Don't think my previous surgery did the Free T4 bit, not sure if that should be T3 or why they have shown that, is that a good thing to show that?
Anyway whatever it says I am still symptomatic and as such have made an appointment but feel I just don't know where to start to convey how unwell I feel or what I should push for with regards to further treatment.
It sounds as if you are very hypo and your TSH is on the high side for someone one medication.
If you email louise.warvill@thyroiduk.org and ask for a copy of the Pulse Online article by Dr Toft. He says the aim is for a TSH as follows:-
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.
****
He also goes on to say that if patient still complaining, the addition of some T3 to a reduced T4 is warranted.
Send a copy highlighting question 6 to your GP to read before your appointment. Your are suffering as you appear to be on too low a dose of meds.
I have started to wonder if I have some other kind of condition ie ME or something. I know at night and sometimes in the day my limbs become painful and stiff and I have a lot of heartburn and sometimes pains sort of underneath my bust line. It's kinda hard to describe all my ailments and how I feel. There's also the issue of my bereavement and with GP appointments being so short I am afraid I will not get it all out and screw up. I'm just not good at talking to doctors sometimes plus this is a new surgery and new doctor for me.
A lot of people with ME or CFS are actually people who are untreated or insufficiently treated for underactive thyroid. Take a friend with you to the doctors if that would help. Some people with hypo have low stomach acid which might account for the heartburn. Random aches and pains can be hypo too - I get a backache when lying in bed in the morning every day when I am undermedicated. It completely disappeared when my dose of levo was increased. Weird or what! The difference in TSH level for me was tiny - TSH=1.1 = backache, cold, weight gain. TSH=0.23 = no backache, warm, able to lose a little weight. Everyone is different but your TSH of 3.02 could definitely be causing your symptoms.
Thanks eeng. I have just printed off the pulse article by Dr Toft, I don't have time to post it to my doctor as my appointment is Friday. I may just bring along the relevant paragraph and mention it to her and see what kind of response I get. It looks like I already have the correct dx I just need the correct or improved treatment. Would not want to complicate matters further I guess with more dx's. The odd thing about it is though that ME now gets a lot of understanding and respect, under active thyroid does not. When I mention to people how ill I feel they say, oh dear is it ME? When I say to them no its under active thyroid I get well I have that, I was just putting on a bit of weight I take thyroxine and Im fine (this from my male gardener)...........go figure. I just feel worse when people say this. So many people just dismiss hypoT as nothing.
What would be an effective increase, at present of 100mcg. Could it be a good time to also add T3?
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