Spoke to GP today - abnormal TFTs

[Angel222]

Hi, I spoke to my new GP today. She has said my latest thyroid results are "normal" and would like to retest my folate, Vitamin B12, Vitamin D, calcium, FBC and coeliac screen. The GP has said I "look anaemic" yet my ferritin has only been done last week and she wants it redone again!

Vitamin D result is still not back from my previous GP practice and this was done over a week ago. It was on my previous GP's system but not on the receptionist's system and not on the hospital's system, either. Does that mean my results for Vitamin D have been lost?

I was surprised to find that the results from the walk-in blood test appointment I had done on the 15th, a week before the blood test date on the 22nd for the retest, are abnormal yet I wasn't told about this by my previous practice or the hospital who arranged this.

TSH: 0.60 (0.2-4.2)

Free T4: 17.3 (12-22)

How could this have happened when I had only just started out on the 50mcg thyroxine please?

[Clutter]

Angell, Your TSH isn't abnormal, just slightly under range. If you took your Levothyroxine before the Walk-In blood test this would explain your low TSH.

[Angel222 in reply to Clutter]

I didn't take the thyroxine before the blood test.

[Clutter in reply to Angel222]

Angell, it's nothing to worry about as your FT4 isn't over range so you don't look overmedicated. If you feel overmedicated ie anxious, jittery, hot, racing heart etc. then a slight dose decrease may be in order.

[Angel222 in reply to Clutter]

Thanks but would I need to talk to my GP first about changing the dose? I am not due to have a repeat thyroid test until the start of November.

[Clutter in reply to Angel222]

Angell, if you feel overmedicated try a slight reduction in dose 50mcg/25mcg on alternate days. It will take 7/10 days to feel any change. If you don't feel overmedicated stay on 50mcg daily. You don't need your doctor's permission just keep her informed what dose you're on next time you see her.

[Angel222 in reply to Clutter]

Thanks. I rarely feel overmedicated. I am more undermedicated most days. I don't sweat, get jittery or racing heart. I have dry skin, dry eyes, cramps, fatigue, heavy eyelids and difficulty swallowing.

[Clutter in reply to Angel222]

Angell, if you don't feel over medicated there's no need to reduce your meds. Your thyroid results don't indicated undermedication so you may have to work on improving your ferritin which may be causing your fatigue.

You don't say how long you've been on Levothyoxine but it can take several months after you are optimally medicated for symptoms to improve.

[Angel222 in reply to Clutter]

I've been on thyroxine for 3 weeks. But the GP has taken me off in the past when my levels reached normal.

[Clutter in reply to Angel222]

Angell, you said in your post you've only just started on 50mcg. Your bloods indicate it is the right dose but you have to allow your body more time to respond to the increased dose. It took over 6 months after I was optimally dosed for my skin and hair to stop shedding.

[Angel222 in reply to Clutter]

So if I just continue to take the 50mcg dose for now and then wait until the retest in November that will be fine. I will look to take the iron supplement after the retest is done and then if I have any overmedication symptoms to cut the dose down to 25mcg or alternate if I need to.

[Clutter in reply to Angel222]

Angell you said you don't have symptoms of overmedication so DON'T reduce your meds. Your metabolism will be all over the place if you raise and reduce your Levothyroxine willy nilly. You need to remain on 50mcg until your November blood test.

[Angel222 in reply to Clutter]

Ok thanks. I just thought if my body is still getting used to the 50mcg dose that meant that I could end up overmedicated.

[Clutter in reply to Angel222]

Angell, that's why one has thyroid bloods taken 8 weeks after dose changes, to see whether the dose change is too much or too little.

[Angel222 in reply to Clutter]

Ok, thanks. I'll keep going on the 50mcg dose for now.

[Angel222]

Ferritin is 15 (30-400)

[Clutter in reply to Angel222]

Angell, ferritin is low. Optimal is 70-90. Supplement iron and take each tablet with 500-1,000mg vitamin C to aid absorption and mitigate constipation.

[Angel222 in reply to Clutter]

I have these supplements to take: ferrous fumarate 210mg (which I have tried taking but they make me feel sick), Feroglobin and Spatone. I have Vitamin C 1000mg fizzy tablets as well. Are any of these better than the other? I don't want to take more than one supplement or stagger them each day.

If my ferritin has been booked in to be done again, is it a good idea to just take the iron supplements now rather than wait for the retest?

[Clutter in reply to Angel222]

Wait until after the retest, Angell. I don't understand why you wouldn't take more than one supplement a day or want to stagger them. If you are deficient or low then supplementation is required.

[Angel222 in reply to Clutter]

The retest is done for tomorrow. My GP prescribed me the ferrous fumerate but when I took it my stomach didn't like them and that was when I added Vitamin C to it.

So I then bought the Spatone and after that the Feroglobin in case I didn't get on with one or the other. I didn't know if there was a variation in how much iron is in the Spatone as opposed to the Feroglobin one.

[Clutter in reply to Angel222]

Angell, it should tell you on the patient information leaflet how much elemental iron each contains. I believe there is very little in Spatone which is why it is easier on the stomach. I don't know anything about Feroglobin.

[Angel222 in reply to Clutter]

Ferrous Fumarate contains 210mg iron, Feroglobin contains 14mg but I can take it twice a day (3 times when on a period). I'm going to have to take the Ferrous Fumarate by the looks of things. Feroglobin contains B12 but the cyano- form of B12. I have read that the preferred form of B12 is the methyl- one which is why I'm not really sure about taking it.

[Clutter in reply to Angel222]

Angell, if you need to supplement B12 methylcobalamin is recommended but the cyanocobalamin is better than none.

[Angel222 in reply to Clutter]

Vitamin B12 hasn't been done recently but my previous result was 364 (180-900). GP says it was normal and didn't need supplementing.

[Clutter in reply to Angel222]

Angell, GPs say everything within range is 'normal'. It isn't optimal though. Most of us supplement because we consider top of the range to be optimal. There's no danger of ODing on B12 supplements as excess is excreted in urine.

[Angel222 in reply to Clutter]

So maybe I should get a supplement in B12 and ditch the Feroglobin if it does not contain the methyl- form of B12. Taking Spatone is no problem as long as it gives good results. If not I'll have to down the Ferrous Fumarate with Vitamin C.