GP Visit today

[karenmyring]

I am currently taking 150mg of levothyroxine after years of increasing slowly from 75mg. I went to see the gp who said my TSH indicates that my levo is too high and i should reduce to 125mg. My issue is that this is the best i have felt  - tired but less tired weight seems to be coming off (at last) skin better hair better feeling happier so much that consider coming off amitriptyline . I said no i cant she said do it every other day - will it be bad to stay on the 150 where i feel better ? I have Hashimotos

[SeasideSusie Remembering]

This seems to be so common now. My old GP was always happy for me to have a suppressed TSH and a high, even just out of range, FT4, although my FT3 was always within range.  That GP retired.

The new one, oh my what a difference. I went for something else. She then said "By the way, you are overmedicated". Now, I really should have said "I thought we weren't allowed to discuss two things, I came for my lungs not my thyroid" LOL!! She was actually looking at thyroid test results that were over 12 months old and didn't suggest retesting. So the conversation went like this:

Me: What do you mean by overmedicated?

GP: Your TSH is suppressed.

Me: It's always been under range or suppressed.

GP: You're overmedicated.

Me: But my FT4 is in range.

GP: You're overmedicated.

Me: And my FT3 is in range.

GP: You're overmedicated.

So now I realised I was getting nowhere so I said

Me: I have 20 years thyroid test results at home, along with how much medication I was taking at the time and notes on how I was feeling. Can I bring them in and discuss them with you.

GP: (with a sigh) Alright

So that was over 12 months ago. I've had a couple of blood tests since, for other things, and the nurse always says "Oh, I'll do your thyroid tests while you're here, you're overdue". To which I always reply "No, I don't want them done this late in the day. I want them done first thing in the morning". Nurse is a bit shocked but I refuse to let her add the thyroid tests.

I've seen the GP a few times since then, I've not mentioned my thyroid, neither has she.

If I were you, as you seem to be feeling a lot better on your current dose, before agreeing to reduce your dose I would request her to do the full thyroid panel, including FT4 and FT3. If they are within range then there is nothing to worry about. You may have to convince your GP of that but there is evidence that you can take in if he/she would be willing to read it. I don't have links but I'm sure other members can help out there.

By the way, what was your TSH result that she is so concerned about? Is it low in range, below range or what?

[karenmyring in reply to SeasideSusie]

I think she said 0.22

[SeasideSusie Remembering in reply to karenmyring]

karenmyring   Not sure what the range is at your lab but that's not suppressed or undetectable. It's probably just slightly below range at most.

Ask your surgery for your results, with ranges, then you will know where you stand (you are legally entitled to your results as per the Data Protection Act). As suggested, ask for FT4 and FT3 tests if not already done, and, as said, if those are in range, particularly FT3, then you don't need to reduce your dose. But convincing the GP is another story!

[dolphin5 in reply to karenmyring]

Your TSH is higher than mine has ever been while on thyroxine, and that includes when I was clearly under-medicated. Your FT3 level is the most important result. I would strongly advise you not to drop your dose if you feel better on your current dose.

[galathea]

The crucial thing about being on thyroxine replacement, is that if you have a supressed tsh you shouldnT have an over range free t3 as well.   If your doctor has measured your free t3 and founf it to be over range then she may be justified in insisting you reduce your dose.   But if she has only measured tsh, then she is just guessing and  really has no idea.....

Suggest you ask for the free t3 figure and agree to reduce your meds if the free t3 is over range, or if you show any symptoms of hyperthyroidism..... These being.... Tremor , heat intolerance, weight loss despite eating a lot......  As soon as you reel off a list and promise you will reduce iff necc, mist doctors just back off, because testing your free t3 is actually going to cost them.....

You could get the free t3 tested privately just to be sure for yourself...

Xx   G

[Clutter]

Karenmyring,

I'm completely in agreement with SeasideSusie and galathea 's comments.

Read Dr. Toft's comments on suppressed TSH in Treatment Options in thyroiduk.org.uk/tuk/about_...

tiredthyroid.com/tsh.html

[shaws Administrator]

Karen, if you feel well there's no need to drop dose due only to the TSH. Particularly as you have been feeling well. What's the point of becoming unwell. People who have had thyroid cancer take suppressive doses of thyroid hormones and they don't appear to develop other diseases.

TSH is only a guide not a definite and patient is the one to know whether it's too much or too little thyroid hormones.

web.archive.org/web/2010103...

thyroiduk.org.uk/tuk/thyroi...

Dr Lowe also wrote a book called The Tyranny of the TSH test but it isn't available on Amazon now. Dr L died about 2 to 3 years ago, unfortunately.

thyroid-info.com/articles/s...

[karenmyring in reply to shaws]

Brilliant  I'm staying on my dose

[spm1]

I have the same issue. Endo convinced me to do a small drop of just 12.5mg a day because of risks of heart conditions and oesteoperosis of long term over medication. I am feeling the drop even though it's small. 

 I think they play it safe tbh but I guess it is up to us as patients to understand the risks are and decide what's best. 

[Glynisrose]

Then disagree!  Your doctor is there to advise only.  If you feel great on your present dose then stay on it!

[karenmyring in reply to Glynisrose]

Thank you