Disappointed in doctors visit

[HypoF3XXY]

Hello all,

So I got my latest results and I am very low, my doctor is not upping my dosage of Levo even though I still feel awful, I cannot believe how much worse I feel on this medication. I have now been referred to an Endo and have to have B12 injections but she doesn't want to do it until I have had my Endo appointment, 2 months away. My hair is still coming out by the handful, I am now a stone and a half heavier than 4 months ago, my skin flakes off, I am cold all the time et etc. She has also referred me to a psychiatrist 🙄. My results: on 75mgs Levo

B12- 121. ( 198 - 771)

TSH - 6.13. ( 0.25 - 5.0 )

T3 - 4.5 ( 3.5 - 6.5)

T4- 16.2 ( 9.0 - 23.0 )

Compared to my first ever set in Jan they are much better (bar B12)

B12 - 178

TSH - 118 ( yes that's right 118)

T4 - 6.1

T3 - 4.1

Just so tired and want to stop taking Levo, I was so healthy.

Thanks for listening.

[Clutter]

HypoF3XXY,

Here's hoping the psychiatrist tells your GP to medicate you properly and stop wasting his/her time.

You are very under medicated to have TSH 6.13 on 75mcg 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.

I don't understand why your GP is reluctant to increase dose before you see the endo.

NICE CKS recommends:

The initial recommended dose is:

For most people: 50–100 micrograms once daily, preferably taken at least 30 minutes before breakfast, caffeine-containing liquids (such as coffee or tea), or other drugs.

This should be adjusted in increments of 25–50 micrograms every 3–4 weeks according to response. The usual maintenance dose is 100–200 micrograms once daily.

cks.nice.org.uk/hypothyroid...

I would go back to your GP and show her the Pulse article and NICE CKS recommendation and ask for Levothyroxine dose to be increased.

B12 deficiency is nothing to do with endocrinology. Your GP should initiate B12 injections as soon as possible. Go to healthunlocked.com/pasoc for advice on B12 deficiency and pernicious anaemia.

[shaws Administrator]

She really has a cheek referring you to a psychiatrist but as Clutter says he may instruct your doctors to do her job properly.

You are woefully low on B12 which is a very important hormone, for the brain in particular, if your psychiatrist prescribes B12 injections ask him to also check your homocysteine levels. If B12 levels are too low the homocysteine levels can rise which isn't good for us.

Your GP should have wanted you to be at the bottom of the TSH instead over range. It is ridiculous. No wonder you don't feel well.

[Clutter]

Delicious21,

HypoF3XXY doesn't mention taking Metformin. B12 121 isn't just depleted it is severely deficient and shouldn't be ignored for 2 months until HypoF3XXY has the endo consultation.

[HypoF3XXY in reply to Clutter]

I just take Levo , I was a very healthy person until 2 years ago , I even ran the London Marathon last year and it's just all gone down hill at warp speed, I can barely get out of bed some days.

[Clutter in reply to HypoF3XXY]

HypoF3XXY,

It may be an idea to see a different GP about Levothyroxine and B12 injections. I don't think your GP knows what she is doing.

[humanbean]

Print this out and show it to your doctor :

web.archive.org/web/2004060...

Notice that the TSH along the X-axis of the graph doesn't go above 6! Your result is so far from normal it doesn't even appear on the graph!

The graph was produced using data gleaned from this research paper :

eje-online.org/content/143/...

Take a look at Table 3 in the above link.

For healthy people with no known thyroid disease, the median TSH of a woman in her 40s is 1.40, for a woman in her 60s is 1.60. (I don't know your age so I've just picked two results at random.)

People with hypothyroidism generally need a TSH lower than the healthy population in order to feel well, not many times higher like yours.

Your doctor is useless.

[HypoF3XXY]

Well I started Iron tablets last Monday, Levo upped to 100mcgs and started my B12 shots yesterday and OMG they hurt !! fingers crossed, they are going to do 9 loading shots as my B12 is now 97 ( 198 - 771). Thank you for the support.