Hi my tsh levels are 2.32! .gp says this is fine and acceptable, i don't feel right , as most fellow sufferers i am not loosing any weight

[lexlou]

And get patronizing comments from .gp like maybe your not eating enough, and your weight did'nt go on over night .shall i request to see an endo? I have had underactive thyroid for the12 years!

[Clutter]

What is the TSH lab ref range please and are you on thyroid medication? If so, what type and what dose?

Under medication can make it impossible to lose weight despite being on low calories and exercising like a fiend.

[lexlou in reply to Clutter]

Hi my tsh is 2.32, i am on thyroxine i alternate days 125 then 100mg

[Clutter in reply to lexlou]

I think your TSH indicates you are under medicated and your symptoms confirm it. Your GP is either ignorant or a sadist. If you took 125mcg daily you'd probably feel a bit better as your TSH drops. Most people feel comfortable with TSH around 1.

[shaws Administrator]

It may be 'fine' for the GP but it's obviously not fine for you. Email [e-mail] and ask for a copy of the Pulse Online article and see question 6 below. Please ignore the stupid comment on the last para - typical! Lyn Mynott has already contacted him re this phrase.:-

6 What is the correct dose of thyroxine and is there any rationale for adding in tri-iodothyronine?

The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range – 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l. Most patients will feel well in that circumstance.

But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This ‘exogenous subclinical hyperthyroidism’ is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l).

Even while taking the slightly higher dose of levothyroxine a handful of patients continue to complain that a sense of wellbeing has not been restored. A trial of levothyroxine and tri-iodothyronine is not unreasonable. The dose of levothyroxine should be reduced by 50µg daily and tri iodothyronine in a dose of 10µg (half a tablet) daily added.

[lexlou in reply to shaws]

Thanks for this information it is really useful, there may be light at the end of the tunnel, i have two boys 6 and 8 and i just want to be well enough for them . Thanks again

[anbuma]

I haven't had these comments from my gp(s) but it is what I have told him(and rheumatologist) to no avail who was so patronising when I saw him on Monday and again refused to listen or accept he was wrong

[eeng]

Do you have T4 results? Doctors seem very scared of making people hyper. If you have a low T4 result ( i.e. a long way off the top of the range) you could point out that it's a high T4 that makes you hyper, not a low TSH. It worked for me (that and telling my GP I am a doctor in my own field). I also promised that she would be the first to know if I felt even the slightest hyper symptoms. She let me try an extra 25mcg of levo even though my TSH was only 1.2. Result!