Blood test results, such as they are!

[Crystalline]

I've been self-medicating since April, substituting 2 grains of Armour for my 100cg of Levo, and in general feeling less dopey. However recently I started to feel very sluggish and have developed Plantar for no apparent reason, so I thought I should ask my doctor for a blood test.

Back came the results, along with the order to drop my dose to 75mcg Levo (they don't seem to have noticed that I'm no longer taking it). The results are:

TSH - 0.13

Free T3 - not tested

Free T4 - 15.4

When I asked why they didn't test for Free T3 I was told it was "specialised" and not normally requested.

Are my sluggish feelings likely to be due to my TSH level? I suspect my doctor is going down this route.

I have an appointment with her next weekand I intend to press for an appointment with an endo. I've been hypo for 15 years and never had any more than fairly rudimentary medical attention.

Any advice on how to tackle my GP much appreciated.

[Clutter]

Crystalline, the thyroid blood test won't show your doctor what medication you are taking so there's no reason why s/he would know you are taking Armour instead of Levothyroxine if you haven't mentioned it.

You haven't included the lab ref ranges but I imagine your GP has asked you to reduce Levothyroxine because your TSH is below the lab ref range and is worried you are overmedicated.

2 grains of Armour is roughly equivalent to 150mcg-200mcg Levothyroxine. It may be an idea to order a private FT3 test from Bluue Horizon or Genova thyroiduk.org.uk/tuk/testin... to check your FT3 isn't over range. Overmedication can cause fatigue as well as under medication.

thyroid.about.com/od/thyroi...

[Crystalline in reply to Clutter]

Thanks, Clutter. Including the lab ref ranges, the results are:

TSH - 0.13 (0.25 - 4.00)

Free T4 - 15.4 (12 - 22)

I may well be over-medicating then, but its so strange that I haven't dropped a single pound

[Clutter in reply to Crystalline]

Crystalline, Those results don't indicate you are overmedicating. The direct T3 circulating in your blood tells the pituitary gland you have enough T3 and it 'switches off' TSH.

Your GP appears to think that TSH below range means you are overmedicated and has advised you to reduce T4 accordingly. Some people do need a lower or suppressed TSH to feel well but as you are self medicating it doesn't really matter if your GP reduces your dose. If you decide to tell GP you are taking Armour take the patient information Leaflet with you as your GP may not be familiar with NDT. If you get any BS about it being dangerous/unstable tell him to look it up in the American equivalent of the BNF.

[galathea in reply to Clutter]

What is the American bnf called please?

[Clutter in reply to galathea]

Galathea, I can't remember. I googled various permutations of 'American Pharmacologic/al List' but didn't find it. I think Helvella may know but I couldn't find the post I thought he'd posted it in either. Big fail!

[Clutter in reply to galathea]

Galathea, Found it! It's the US Pharmacopeia-NF.

[helvella in reply to Clutter]

usp.org/usp-nf

[Spareribs in reply to Crystalline]

or you could postpone the telling off and just say you took 2 by accident before your test.

[Hidden in reply to Clutter]

Actually, this is a bugbear of mine: a glance at the patient's notes will surely show that no scrip for Levo has been requested for whatever period of time one has stopped taking it. Are doctors so uninterested in their patients now that a simple 'I see you've stopped taking your medication - would you like to tell me why?' is beyond them? Although, I suppose that for those of us who have kicked our NHS Levo into touch, we should be grateful we get no searching questions. What a sick sad world we live in.

[Clutter in reply to Hidden]

Humphrey, a lot of people still collect their repeat scripts. Hopefully they won't get the pharmacy to dispense them if they don't intend taking Levothyroxine.

[Hidden in reply to Clutter]

Do the pharmacy and the surgery not communicate at all? That many-billion-pound, all singing and dancing computer system - does it not link meds from surgery to chemist? Unbelievable!

[Clutter in reply to Hidden]

Humphrey, People may collect their script and have it dispensed at a pharmacy miles away which isn't connected to their GP surgery. I expect there is reconciliation of scripts issued and scripts dispensed but it may be at national rather than local level.

[Hidden in reply to Clutter]

You have more faith in them having a 'system' than I do ...

[Clutter in reply to Hidden]

Humphrey, I'm sitting here clapping my hands hoping to save Tinkerbell

[helvella in reply to Hidden]

At least some surgeries don't even notice that one of their hypothyroid patients (not me!) hasn't:

a) Attended for a blood test;

b) Requested any prescriptions at all;

c) Made any contact with the surgery at all.

For a period of years.

This despite that they must maintain a thyroid register (although only a simple software issue these days), must ensure that a certain percentage of thyroid patients are checked every year, they get paid for achieving this target.

[Hidden in reply to helvella]

Quite. I am one who is a, b and c. I never been called for a blood test. In the days when I was still playing the game, I used to request one each year, which was reluctantly set up, for the bare minimum of information. I was always 'normal'.

I wonder if there is a tick box on these thyroid registers for 'spontaneously recovered', or 'miracle'? Or even 'vanished without trace'?

Grrr.

[Crystalline in reply to Hidden]

My interrogation, sorry appointment, is Thursday. Hopefully my GP will agree to work with me rather than try to tell me off.

[Hidden in reply to Crystalline]

I suppose the thing is to attend hoping to have an intelligent conversation with a buoyant outcome, but to go loaded for bear. Take someone with you if you can. A witness is always handy, and can improve doctor behaviour. Also go with a list of the outcomes you want, and the main symptoms you still have.

Sorry about the cross-fire which I have begun in your thread. Sometimes I still get sooo mad. Better now.

Wishing you all luck for Thursday.

[Crystalline in reply to Hidden]

Humphrey, I'm fascinated by the way in which we are polarised into 'them' (the medical profession) and 'us' (the patients). And the way we collectively seem to have to take control of our own treatment to remain sane and reasonably healthy. So rant all you want!