panel at least 3 times a year minimum

[SlowDragon Administrator]

Levothyroxine doesn’t top up failing thyroid it replaces it.

Unless extremely petite you’re likely to eventually be on at least 100mcg levothyroxine per day

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 near full replacement dose

NICE guidelines on full replacement dose

nice.org.uk/guidance/ng145/...

1.3.6

Consider starting levothyroxine at a dosage of 1.6 micrograms per kilogram of body weight per day (rounded to the nearest 25 micrograms) for adults under 65 with primary hypothyroidism and no history of cardiovascular disease.

Also here

cks.nice.org.uk/topics/hypo...

pathlabs.rlbuht.nhs.uk/tft_...

Guiding Treatment with Thyroxine:

In the majority of patients 50-100 μg thyroxine can be used as the starting dose. Alterations in dose are achieved by using 25-50 μg increments and adequacy of the new dose can be confirmed by repeat measurement of TSH after 2-3 months.

The majority of patients will be clinically euthyroid with a ‘normal’ TSH and having thyroxine replacement in the range 75-150 μg/day (1.6ug/Kg on average).

The recommended approach is to titrate thyroxine therapy against the TSH concentration whilst assessing clinical well-being. The target is a serum TSH within the reference range.

……The primary target of thyroxine replacement therapy is to make the patient feel well and to achieve a serum TSH that is within the reference range. The corresponding FT4 will be within or slightly above its reference range.

The minimum period to achieve stable concentrations after a change in dose of thyroxine is two months and thyroid function tests should not normally be requested before this period has elapsed.

if GP won’t increase dose …..see different GP

Or see thyroid specialist

List of thyroid specialists and endocrinologists

healthunlocked.com/thyroidu...