Am I really over medicated

[Shon]

I have included a photo of my last lab results for thyroid.

For the past 4 months I have felt quite well for the first time in 5 years. I am still over wieght and can not loose any wieght, my muscles are still weak. But on the plus side I have reduced my body pain by 70 percent, and reduced my tiredness by 60 percent.

But on having this blood test my doctor called me demanding I reduce my levo. I am worried about doing this, and the more I argue the point I have learned against doing this and begging for T3 melds, seems I alienate my doctors they get really irritated by my arguments gone through all 4 of my doctors in my health centre, makes me feel that I must be in the wrong to annoy them all. The last doctor I had never spoken too before, she became annoyed very quickly when I argued that by lowering my levo to drop mt T4 level would drop my T3 level. I suspect there is a note on my file saying I am trouble.

Anyway what do you feel about my blood results attached?

Thanks as always

Sean

[sezzy]

T3 level looks good if you feel well I'd stay at the same dose as your t3 isn't over.

[Clutter]

Shon, although your TSH is low and your FT4 very slightly over range your FT3 is nowhere near the top of range, so you are not overmedicated. I'd say you are optimally medicated. Read Dr. Toft's comments in the link below saying that some patients need a low/suppressed TSH to feel well which may mean that FT4 goes over range and is fine as long as FT3 remains within range. Email [e-mail] if you want a copy of the full article to show your GP.

thyroiduk.org.uk/tuk/about_...

[Shon in reply to Clutter]

Thanks cutter, I know we already talked about this Friday. But the doctor is worrying me, she talks of heart failure if I continue.

I also have a three week trip to thailand because of my ailments I have taken out insurance, I am concerned if I do not follow doctors demands, then my be insurance will not cover me if anything happens while away.

Sean

[Angel_of_the_North in reply to Shon]

Say you are happy with your dose but will agree to have regular ECGs to monitor your heart (and a DEXA scan, if they come out with the osteoporosis argument)

[Clutter in reply to Shon]

Shon, your doctor might have a point IF you were overmedicated for a long time but you aren't and won't be. Re insurance, if something happens to you it won't be because you aren't taking the doctor's advice and they wouldn't be able to determine whether you are taking 150mcg or 100mcg from a blood test.

Have a lovely time in Thailand.

[humanbean]

Under what conditions was the blood taken for the test?

1) Had you fasted before the blood draw? If yes, for how long?

2) How long a gap did you leave between your previous dose of levothyroxine and the blood draw?

3) What time of day was the blood taken?

[Shon in reply to humanbean]

Hi, no fasting. About 3 hours after taking meds at 12.30pm

Thsnks

[humanbean in reply to Shon]

For future reference, to reduce the risk of the doctors reducing your medication, follow this procedure :

1) Always get the earliest appointment possible for getting blood drawn for a thyroid blood test. Between 7am - 9am is best. If you get tested later than this your TSH will be lower. Many doctors will reduce medication on the basis of a low TSH and most of us don't want this to happen.

2) Do not eat or drink for 10 - 12 hours before the test, except for plain water. Apparently TSH lowers after eating.

3) If you usually take your levothyroxine in the morning, don't take it on the morning of the test until after the blood draw. Instead, take it immediately after the blood draw.

4) If you usually take your levothyroxine at night, the day before the test don't take any levothyroxine at all. On the day of the test take two doses - one immediately after the blood draw, and the other at night as usual.

5) Stick to these conditions every single time you get your thyroid tested. It will reduce the risk of you getting inappropriate cuts to your medication. It also means that your tests can be sensibly compared from one time to the next to see if something is changing that you need to know about.

[humanbean in reply to humanbean]

Take a look at this research paper - the graphs on page 2 :

press.endocrine.org/doi/pdf...

Thyroid hormone levels vary according to the time of day, which is the reason for all those shenanigans I listed above, to try and work the system to your advantage.

[Clutter in reply to humanbean]

Shon, Levothyroxine peaks in your blood 2 hours after taking a dose and the peak level can last for up to six hours. Your TSH and FT3 would have been higher had you left 24 hours between last dose and blood draw and had the blood draw earlier in the morning. Some research has shown that TSH falls after eating so a fasting test can be helpful too.