blood test results ...help please

Hi my latest blood test results are

TSH 0.9

T4 15.8

"No action required" according to the lab but I feel very unwell and ache all over still on many days.

I felt most well 3 months ago with TSH near zero and T4 near the top of range. (my cholesterol was also much reduced then too)...but I was told that I was overmedicated and my dose was reduced. Not felt well since.

Please can anyone advise. Many thanks.

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  • Jen15 What are the reference ranges for these new results? What dose of thyroid meds are you taking?

    What were your previous results (with ranges) and dose which prompted your GP to reduce your dose?

  • blood test results 4 months ago were

    tsh 0.02 (0.35-5)

    T4 18.4 (9-20)

    I was on 100mgc a day up until then and feeling great

    But the consultant has reduced my dose to 100 mcg 5 days a week and 75mcg 2 days a week.Have hurt all over ever since most days.

    blood test resuls today were

    tsh 0.9 (0.35 - 5)

    T4 14.7 (9-20)

    many thanks

  • Jen15 Well, it's clear that your doctor is dosing purely by TSH alone. There was nothing in your first results that indicate the need to reduce your dose of Levo. Your FT4 was in range, you were feeling good and that reduction in dose has brought your TSH up, reduced your FT4 considerably and you now feel symptomatic. So you need to put up a bit of a fight to get your former dose reinstated.

    From ThyroidUK's main website > About the Thyroid > Hypothyroidism > Treatment Options:

    "According to the BMA's booklet, "Understanding Thyroid Disorders", many people do not feel well unless their levels are at the bottom of the TSH range or below and at the top of the FT4 range or a little above."

    You can buy that little book from Amazon, about £4.95, or maybe your local pharmacy. Show the appropriate part to your GP. Point out that the book is published by the British Medical Association.

    Also:

    "Dr Toft states in Pulse Magazine, "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)."

    Dr Toft is past president of The British Thyroid Association and leading endocrinologist. You can obtain a copy of Dr Toft's article by emailing louise.roberts@thyroiduk.org.uk . Print the article, highlight question 6 and show to your GP. Ask for an increase in your Levo dose as you wish to get back to where you were before - symptom free. If he isn't happy, ask for a 3 month trial back on your original dose and he can then retest. When retesting, if your results are similar to those that caused him to reduce your dose and he wants to reduce again, tell him you want FT3 tested to see if you are in range, as mentioned in Dr Toft's article.

    In case you don't already know, when having thyroid tests it should be at the earliest appointment of the morning, fast overnight (you can have water), and leave off Levo for 24 hours. This gives the highest possible TSH which is what is needed for an increase in dose or to avoid a reduction.

  • Thankyou. My endo was concerned about possible heart/bone problems longterm. All I know is I am in too much pain too regularly to carry on with this current level of thyroxine.

  • "My endo was concerned about possible heart/bone problems longterm."

    Oh yes, scare tactics, they like to do that. They don't tell you about all the health problems you'll have if undermedicated though!

  • You have to ask for a rise in your medication. The TSH is useless in informing the doctor how the patient is feeling and it's ridiculous not to listen to the patient. Or you have to source some of your own.

    They cannot tell if you are overmedicated due to a blood test, spread rumours about heart attacks etc. If we are overmedicated we'd soon reduce meds ourself, I'm sure and if you felt better with the higher dose he should have left dose alone.

  • thanks..I will push for an increased dose.

  • blood test results 4 months ago were

    tsh 0.02 (0.35-5)

    T4 18.4 (9-20)

    I was on 100mgc a day up until then and feeling great

    But the consultant has reduced my dose to 100 mcg 5 days a week and 75mcg 2 days a week.Have hurt all over ever since most days.

    blood test resuls today were

    tsh 0.9 (0.35 - 5)

    T4 14.7 (9-20)

    many thanks

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