Am i really over medicated ?

[karenmyring]

Just had yet another blood test Serum TSH level 0.02 i'm on 150mg of levothyroxine and for the first time i actually feel well and now they want to reduce my meds and i know i cant tolerate being on less

[HarryE]

Without measurement of your FT4 & FT3 they have no idea if you are over medicated or not.  Before you agree to a reduction I would insist they measure those

[karenmyring in reply to HarryE]

they said they were bang in the middle of the required range i think i heard a figure of 17

[Clutter in reply to karenmyring]

Karenmyring,

Having suppressed TSH doesn't mean you are over medicated unless FT3 is over range.  Read Treatment Options in thyroiduk.org.uk/tuk/about_...  Email [e-mail] if you would like a copy of the Pulse article to show your GP.

[HarryE in reply to karenmyring]

I would recommend you get a copy so you know for sure. Most people feel best with their levels in the upper part of the range

[shaws Administrator]

As they've been brainwashed into believing the TSH is the 'be all and end all' they think they are protecting you. With thyroid hormones to feel well means you are on the optimum dose your body needs. Just compare this following post which was a few minutes ago.

healthunlocked.com/thyroidu...

[shaws Administrator]

This is a quote from Dr Toft, who was the President of the BTA.

6 What is the correct dose of thyroxine and is there any rationale for adding in tri-iodothyronine?

The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range – 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l. Most patients will feel well in that circumstance.

But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This ‘exogenous subclinical hyperthyroidism’ is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l). 

Even while taking the slightly higher dose of levothyroxine a handful of patients continue to complain that a sense of wellbeing has not been restored. A trial of levothyroxine and tri-iodothyronine is not unreasonable. The dose of levothyroxine should be reduced by 50µg daily and tri iodothyronine in a dose of 10µg (half a tablet) daily added.

The above is an extract from a Pulse Online article (the doctors magazine).

[shaws Administrator]

This is regarding osteoporosis and heart which concerns doctors but there is more likelyhood of these happening if underdosed:

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

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

[karenmyring]

Thank you all for taking the time to help me 

[Chris1961]

Why don't doctors listen to us. !!! ... Their range isn't necessarily ours !!! ... 

[karenmyring in reply to Chris1961]

Definitely x I have no confidence in mine I don't think she understands 

[Chris1961]

I have been struggling with menopause ... My meds aren't as effective. ... Been on 100 gone onto 125 and feel much better ... Bet they will tell me am taking too much when I go back !! Well I aren't dropping it !! 

[karenmyring in reply to Chris1961]

I'm on 150 it's the best I've felt I'm really scared of dropping it

[Chris1961]

Great news ... Glad you are well it's awful illness x

[karenmyring in reply to Chris1961]

I'll never feel as well as I want I know that but it's the best I've felt

[shaws Administrator]

Dr Toft was probably trained in the late 50/60's (I think) when levo was introduced but he was against NDT, unfortunately. He was physician to our Queen Elizabeth when she stayed in Scotland.

[humanbean in reply to shaws]

He isn't quite such an antique according to the GMC Medical Register. He got his medical degree in 1969, and was fully registered in 1970.

[shaws Administrator in reply to humanbean]

He's a Good Guy as he does mention that some T3 can be added to levo. I know he is against NDT most probably because he qualified after levo was introduced and also believed the 'hype' that levothyroxine was superior. He does state:-

"But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l."

He also wrongly quotes the 'hype':-

"There is no place for the use of animal thyroid extract in the treatment of hypothyroidism. Although preparations contain both thyroxine and tri-iodothyronine, the hormone content varies between batches"

We all know that levo also has inconsistencies too.

[Glynisrose]

Just don't let them.  Your doctor is an advisor only he/she cannot dictate what you take or don't take.

[dolphin5]

My TSH has been lower than yours since I started taking T4 about 16 years ago, and I was also under-medicated until recently when I began to add T3. It was my FT3 that was too low. I would refuse to drop my dose if I was in your situation, unless they can demonstrate that the FT3 level is too high (which, in any case, would no doubt feel awful, and you wouldn't want it to stay there).

T4 is primarily a storage hormone, and not likely to be a problem unless it leads to too much T3. Until I took T3, my FT4 was always just above the top of the range, but I was not totally well as my FT3 was at the bottom, or below the reference range.

Don't let them steam-roller you. You can refuse to drop your dose, but you can't make them put it up.

Good luck.

[karenmyring in reply to dolphin5]

 The support on here has given me the strength to stick to my guns I am so grateful xxx

[JuneRose]

Please can you tell me where you hold your meetings.

[karenmyring in reply to JuneRose]

Email me and I'll add you to my list .meetings are held at mine in selsdon

<redacted personal email address>

[helvella Administrator Thyroid UK in reply to karenmyring]

For your own safety and security, please do not post personal email addresses. The Private Message system should be used.