Advice Please.

[Gigi71]

I haven't posted on here before, am on the NRAS site and Bone Health. I was dx with Hashismoto's 39 years ago and given thyroxine, the dose has been adjusted over the years when the GP thought it was needed. I have RA dx 32 years ago. In recent years a few more conditions, either RA or meds related. I have b12 inj every 3 months, take 2 calceos tabs a day, Vit k2. Take RA meds including Humira and low dose pred 5 mg a day. I am on 125/150 alt days. My latest blood test reads TSH 5.07 and T4 16.7 and the rheumy nurse said all in range. Your advices please.

[Clutter]

Welcome to the forum, Gigi71.

You are under medicated to have TSH so high while taking Levothyroxine. 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 [e-mail] if you would like a copy of the Pulse article to show your GP.

[Gigi71 in reply to Clutter]

Yes I thought it was high too. So will do both, thank you for reply.

[Raventhorpe]

Gigi71 have you got ranges for t4and tsh they will be in brackets after the numbers as ranges can differ from lab to lab so we will be able to see where you are in the range , saying that you tsh seems high for someone on levo, we usually feel well when tsh is 1or below and t4in top quarter of range

[Gigi71 in reply to Raventhorpe]

I only got the results by phone today, I needed to know what else I need to know. Results were meant to be sent to my GP as well, but seem to have got lost in the system, two different health authorities. It takes so long to get an appointment with my GP so will try for a telephone appointment. Thank you for your reply.

[Gigi71 in reply to Raventhorpe]

Called the hospital today and the levels for TSH 0.25-5.55 and T4 10-19.8 I would be very grateful for your further advices. I have a telephone telephone appointment with my GP next Friday. I have also emailed Louise as advised by Clutter, I am usually very proactive with my health, but still trying to get my head round the information on here. Thank you so much.

[veryangirl44]

My feelings are your tsh is to high I would say your undermedicated for your thyroid.

[Gigi71 in reply to veryangirl44]

I was on 150 a couple of years ago, but since then have gone on mtx an naproxen, alendronate acid, and put on half a stone, although not big anyway. I have a good diet and gluten free. I also take my thyroxine at night on an empty stomach. Thank you.

[SlowDragon Administrator]

Also be good idea to check current 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.

[Gigi71 in reply to SlowDragon]

Thanks SlowDragon. It's time I had them redone, especially with a change in meds.

[Raventhorpe]

Hi gigi 71 your Tsh is very near top of range it's far too high for someone on levo which suggests you are under medicated, it needs to be around 1. T4 doesn't seem too bad but there is room for increase in levo, I'm wondering if your converting your t4 to t3 efficiently, can't tell without t3 result which NHS won't normally test.you might consider having private one done so you can get a better picture of where you are.before you speak to gp write a list of all your symptoms that you feel are thyroid related if your not sure which ones are have a look at home page for list of hypo symptoms, tell gp about the article in pulse magazine by dr toft making sure you tell them he's eminent endocrinologists and past president of British thyroid association so they know it's not just you saying what your Tsh should be. The bit you need to read to gp is paragraph 6 it's a pity you can't see gp as it would be easier to show the article so they can read it for themselves.hope this helps.prehaps clutter might have some suggestions that I haven't thought of good luck let us know how you get on x

[Gigi71]

Many thanks, with so many health problems and many meds it's hard to know which is which, but thx for the info, I think maybe I need quite a bit more researching, I have always had a good relationship with my GP, but it's hard to get an appointment these days.I will see what he has to say and go from there, if I'm not happy I will go for private testing. X