Balancing results and feeling of wellbeing

I would be grateful for any advice. I have been medicated for 24 years always taking 150mcg daily. Last summer my GP lowered my dose to 125 mcg with results of TSH 0.72 and T4 11.9 (these are the only levels he does) but quite a number of months on I don't feel great with all the usual reported symptoms of hypo. The GP won't put the dose back to what it is because he says it will affect my heart. Is there any room for negotiation do you think - I have gained 2 stones and feel pretty miserable.

Thank you for any advice.

8 Replies

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  • Annegal,

    Do you have the lab ref range for T4?

  • Hi - lab range is TSH 0.72 (0.30 - 5.00)

    T4 11.9 (11.0 - 23.0)

    Thank you

  • Annegal,

    I think you are under medicated because FT4 is very low in range. The goal of Levothyroxine is to restore the patient to euthyroid status. For most patients that will be when TSH is 1.0 or lower with FT4 in the upper range. FT4 needs to be in the upper range in order that sufficient T3 is converted. Read Treatment Options in thyroiduk.org.uk/tuk/about_... Email louise.roberts@thyroiduk.org.uk if you would like a copy of the Pulse article to show your GP.

  • Your T4 is too low, most need it right at top third - e.g. 18-22. You need an increase in dose. But GP is only looking at TSH

    Look at vitamin levels, they are probably too low as well.

  • Most people on levo need low TSH around 1-2 to be adequately treated.

    Do you have your latest blood test results, ideally TSH and including FT4 & FT3

    If they have not been done ......Suggest you ask GP to check levels of vitamin d, b12, folate and ferritin. These all need to at good (not just average) levels for thyroid hormones (our own or replacement ones) to work in our cells. Very common for them to be far to low, especially if you are under medicated or have Hashimoto's

    Also do you know if you have ever had thyroid antibodies checked? There are two sorts TPO Ab and TG Ab. (Thyroid peroxidase and thyroglobulin) Both need checking, if either, or both antibodies are high this means autoimmune thyroid - called Hashimoto's the most common cause in UK of being hypo.

    TPO is rarely checked and TG almost never checked. More common to have high TPO or high TPO AND high TG, but negative TPO and raised TG is possible, though rarer.

    ALWAYS Make sure you get the actual figures from tests (including ranges - figures in brackets). You are entitled to copies of your own results.

    If you can not get GP to do these tests, then like many of us, you can get them done privately

    thyroiduk.org.uk/tuk/testin...

    Special offer at moment

    thyroiduk.org.uk/medichecks

    Usual advice on ALL thyroid tests, is to do early in morning, ideally before 9am. No food or drink beforehand (other than water) If you are taking Levo, then don't take it in 24 hours before (take straight after). This way your tests are always consistent, and it will show highest TSH, and as this is mainly all the medics decide dose on, best idea is to keep result as high as possible

    If you have Hashimoto's then you may find adopting 100% gluten free diet can really help reduce symptoms, and lower antibodies slowly over time too.

    Excellent free web based document-series - re-running, starting March 1st

    Masses of advice for all thyroid issues, but especially for Hashimoto's or Graves

    thethyroidsecret.com/trailer/

    chriskresser.com/the-gluten...

    hypothyroidmom.com/92-of-ha...

    amymyersmd.com

  • Hi I feel your t4 should be increased. Do you know or can you find out what your results where at 150?

  • Thanks for all the useful comments. I think it would be interesting to get previous results for comparison and will try to arrange this.

  • NEVER let a doctor reduce your meds based on blood tests alone. Demand a full physical examination first.

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