Sorry, I can’t give any current thyroid results as am on some medication for an abscess which affects blood results . Am still on 50mcg. Since diagnosis from scan initially last December I have been diagnosed with diabetes , which I’m not happy about really . I had one blood test which was 51, then given another blood test just a week later which was 50. This gave the diagnosis and set the medical wheels rolling. After this it was checked again with another test and it was 47 ( test was done when shouldn’t have bp been done due to abx.) Attempting to address through diet as I don’t want medication. I do have a healthy diet, could always be better, and exercise regularly. Need to lose weight as piled on with long covid. The next issue was my cholesterol , reading 5.2 in January though LDL was far too high . Again done again whilst on abx and jumped to 6.3, again with LDL too high though HDL accounted for most of increase. Had call re statins and have refused. Today , I had to attend hospital , I get anxious and suffer from white coat hypertension. Anyways , it was sky high. Took again straightaway and it was even higher ( top figure by 30!) . So now talk of 24 hour monitor, medication etc. At home I took it again and it was normal range . Is normally ok at drs unless it’s someone I don’t know . I hate the noise the machine makes and nurse said she could see me tensing so I don’t see what good a 24 hour monitor will do other than totally stress me. The non electric BP monitor I find less stressful as no horrid noise and it doesn’t nip! I’d not felt unwell going to hospital but was totally stressed out on way home. I may have health conditions but it all seems very odd that these have all appeared since my Hashimoto’s diagnosis in December?! Is this common? Should I be worried? (I am , very!) Do I need to see an Endo? Would be extremely grateful for any advice and sorry for the long post .
No health issues before diagnosis, now everythi... - Thyroid UK
No health issues before diagnosis, now everything is a little scary
how long since thyroid and vitamin levels last tested
Request dose increase in Levo
High cholesterol is directly linked to being hypothyroid and will improve as dose Levo is increased over coming months
nhs.uk/conditions/statins/c...
If you have an underactive thyroid (hypothyroidism), treatment may be delayed until this problem is treated. This is because having an underactive thyroid can lead to an increased cholesterol level, and treating hypothyroidism may cause your cholesterol level to decrease, without the need for statins. Statins are also more likely to cause muscle damage in people with an underactive thyroid.
High blood sugar can similarly be worse as result of being hypothyroid
thyroid.org/patient-thyroid....
Thank you. Last result was 23/4 but taking antibiotic then that could affect result. My TSH I has gone up from 1,71 on last test. Am unable to be tested again till I come off antibiotics so no idea what is happening currently.
T4 14.8 (11-26)
TSH 1.88 (0.27-4.2)
Was test early morning and last dose levothyroxine 24 hours before test
Free T4 (fT4) 14.8 pmol/L (11 - 26)
Ft4 only 25.3% through range
Most people, when adequately treated, will have Ft4 at least 70% through range
Clearly you are currently in need of next increase in Levo
Likely to need several further increases over next 12-18 months
Essential to test vitamin D, folate, ferritin and B12 at least annually. Ideally more frequently when not on high enough dose levothyroxine as low vitamin levels are far more likely
Yes, I always follow helpful protocol. The only query I have is I eat kefir for part of breakfast most days and it I’ve just noticed this in ingredients.
B12, .45 per 100g, 18%.
Riboflavin, B2, .3 per 100g, 21% of reference intake per 100g.
Could this affect my results and if so how and in what direction please?
No unlikely to have any impact on results
Other than possibly increasing B12
Thank you! I was just a tad concerned as says biotiful on it, noticed b vitamin s and thought of biotin, which I don’t what it is!!
I will make a comment about one thing - is it accurate you have been on 50 mcgs Levo for 4 months since your diagnosis?
I haven’t looked back at your bloods, per SD would be very helpful to see an update on your TSH, FT4 and FT3.
But here’s one thing I will point out. 50 mcg is a starter dose that should be increased as early as 6-8 weeks upon starting.
Levo does not “top up” rather it fully replaces your thyroid hormone in your body. Therefore, the longer your are on just 50, you are actually halting the progress towards your full replacement by probably about at least half where you will ultimately end up.
I was left on 50 mcgs for 9 months. It was before I found this forum and it was a very confusing and disheartening 9 months. My doctor essentially threw up his hands and was confused why I didn’t feel better, which made me think something else was wrong.
Now 9 months after that I am at 75 mcgs Levo and 10 T3 and just about a month or so ago began to see that light at the end of the tunnel.
The first year (ish) when getting in Levo has ups and downs.
It’s not the Hashis diagnosis that has made your symptoms appear… it’s that you HAVE hashis and it’s SUBOPTIMALLY treated at the moment.
ALSO without recent bloods no one can say any of those for 100% certain.
My cholesterol climbed and climbed year after year while I had low thyroid hormone levels. Within months of getting on the right dose it just dropped in its own.
The co-incidence of our thyroid and other health issues can be so dynamic and confusing.
The approach I have taken is to hold my breath and get my thyroid levels up… over that last 9-18 months! Patience.
But those low free Ts are absolutely the root cause of a multitude of your issues. I know nothing else about you, but low Free T3 affects anyone from head to toe.
As SD says - get an increase in Levo.
You can simplify your next step for that one thing… 50 mcgs is too low for anyone.
Thank you !
My last results in April were whilst taking an antibiotic that can affect blood test so I now have to wait till I no longer need them ,
T4 14.8
TSH 1.88
No FT3 though I did request on one of my previous printouts the lab was querying why testing
Dr says I’m responding really well to hormone so no suggestion of increase, but probably not helped if I’m honest by my fear of medication. However, now everything with BP, cholesterol and blood sugar apppears to suddenly have gone so out of synch all at once . It is quite frightening. Symptom wise , I’m not too bad, a little tired but that could be my long covid. However, I’m now feeling extremely stressed and miserable and beginning to dread any further testing and wondering if my body is getting ready to just conk out!
I fully understand the white coat syndrome, as my BP rises alarmingly in the GP surgery/ hospital. For this reason, I take regular readings of BP and pulse myself and provide any medics with a copy as needed. I’ve also had a 24 hour monitor, as I had palpitations following an increase in thyroid medication. I now only increase or decrease thyroid medication super slowly, adjusting by 12.5mcg as it definitely gives me adverse symptoms.
Your worsening anxiety is likely linked to your thyroid medication & key vitamins not being optimal. I always feel worse when either thyroid medication or key vitamins need adjusting.
As a first step I would test TSH/ FT3/FT4 plus folate, ferritin, B12 and vit D and share results with us.
Thank you! I’m so stressed now I wonder what good the visit actually did me! My blood pressure has been normal again once home. Why it went so high though I’m not sure, always goes high in hospital setting but was ridiculously so, and actually increased by 30 when did second reading so I was unable to do an exercise test. I know my folate is at the low end and since being on antibiotics I have stopped supplements so there is no possible disruption to treatment . No testing till I can come off antibiotics now. I know the monitor will give high readings as I get so agitated by it and would hate to be falsely medicated as my BP can often be quite low
Hi there…. I think what you need is a big hug!!!! I’d give you one if I could. 🤗
Big hug, no words, and long deep breaths!
Ok, So to simplify!
You do need a Levo increase. Also - Levo is NOT medication. It’s not a pharmaceutical or drug. It’s a replacement of a hormone our bodies need but cannot make on its own.
I am always careful to say we are “underreplaced” or “overreplaced” vs undermedicated or overmedicated. Subtle but important difference.
With a TSH over 1 we see you need a bit more Levo, and your T4 is only about ~25% through range when we aim for about 75%.
Complete picture of thyroid health - These things should be your “dashboard” over time: TSH/ FT3/FT4 plus folate, ferritin, B12 and vit D . After your antibiotics are done, see what you can get from your doctor, or go medichecks. But start to build a history of these numbers they will be helpful over time.
Blood pressure - I have no experience here, but like what Buddy says. Get a home blood pressure checker, and just get your own peace of mind that on a normal day your BP is fine. Track it and bring it next time you need to have it checked at the doctor/hospital.
Diabetes - I only have a little experience here (had gestational diabetes that I controlled with diet/exercise; and family history of it all over the place!)
Can you tell me when you say “one blood test which was 51, then given another blood test just a week later which was 50.” What unit of measure is that?
In usual diabetes measures 50 is fine… so that must be some other measure or some different unit.
Thank you! And for the virtual hug. I am so unhappy and having many tears this morning. After being perfectly healthy and fit these new health diagnoses have been hitting me relentlessly since the end of December and I really have to question are they all related to thyroid as I don’t understand why everything should suddenly become problematic.
I am concerned as I understand increase in levo can cause heart issues, but also that if not enough you can also have heart issues
My TSH has oddly gone up after falling on the previous tests . On one test it fell from 2.5 to 1.71 in one month!
My T4 is slowly rising.
All my important other bits were high , though vit d was 75 so understand this could be better , but folate was low and I suspect had been dire at one point as I’ve been supplementing with b vits. I have bought a folate supplement but stopped all supplementation to try and ensure nothing interferes with my antibiotics third course).
The range is anything over 48 is diabetic, over 42 is pre diabetic. I just need to lose some weight and although eat well and exercise it isn’t easy. Have lost a little recently and trying really hard. Is Hbac1 , mmol.
Thank you for responding, feeling quite desperate and although all medical staff have been kind I really don’t think there is any understanding as to how desperate you can feel with all this being thrown at once . And then I have the added worry of if it is all my thyroid what on earth do I do next to get the help and expertise I need without the medical world frightening me to death and making me feel I am about to drop off my perch unless I take a boatload of medication and have continuous multiple tests.
I do apologise, I am in a dark place and feeling extremely sorry for myself . Hopefully, I will perk up after my wail!
Please wail all you want! I am channeling your feeling right now, I’ve been there, most (all?) of us have.
Everything does seem to happen all at once. Some of it is directly related, some of it is correlated, but it is only time where you can get your head around the whole big picture. When I was where you were it was helpful for me to take it step at a time. Prioritize what next, and let those actions take their course for however many days/weeks needed.
Here is one thing that you can detangle (this is a thyroid forum after all):
* You need a Levo increase. See SD’s post just a few minutes ago below. Read, ponder, get an action plan. Regardless of all the other dynamic aspects of your health right now - you need a Levo increase.
I have always taken the approach to increase my Levo and “set it and forget it” for 6-8 weeks. You need to be on a new dose for that long before testing again. And that is helpful because in that long 6-8 weeks… no more over analyzing, worrying, etc about your thyroid. This one thing is a necessary step no matter what else is going on.
Again - read SD’s post below in detail.
Diabetes - again, not an expert, but I did control gestational diabetes with diet and excercise. I was very scientific about my exact carb intake, and taking my glucose readings way more than I needed to see how my own body was responding. Funny thing about it - when pregnant you can’t go low carb as the baby needs carbs to grow. Same thing with thyroid - you need carbs for it to work well.
Assuming you are tracking your food and glucose at this point?
For me, when I take action and take control I do feel calmer. Control what you can.
What guidance/advice did the diabetes folks tell you? Are they saying insulin yet, or not yet.
What ARE your glucose readings anyway?
As for the emotional part of the “all at once”
I was diagnosed Hashis Aug 2022. Between 2012 and 2019 I ran two marathons and tons of other short races (including several half marathons each year), and was full into the joys of being fit and healthy. Living life. In 2021 symptoms started. In 2022 I thought I was dying. I felt 90 years old. By 2023 I found this forum and my life started turning around. You are at the start of getting on track. Do not lose hope… it will be a bumpy ride, but your thyroid will get better than it is now.
And don’t forget our low thyroid hormones create depression and anxiety. It’s a symptom. It’s related to blood chemistry. Now - the emotional stress of dealing with new chronic illness is… crushing. But our blood chemistry will make us feel absolutely frantic. This will get better as your thyroid hormones improve. You will find patience and strength you did not know you had.
“You do not know how strong you are until being strong is the only option.”
Me and this forum are all here for you.
Levothyroxine doesn’t “top up” failing thyroid, it replaces it
Even if we frequently start on only 50mcg, majority of 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, aiming for Ft4 at least 70% through range
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.
Some people need a bit less than guidelines, some a bit more
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...
TSH should be under 2 as an absolute maximum when on levothyroxine
gponline.com/endocrinology-...
Graph showing median TSH in healthy population is 1-1.5
web.archive.org/web/2004060...
Comprehensive list of references for needing LOW TSH on levothyroxine
healthunlocked.com/thyroidu....
onlinelibrary.wiley.com/doi...
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).
Thank you! Excuse my lack of knowledge , but if my results have been moving slowly in the right direction then is the dose ok and these will continue to do so? Though I suppose my symptoms may be suggesting otherwise?
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