Can I push for an increase in medication. - Thyroid UK

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Can I push for an increase in medication.

dee2229 profile image
10 Replies

Long story short.

Sept 2013 tsh 60 (0.35 - 5.00), T4 6.3 (9.00 - 24) t3 2.8 (3.50 -6.50) Tpo 1005 (0.00 - 50) started on 50 mcg of thyroxine. Tsh 6 weeks later 10.4 and medication left at 50mcg. Next test tsh 19.8 med upped to 75mcg. Next test 18.5 different Dr upped med to 150 mcg and requested a ferritin test. Next results tsh 0.17 and T4 14.9 ferritin was 19 don't have full range but bottom end 15 thyroxine left and iron added. Then had b 12 and vit d test called back to Dr's as vit d out of range was different Dr again and as I was explaining everything the first thing she said was she would of reduced my thyroxine, no questions re how I felt just looked at the numbers. My problem is she is my named gp and have an appointment tomorrow - as you can imagine think I am going to have a battle on my hands. My question is if my new results are similar to last can I request a trial of an increase to bring my T4 up. Weight is a big issue had managed to lose 4 St before this and kept it off for 18 mths. Still cold and hair and skin still not good. Have taken morning temp unfortunately middle of cycle so will be up a bit and readings for last 3 days were 36.1, 36.3 and 36.6. Not such a short story after all lolx Any insights from fellow suffers would be greatly appreciated.

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dee2229
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Clutter profile image
Clutter

If your Levothyroxine was increased from 75mcg to 150mcg in one hit I think that GP was reckless. 25mcg increments are the norm. Your TSH is low, but not suppressed, and your FT4 is low in range and would be better in the top 75% of range.

If your GP won't accept that you feel well(er) on your current dose try and negotiate 150/125 alternate days or lie, tell her you took your Levo just before the test and ask that she maintains your current dose until your next TFT.

Make sure not to take meds the night or morning before a blood draw and have it done early as possible in the morning when TSH is highest and make sure to book in with the reckless GP in future :)

waveylines profile image
waveylines

Am I bonkers or did i read somewhere that T3 was the way to go if you suffer with Hashi's? You might want to nosey on Stopthethyroidmadness website -I think it was on there.... If so next time book in with the 'reckless' GP and see if she'll at least consider adding some T3 into the mix.....

Clutter profile image
Clutter in reply to waveylines

Dunno if T3 is recommended for Hashi's Wavy, but it sure is good for people on loadsa Levothyroxine but with low FT3.

Are you bonkers? It's probably your thyroid ;)

waveylines profile image
waveylines in reply to Clutter

He he -without doubt CLutter -am stil recovering from bad batch of Erfa Thyroid ( NDT) that I sadly took for 5 whole months.....not been the same since :0 :) :0O

shaws profile image
shawsAdministrator

Unfortunately, GPs have no knowledge of clinical symptons, i.e. cold, low temp etc etc.

Yours doesn't seem capable of treating hypo patients.

The aim of the medication is to make you well, not unwell. You should be treated till you feel well. Weight gain is a common symptom of too low a dose as well as feeling awful.

If your GP is going to up/down your meds according to the blood test, maybe educate your GP by emailing louise.warvill@thyroiduk.org and ask for a copy of the Pulse Article by Dr Toft of the BTA, wherein he advises the range GP's should aim for. make a copy and take to your GP. She will also see that some T3 can be added if necessary.

dee2229 profile image
dee2229 in reply to shaws

Thanks for all the reply guys. As so many members say this group help enormously. The reckless gp is a long term locum so not always there and I have to say was a little worried about taking the double dose in one hit but it was ok. Will email for a copy of the toft document. Will come back later and let you know how I got on. Once again thanks guys x

dee2229 profile image
dee2229

Back from Dr without any change to meds. .. took a little bit of persuading. Tsh 0.07 (.35 - 5.00 )

T4 15 (9.00 - 24 )

T3 requested but no result

Vit d 76 (75 - 200)

Ferritin 35 (15 - 250) Dr has requested t3 again. Asked if I wanted to see an endo said I would wait for t3 result. Any views on this array of results would be welcome also any recommendations for an nhs endo in the Surrey area. Have to say am feeling so much better than I did and would be happy if I could shift the stone I have put on in the last 9 months which would bring me back to a healthy bmi. Should add taking 75 mg losartan for hypertension not sure if that could be a reason for not being able to shift the weight as been on this since Nov 13.

shaws profile image
shawsAdministrator in reply to dee2229

Do you take iosartan at least 4 hours apart from levo as some things can interfere with the uptake.

This is a previous post re ferritin and level should be 70-90 minimum:-

healthunlocked.com/thyroidu...

and Vitamin D

healthunlocked.com/thyroidu....

Clutter profile image
Clutter in reply to dee2229

Well done in resisting a decrease.

Your vitD is only just in the optimal range. You'll probably build vitD during the summer months but it would be an idea to supplement 2,000iu daily Oct-April.

Your ferritin is very low. Halfway in range should be your target. Try ferrous fumerate taken with 500mg-1000mg of vitC with each dose to aid absorption and mitigate constipation effects.

If you're feeling well there's no point in seeing an endo. Endo won't bring anything to the party and is more likely to interfere and insist your dose is decreased.

dee2229 profile image
dee2229 in reply to Clutter

Clutter thanks for the info on the vit d and ferritin always helps to know what to aim for.

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