Subclinical thyroid result

[Lje05]

Hi

In February of this year I had a thyroid test as an outcome of a visit to GP suffering from anxiety. Because the result of a previous test (2 years ago) had shown that my thyroid was 'borderline' (GPs words) my GP suggested that I have another test which again showed borderline. At the time I didn't ask for the details but I then I started to feel rough: fatigue, low mood, feeling of a lump in my throat etc. My Mother has an underactive thyroid and my Grandmother also had an underactive thyroid. I found this very informative site and printed the symptom list, ticked the symptoms I was experiencing and tok it to my GP. The outcome was that the GP said I could try 25mg dose of levothyroxine if I wished. I also had some more bloods taken. So I have been taking levothyroxine for a couple of weeks but still feeling rough. Some days I feel OK (never great) other days I feel awful. I have asked for a printout of my results which are as follows:

23/02/17: Serum TSH level 9.8 mIU/L (0.4 -5.00) 'Abnormal'

Serum free T4 level 10pmol/L (9-19)

22/06/17: Serum TSH level 6.6mIU/L (0.4-0.5) 'Abnormal'

Serum free T4 level 12pmol/L (9-19)

There is a note on my lab results to to repeat in 3-6 months with TPO antibodies to confirm.

Any advice anyone can give me would be much appreciated.

[bluebug]

It takes longer than 2 weeks before you will feel better it is a slow process. You need to be retested at 6-8 weeks then have your dose increased and the cycle repeated until your TSH is 1 or under, your Free T4 is in the top quarter of the range and your Free T3 is in the top third of the range.

Make sure you have your blood test as early as possible in the morning after fasting over night - you can drink water - and take your levo after your appointment.

[Lje05 in reply to bluebug]

Thank you for the advice. I have read it can take a while before you start to feel any better. I also saw the advice on this site about taking your levo after the blood test so I will do this and ask for an early morning appointment.

My free T3 wasn't tested but from what I've read it seems standard practice not to test T3. Do you think I should be pushing my GP to test my T3 as well or would it be better to give the levo time to work to see if I feel any better before asking for T3 test?

[bluebug in reply to Lje05]

It is unlikely you will get it done on the NHS as the GP may not actually know what T3 is and then the lab can simply refuse to do it.

Get your TSH down to 1 or below and your free T4 into the upper quarter of the range, and your nutrient levels checked and optimised first.

[Lje05 in reply to bluebug]

Thank you. I see there are links for thyroid testing on this site so I could get a private T3 test if I send a blood sample. I will ask the GP when I see her next week if I can have my nutrient levels checked and see what response I receive.

[cwill]

In my opinion your GP was a bit slow off the mark in February. And you need regular monitoring with bloods and revisits to increase the dose at six to eight week intervals. The doctor may need educating that most of us need our TSH around one and FT4 FT3 high in range to actually feel any better. I also don't understand why you are waiting so long for the antibody test. Have you read the Thyroid UK guidelines? I am sure that if you have been reading posts here you are aware of the role of vitamin B12, D, ferritin and folate so you can request those too. If this doctor is not helpful in following the treatment guidelines you may have to see someone else or change GP surgery.

Welcome to the forum and it looks as if you have some work to do with that docor.

[Lje05 in reply to cwill]

Thank you for the advice. I found out that my thyroid function was borderline approx 2 years ago but wasn't offered medication and it was only when I started feeling so rough and spoke to my Mother about her symptoms that I started to wonder if my thyroid was to blame. It was only recently on speaking to my Mother that I found out my Grandmother also had problems with her thyroid function. I saw a different doctor in my practice on my last visit and she is the only female doctor I have seen and she was the one to suggest I try a low dose of levothyroixne and wrote me a prescription. I have a GP appointment next week and I have asked to see the same female doctor as I feel she may be my best option at my practice as she seemed more receptive then other GPs I have seen. Another GP I saw sometime in March (went in because of the constant following of a lump in my throat, tightness across my throat and acid reflux type symptoms) simply suggested I come back in a month if I was still experiencing the same symptoms!

[SlowDragon Administrator]

Make sure you get vitamin D, folate, B12 & ferritin tested as well as thyroid antibodies.

A TSH of 9 before starting Levo is pretty high. Unless very frail or elderly your GP could have started you on 50mcg. But stick at the 25mcg now your 2 weeks into it.

Very common to have low vitamin levels, they may need supplementing once you get results. Do not supplement anything before testing

Always get copies of al your test results including ranges and keep good records, noting how you feel at that time too.

Always try to make sure you get same brand of Levo, if the one you are on suits you. Different brands are not necessarily interchangeable for all patients.

[Lje05 in reply to SlowDragon]

Once again thanks for all the advice. No I'm not frail or elderly. I have copies of my blood works and I will start taking notes of how I feel too. I get very anxious about GP visits so usually write a few notes and questions I wan't to ask before a visit anyway as I get so nervous I forget everything I want to say once I'm there.