t3

[susiebow]

Been taking 10 mcg t3 and 50 mcg thyroxine for 6 weeks ,felt bit better ,but still rough.Bloods done yesterday ,tsh 7 .83 ,free thyroxine 8.7.tsh gone way up and free thyroxine never been as low.GP did order t3 but lab ha not done it.I thought I was starting to feel hyper ,but surley this is not possible with bloods like this what should I do.

[Jazzw]

Hi Suziebow

It's normal for FT4 to be lower when you're on liothyronine, so don't worry too much about that. It's a real pity no FT3 was done, but I'd lay money on it not being high in range, given your TSH.

Others will advise better than me, but it looks like you need more T3 than you're currently taking. The jittery feeling might be due to undermedication, though I know you've had trouble raising your dose in the past.

[susiebow in reply to Jazzw]

Hi Jazzw,yes I think your right,I need more t3, GP phoned to let me know these results at 6 pm today and he is not sure what to do and he is on hols next week,so I will phone Endo myself on Monday for advice ,lucky I can do this.

[shaws Administrator]

Hi susie

Don't worry too much about blood test results. It's how we feel which is the best way to judge a dose. Your TSH is far too high so you are not on sufficient medication. The dose you are taking - combined T3 and T4 - equals an amount equal to 90mcg of levothyroxine which is quite low, and that shows in your TSH result. Your GP should add another 10mcg of T3, bringing your dose up to around 110mcg which is also a low dose.

It used to be common, before the blood tests came in, that we had doses between 200mcg and 400mcg NDT (before the introduction of blood tests and levothyroxine, which is what it took to alleviate clinical symptoms.

The only thing you can judge by when you are on a combination of T4/T3 or NDT is the TSH because the T4 or T3 cannot be the same. When we take T3 it lowers the T4 as you have lowered the T4 anyway and the T3 will show higher as you are taking it directly and not being converted from levothyroxine. This is an excerpt from the World Thyroid register:

Throughout his work with this group of patients Dr Skinner tried very hard to engage with the rest of the medical profession and address this difference of medical opinion which results in lack of proper medical care in this particular cohort. As far back at 1999 he organised a conference and invited Endocrinologists, General Practitioners and representatives of the Royal Colleges and Department of Health and other medical bodies to engage and discuss their difference of opinion and formulate a way forward for the diagnosis and treatment of these patients. No representative from any organisation except an epidemiologist from the Department of Health attended. The same pattern followed all efforts including further conferences, meetings and letters by Dr Skinner to have a public discussion with medical colleagues to address this shortfall in the care of this particular group of patients.

The Royal Society of Medicine’s reply to Dr Skinner’s repeated request for a conference to address this problem was to organise a conference on thyroid disease and refuse Dr Skinner’s request to speak on his experience in diagnosis and treatment of hypothyroidism. The only Royal College which sent a representative to speak at the World Thyroid Forum organised by Dr Skinner in 2012 was from the Royal College of Obstetrics and Gynaecology to speak on fertility problems in hypothyroid patients.

Dr Skinner vigorously opposed certain aspects of the UK Guidelines at the time they were being formulated and lodged his ‘Document of Record concerning UK Guidelines for thyroid function tests’ in 2005 with all the Royal Colleges, National and Local Health Organisations, the British Medical Association and tried with the Society for Endocrinology who rejected it. He also wrote to Dr G H Beastall, Secretary, Guidelines Development Group, British Thyroid Foundation in 2005 to comment on the pitfalls in the proposed guidelines.

It is disappointing that Dr Skinner’s medical colleagues have been and still are behaving like bullies in a playground forming their gangs and stopping all others from engaging with doctors they have chosen to cast out of their inner circle. Sadly, they have neglected their duty in caring for these patients resulting in a serious shortfall in their medical care leading to unnecessary suffering and years of mental and physical ill health.

These Endocrinologists and General Practitioners have harassed Dr Skinner and doctors like him and instead of constructive scientific discussions have resorted to firing their guns from the shoulders of the General Medical Council and patients and their needs have been completely forgotten. It takes a great deal of courage and determination to persevere in the face of such adversity and Dr Skinner’s bravery and belief in doing the best for his patients brought respect and loyalty from all those who knew him.

This is borne out by numerous patients attending the General Medical Council every time Dr Skinner appeared before them and by more than 2500 testimonials from patients presented before the General Medical Council at his Hearings.

By their own admission, the majority of Endocrinologists and General Practitioners would not treat the patients who were treated by Dr Skinner so they have no experience of diagnosing and treating these patients. Dr Skinner successfully treated thousands of these patients and accumulated a vast treasure of information including blood tests and clinical signs and symptoms at their first consultation and at follow-up.

The difficulty in publishing when one has a difference of opinion from the established medical world is that the so called ‘peer review’ journals are very much influenced by these self-professed ‘Experts’ who proudly proclaim that they are on the Editorial Boards of all journals of repute thus stifling any work which is contrary to their view. This has resulted in control of what is published and what is rejected by a group of scientists and doctors who are preventing important evidence in diagnosis and treatment of hypothyroidism from being debated in mainstream medicine. A difference of medical opinion has been turned into a territorial war at the expense of the patients.

Dr Skinner was a fearless doctor who was true to his Hippocratic Oath and behaved with integrity and carried himself with dignity in the face of callous and unprofessional opposition from Endocrinologists and General Practitioners who ganged up against him and tried very hard to discredit him; the support of patients whose lives have been dramatically changed by Dr Skinner’s care bears witness to his dedication and his determination to do the best for them. I hope in time doctors will be brave enough to once again put patients before all else and stop being so fearful of ‘senior colleagues’ and litigation.

It is a great loss to the scientific and medical world that this brave, articulate and fiercely independent thinker is no longer with us.

Yours sincerely,

Afshan Ahmad PhD

You can also read a letter sent by Dr S sent to Daily Mail and Telegraph.

worldthyroidregister.com/Le...

[susiebow in reply to shaws]

Thanks Shaws,Very good info if only my Endo could off told me all that !

[mstp in reply to shaws]

In psychological/sociological terms, it has just occurred to me that the GMC and others who wouldn't listen to Dr Skinner were probably experiencing Group Think. This is a description to clarify what I mean:

"‘Groupthink’ is a phenomenon whereby the dynamics of a team unduly affect the outcome of the decision making process. This concept can be one of the main contributors towards making ill-informed decisions. When members of a group are too focused on harmony and minimising conflict, they may censor any objections or reservations, resulting in a loss of independent thinking, failure to give adequate consideration to the negatives and an inflated sense of confidence that the decision taken is the right one."

This was the phenomenon that led to all sorts of poor decisions in the past, a prime example of which was the Poll Tax. Unfortunately, I'm not sure how to counteract Groupthink because it seems to me when I look it up that Dr Skinner did it all. In future though I will be pointing this out to my GP and anyone else who may have an influence on thyroid treatment. I think if enough of us talk about Groupthink, gradually doctors might start to question and become more suspicious of the way thyroid problems are treated at the moment.

[Clutter]

Susiebow, you are undermedicated and with TSH 7.83 it is highly unlikely that FT3 is high. Hopefully endo will tell you to increase T3 on Monday. If the increase is 10mcg you can start it at 5mcg to acclimatise if you are worried the full increase will make you feel hyper. Let us know how you get on Monday.

[Aurealis]

You could ring lab and ask them to do it - their number is sometimes available on Google. They don't throw the sample away immediately. But also you could increase T3. If it doesn't feel any better or you feel worse, just revert to current dose, that's the good thing about T3, you can bail out quickly if you need to. Good luck

[susiebow]

My Endo on hols for 2 weeks ,GP back from his hols ,he said to take another 10 mcg of t3 starting from this week. he will write letter to Endo to see if this is ok.Is it possible to feel hyper due to 10 mcg of t3 or do you think I feel bad due to too low a doseage.I do not know why I feel bad.