Reading my second set of results

[Redroz1e]

My results are

TSH 2.1 0.3-4.2

T3 4.5 4-6.8

T4 20.9 12-22

This is only my second set of results so I'm not really up to speed with it all yet. I'm on 75mcg but still have symptoms. Doctor says they're fine so no action needed. Any thoughts?

[SeasideSusie Remembering]

Redroz1e No, they're not fine. Your TSH is too high and your FT3 is very low in it's range. You need an increase in thyroid meds.

The aim of a treated hypo patient is for TSH to be 1 or below or wherever it is needed for FT4 and FT3 to be in the upper part of their respective reference ranges.

Your FT4 is actually good, but it doesn't look like you're converting T4 to T3 very well.

You can supplement with selenium L-selenomethionine 200mcg daily which help, with conversion but I suggest you ask you GP to refer you to an endo with a view to adding T3 to your Levo. GPs can't prescribe it initially, that has to be done by an endo. However, a lot of CCGs are stopping the prescribing of T3 due to cost so it may not be easy.

[Redroz1e in reply to SeasideSusie]

Thank you. All that I am reading on this forum suggests the same so I can't understand why doctors see it so differently? I really don't like confrontation and the thought of disagreeing with a doctor 😔

[SeasideSusie Remembering in reply to Redroz1e]

Redroz1e The problem is thyroid disease is given so little time during a doctor's training (some say just half a day) and they are brainwashed to think that Hypothyroidism is easily treated with just Levothyroxine. It seems that they just dose by TSH alone, which is so wrong, and if we still have symptoms then it must be something else.

It is very difficult to get our Hypothyroidism treated properly because of this reliance on TSH only, and most doctors certainly don't like us to go along with an understanding of our condition and to question them.

My own doctor is like this and I no longer wish to have a discussion with such a blinkered individual who refuses to discuss anything with me. I've lived with my Hypothyroidism for 43 years, I know what it's like and how it affects me, she doesn't and won't listen, so I now just accept my prescription for Levo and do my own thing. An unfortunate situation that a lot of us have resorted to.

[Redroz1e in reply to SeasideSusie]

I'm sorry to hear that you, like so many others, have had to battle with your GPs for them to take any notice of the way you feel or not in some cases . I've spoken to mine today and having initially said no action, following your advice I have pushed her and she has now increased my dose to 100 with a retest in 8 weeks. Thank you for your support and I really do hope that things improve for both of us and the other thyroid "sufferers" on here.

[SeasideSusie Remembering in reply to Redroz1e]

Redroz1e Well, that is good news! A step forward at least. Well done for standing your ground

When you have future tests, always book the earliest appointment of the day, fast overnight (water only) and leave off your Levo for 24 hours. This will give the highest possible TSH which is what we need when looking for an increase or to avoid a reduction.

What you now need, is to keep an eye on your FT3. It's possible that your FT4 could go over range, which your GP wont like. If she wants to reduce your dose, insist that FT3 is done to see where that is within it's range before agreeing to any reduction, and stick to your guns. FT3 is the important one, so challenge her to prove you're over medicated by testing your FT3.

Here's a little bit of information that could come in very useful next time:

Dr Toft, past president of the British Thyroid Association and leading endocrinologist, wrote this in a Pulse Online magazine article:

"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)."

So that confirms that TSH can be suppressed and that FT4 can go over range as long as FT3 is within range. If she doesn't like it, or feels she is out of her depth, ask for a referral to an endocrinologist then email Louise (addy below) for the list of thyroid friendly endos and ask on the forum for feedback of any in your area.

If you email [e-mail] she will let you have a copy of the article which you can print out and show your GP/Endo.

[Redroz1e in reply to SeasideSusie]

What a star you are thank you! I mentioned my Tsh should be 1 or under but she said that was during pregnancy? It must have been obvious to her that I'm doing my homework which made her change her mind. Unfortunately my last test was done in the afternoon though I hadn't taken my meds but I will be sure to book an early one next time. I will bear in mind all the other information you have given me for next time. Thank you so much. 😀

[SeasideSusie Remembering in reply to Redroz1e]

You're very welcome Good luck with your next test and follow up appointment. Let us know how it goes.

And during pregnancy, it's recommended that TSH is kept below 2, so she sort of was right (but not quite) but that doesn't mean everyone who isn't pregnant can have a TSH higher and everything will be hunky dory!

[Redroz1e in reply to SeasideSusie]

Will keep you posted. Thanks again 😀