Help with test results please

[Mayflower53]

TSH Feb -3.66, Apr - 4.17, Jun - 3.49, Range (0.35 - 3.50)

FT4 Feb - 12, Apr - 11 not tested in June.

I was prescribed 25mg levo in April. This has made a modest difference, my finger nails are much better and the low moods have lifted but I still feel very tired and get constipated a lot. My weight has increased by over a stone this year, I am craving sweets because I am tired and I am not exercising. I thought the Dr would up my prescription to 50mg however he flatly refused and said he didn't think I really needed to be on levothyroxine at all. He thinks patients need to have test results of 10 or over before levo is prescribed. Regular exercise would be better for me. I used to exercise regularly and completed the moon walk last year in 6 hours but I have dwindled down to nil. I just feel too tired!

I would appreciate your opinions. Should I see another Dr or try and do some exercise to see if things improve?

Thank you

[Sunnyday66]

Have you had your antibodies checked? These are thyroid peroxidase antibodies (TPOAb) and thyroglobulin antibodies (TGAb)? It's another blood test. You may have to go privately but would be worth checking. Medichecks are an online company you can order thyroid blood tests from, pretty reasonably priced too.

You may have an underlying autoimmune condition if the antibodies are high. I have Hashimoto's. My TSH, also in April, was 53 and T4 was 6. I am now biochemically and artificially normal taking 100mg thyroxine a day BUT I still have muscle/joint pain. My antibodies are over 1300 (the lab equipment testing range) and, without further pushing, my GP is at a loss as my problem is now pushed into the long grass as it's autoimmune. Am using a great book Hashimoto's Root Cause as my rescue plan. Gluten-free, diary-free and supplementing with Vit D etc

[NatChap]

I'm not an expert at interpreting test results but I was still suffering with Hypo symptoms when my TSH was the same as yours. I would try and see another doctor. If you are under medicated then exercising will probably make you feel worse not better. If you have no luck with doctors you could order some private blood tests (if you can afford it of course), they would give a bigger picture and allow members to advise on what course of action to take.

[SeasideSusie Remembering]

I don't think your GP knows very much about thyroid.

Your April results were

TSH 4.7 range (0.35 - 3.5)

T4 11 range (8.0 - 21.0)

and he was happy enough to prescribe levo at a low starting dose. Yes, you were lucky, many doctors do wait until TSH reaches the magic number 10.

So now, in June, you have TSH 3.49, Range (0.35 - 3.50). Does he not see that the levo is working? However, you've only gone 0.1 under the range. If he stops your levo then does he not realise your TSH will go back up to at least where you were before?

He needs educating. The aim for a treated hypo patient is for TSH to be 1 or below and FT4 and FT3 in their upper part of their ranges.

Email [e-mail] and ask for the Pulse article by Dr Toft (past president of the British Thyroid Association) which states:

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

Go to the main Thyroid UK website and learn as much as you can so you can start educating your doctor.

You could ask your GP to test for (TSH of course) FT4, FT3, TPO and TG antibodies. Also your vitamins and minerals need to be at optimal levels (not just in range but optimal) so ask for Vit D, B12, ferritin and folate. If your doctor wont do those tests, you can get them all done through Blue Horizon, the Thyroid Plus Ten or Plus Eleven covers them all and can be done by fingerprick test.

[greygoose]

Things won't improve with exercise. Exercise cannot repair a failing gland. Stupid man! And, if you exercise, you will use up your T3, and you obviously don't have enough as it is. That will make you feel worse. Leave the exercise until your T3 is optimal.