Dose adjustments

[Secondchance]

Hi all, my teenage daughter has been on 25mcg levothyroxine since last summer and was supposed to have hospital review in 2 months which still has not happened. She recently got sent a letter to make an appointment so I got her retested at GP, but that hospital review appointment has since been cancelled by hospital.

Her TSH is up to 4.2 again and T4 is mid-range at 16, so GP is not changing anything. Her symptoms are much improved- one of worst ones was daily headaches but now only occasional headaches and not as cold, better concentration etc.

Overall things are better but I suppose I would prefer if they were optimal as she has exams coming up.

Is the TSH a sign that thyroxine needs increased? Her T4 was never low (below range) so as per blood results she was sub clinical but actually had lots of hypothyroid symptoms. Antibody negative.

Her brother has just started levothyroxine too, again symptomatic with high TSH, normal T4 and antibody negative.

For those with 'subclinical' hypothyroidism, when was the decision made to increase dose?

Thanks

[shaws Administrator]

Usually, when initially diagnosed and prescribed, a blood test six weeks later is taken. I am assuming doctor took a test? However, 25mcg is such a small dose and it could backfire as symptoms return. I am assuming as she is seeing an Endo, GP will not adjust. However, I am sure he could leave a message for the Endo giving your daughter's latest blood test results and ask how best to treat/increase.

When your daughter has a blood test it should always be the earliest, fasting (she can drink water) and allow 24 hours between last dose of levo and the test and take it afterwards. It is most important that we have sufficient thyroid hormones as our heart and brain in particular need it for us to function normally. Ask GP for a full thyroid function test, TSH, T4, T3, Free T4, Free T4 and thyroid antibodies, B12, Vit D, iron, ferritin and folate. Get a print-out and post. You can tell GP you've taken advice from the NHS Choices for info on dysfunctions of the thyroid gland.

(p.s I am not medically qualified - I had undiagnosed hypothyroidism for which I was given quite a few different ' diagnosis' and treatment from 'supposed' to be Professionals, until a first aider came my way and suggested thyroid). It is all down to Thyroiudk.org.uk that I am now well.

[Secondchance]

Thanks yes bloods were taken 6 weeks after as fasting morning samples 24 hours after last dose thanks to advice here. Got her retested as hospital letter came in. GP had said after first retest after treatment that it was up to endo to change dose as they started it. Pity that appointment is now 7 months overdue and the one booked for next month was cancelled by the hospital.

All other bloods were good but they won't do T3.

I can try GP to see if they will contact endo but they did not think there was a problem as T4 was normal despite symptoms

Thanks shaws for the advice.

[silverfox7]

I would ring the department at the hospital, bookings can't do anything, and voice your concern that appointment that you have waited for has been cancelled and you are worried as she is feeling worse and you are concerned about the coming exams etc.

[Secondchance]

Will do, thanks. I have emailed months ago but got no reply, so will try again.