Doctor won't try therapeutic trial of levo for subclinical hypothyroidism as fears causing hyperthyroidism - help?!

I am new here and hypothyroid myself (receiving treatment if not yet adequately!), but am posting today on behalf of my partner. He is currently subclinical hypothyroid with many symptoms both physical and mental, and a family history.

His results are as follows:

Date TSH FT4

8/4/2013 5 14

13/8/14 3.8 17

15/5/15 3.8 15.7

24/2/16 4.7 16

4/6/16 4.1 15.9

(I only know ranges for the last two as others may have been under different lab tests. Range for TSH is 0.2-4.0 and FT4 10.0-20.0

Our doctor said at his last appointment that he would retest in 6 months but otherwise would not offer a therapeutic trial of levo as he did not want to send my partner into hyperthyroidism. He has been offered medications etc for the symptoms, but won't be treated for the thyroid cause.

We are looking to get a BlueHorizon Thyroid plus 12 test done (if we can find somewhere to draw blood) but I wondered if anyone on here could help us with arguments against this doctor's fear of medication sending him hyperthyroid?

We are Leeds based.

12 Replies

  • Many have used Blue Horizon so I think you can get advice about the draw. It's really absurd if they aren't offering anything else to just send you home. It's a possibility that going gluten free and avoiding sugar and eating organic may possibly make a difference but his TSH is too high and his T4 while not extremely low is lowering and barely midrange. Sometimes other factors come into play and could be hormones but the tests from BH will include all the thyroid and autoimmune tests. Would it be possible to get those evaluated? Low thyroid has a huge impact as shown in this short video.

  • Thanks for the link to the video! Will go through his whole series. I have been taking 5-htp for serotonin but I'm not sure it's being as effective right not as when I started it. I've been eating gluten free for a while, and have cut sugar down quite a lot which has had a positive effect on my weight (losing weight very, very slowly, but at least I'm losing it!)

  • Levothyroxine will not send someone into hyperthyroidism.

    1) Hyperthyroidism is often defined as when the thyroid is producing too much thyroid hormone. Not just having high-ish blood levels of T4 - as could occur with too high a dose of levothyroxine. (That is sometimes called hyperthyroxinaemia - if high enough to be a concern.)

    2) See this recent post:

  • Thank you, we shall print that and present it!

  • NICE guidelines suggest a trial of levo for sub-clinical hypothyroidism, where there are related symptoms. This doctor sounds like he doesn't know what he is talking about. Could you try a different doctor?

  • Thank you, I'll go and find that clause in the NICE guidelines :) Eventually we may end up trying a different doctor, but I think it will involve changing practice!

  • I've emailed NICE as I couldn't find them on their website. When I get them, I'll PM You.

  • Great, thank you so much :)

  • Blue Horizon - Thyroid plus eleven test is much cheaper and you can do finger prick test at home. Early morning, before any food or drink is ideal time to test. TSH is highest early in morning.

    Do you really need to do the Reverse T3 test. Most Endos and medics seem to have no idea about what it is or how to treat anyway

  • When I did my FT3 with BlueHorizon I think I did it in the afternoon, I wonder if that's where I went wrong! Thanks for the reminder.

    I think we were reading that Reverse T3 is useful for other things and so thought we might as well go the whole hog, but if it causes us so much difficulty in obtaining the test (I struggled to find a place locally who would draw my blood for a private test!) then I think the Thyroid Plus Eleven is a good bet :)

  • I found this on the NICE website :-

    "If the person does not feel well with TSH in the upper half of the reference range (2.5–4.5 mU/L), then it is reasonable to aim for a TSH in the lower reference range (0.4–2.5 mU/L). For example, by increasing the levothyroxine dose by 25 micrograms daily or on alternate days."

  • Hi once you get the blue horizon results back you will know if your partner has high thyroid antibodies. If so, that will hopefully help you get treatment. Also you could try listing all the symptoms and charting his temperature for a week. If it is low (as most hypothyroid sufferers have very low temperatures) that will further help get a trial of levothyroxine. As you probably know they usually start at 50 mcg and raise it after 6 - 8 weeks if necessary. Good luck!

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