Doctors this morning, what options can I request?

[Zubakuki]

Seeing the doctor finally this morning, they want to drop my levothyroxine to 100, but will keep it at 125 for another two months before rechecking the levels. Purely because I freaked out on The phone yesterday and demanded to know why I am still not able to lose weight and I am practically starving myself! Why I still feel tired and lethargic. Basically why I am still the same, as before getting treatment. I am asking to see a specialist but in the meantime is there something else the doctor could prescribe for me to try? TIA Donna x

[helvella Administrator]

Starving yourself is not good. It can affect the rate at which T4 is converted to T3.

Not sure if you have been checked out for vitamin B12, folates, iron/ferritin and vitamin D?

Also, do you have any actual results? They can help in trying to see where you are.

Rod

[Zubakuki in reply to helvella]

Hi Rod,

I will be requesting a copy of the results today and will update later. Pretty sure I have not had a test for the other things, only ever taken one vile of blood with gold top.

I am 3 stone heavier than I was after having my first two children. I was diagnosed after my third and I literally lived on nothing but fruit for a week, lost 6pounds and within a day of eating normally the 6 pounds was back. I am down to 1200 calories a day to maintain my overweight body. If I look at a packet of crisps I gain a pound!

Donna x

[helvella Administrator in reply to Zubakuki]

Look forward to your next post.

[Zubakuki in reply to helvella]

Hi Rod,

Back from the doctors! No T3 results as wasn't tested. The doctor has requested that in 6wks time I retest and the t3 will be done then! To say I am annoyed is an understatement.

Results say I need a drop in thyroxine apparently...

Tsh 0.02mu/L

Free T4 15.2pmol/L

Holding off on taking a drop to 100 until the next blood results.

Got blood test tomorrow for FBC, U&E, liver profile and bone profile.

I am so upset, he told me that in his experience people who are hypo never really lose weight and easily gain. I could well face the rest of my life avoiding foods I love

[helvella Administrator in reply to Zubakuki]

If doctor has not checked that the lab really will do T3, I suspect it will not be done then either. Labs usually/frequently refuse unless the TSH and FT4 results strongly suggest that something is very wrong. Sometimes they refuse simply because request is from a GP rather than an endo.

Remember you can do something like drop to 100 alternate days (or any other pattern that works for you). So you can achieve average doses of 110, 115, 120, or whatever quite easily.

Have you got the reference ranges, especially for FT4? (They vary widely between labs.)

Rod

[Zubakuki]

Thanks Rod,

And the ref rages are...

Tsh 0.35-5.0

T4 7.0-20.0

I hope I am reading it right, I am a bit bleary eyed lol.

Donna x

[helvella Administrator in reply to Zubakuki]

That suggests to me that your TSH is rather low for an only-a-bit-over-halfway FT4 result.

I'd be happier seeing FT4 nearer 20.

From the FT4 numbers you DO NOT NEED a reduction and might even do better with an increase.

Rod

[Zubakuki in reply to helvella]

It has suddenly dawned on me, thanks to you, that the tsh is irrelevant. My thyroid stopped producing t4 regardless of what my tsh levels were and even if my tsh is in the normal range it won't make my thyroid produce t4, so why do they even care what the tsh level is? Is there any problems that occur from not producing tsh? X

[helvella Administrator in reply to Zubakuki]

Yes, quite!

"They" do seem to care because so many people only get a TSH test so everything is based on that. Often people are warned of heart problems and bone loss through low TSH but it always seems to me that the problem is when FT4 and/or FT3 are too high.

Not aware of any clear-cut research which shows low or suppressed TSH in itself to be bad but certainly the question has been raised and some people seem to think so.

Rod

[Zubakuki in reply to helvella]

The doctor told me that it was the t4 t3 being too high that caused bone problems not the tsh. I can't see how low tsh could do any damage if t4/t3 is normal. I thought the only thing that tsh did was tell your thyroid what to do. People who have had the pituitary gland removed due to cancer do not take a replacement tsh, they take t4 don't they? X

[helvella Administrator in reply to Zubakuki]

Yes - all true. But there continues to be niggling doubt - with some at least suggesting that TSH itself just might have some other function, somewhere. (Or maybe not so much "function" as "effect".)

[Zubakuki in reply to helvella]

I suppose they once thought the spleen was useless