I wonder if anyone can give me some advice? I was diagnosed with under active thyroid about 10 years ago, and am on 125mg levothyroxine daily.
Unfortunately for years I have continued to struggle with tiredness and weight gain and find it very hard to lose weight.
Recently I had my tsh and t4 tested and gp said results were normal, no need for any change in meds. I asked for a copy of my results and they were as follows:
- TSH: 5.10 mu/L (range 0.3 -5.6)
- FT4 :10.4 pmol/ L (range 6.3-14.0)
I feel I am not on enough thyroxine but gp sees results as normal . Have looked up ranges and very confused as british thyroid foundation ranges seem different to above. Any advice very welcome!
Manythanks
Izzybe
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Izzybe
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My Goodness Gracious - a TSH of 5.10 (and above the top of the range!) you are on insufficient levothyroxine.
Your doctor is like many others, make assumptions that if the TSH is 'somewhere' in the range their job is done.
Doctors are so poorly trained in the UK, that's why this forum has about 60,000 looking for help. Worldwide,
Endocrinologists are poorly trained. They took the Pharmaceutical Companies at their word that levothyroxine was much more preferable than Natural Dessicated Thyroid Hormones which had a successful period since 1892 up until the blood tests were introduced along with levothyroxine. Lots of members prefer NDT but the BTA also removed this from being prescribed. I wonder why when so many would get all the hormones a healthy gland would produce (more or less).
Levothyroine is T4. T4 is inactive and has to convert to T3 the only Active Thyroid hormone. Whereas with NDT it contains, T4, T3, T2, T1 and Calcitonin and calcitonn helps bones stay strong.
Ranges differ throughout labs so BTAs may be different. One of the facts that I disagree with amongst lots of others is that if someone has clinical symptoms but TSH doesn't reach 10, we haven't to be given levothyroxine.
You are just over the top of your range so make an appointment with your doctor and say you have taken advice of the thyroid gland and have been told you need increases until your TSH is 1 or lower. Whatever makes you feel well. Not only that but your need a Free T4 and Free T3 towards the top of the range. (Most doctors wont ask or lab will not as BTA has stated all that is required is a TH and T4 - wrong again). FT4 and FT3 help to advise if patient is converting levothyroxine sufficiently. You can get a private pin-prick home test from one of our recommended labs.
Your also need B12, Vit D, iron, ferritin and folate tested too.
Blood tests have always to be at the very earliest, fasting (you can drink water) and allow a gap of 24 hours between your last dose of levo and the test and take it afterwards. This helps TSH stay higher as it drops throughout the day.
Levothyroxine should be taken first thing with one full glass of water and allow an hour before eating as food interferes with the uptake. Or last thing at night and if you were having a test next a.m., you'd miss this dose and take after test and night dose as usual the same day.
Get a print-out with the ranges for your own records and you can post if you have a query.
Some have been disappointed going private but if you email louise.roberts@thyroiduk.org.uk she has a list of Endocrinologists. She is on holiday at present.
You can do what many do on this forum, they source their own or top up levothyroxine.
First make an appointment with your GP and say you have been in touch with the NHS Choices Thyroiduk.org.uk for help/advice about hypothyroidism and you've been advised you need to have an increase for TSH to be 1 or below. You can give him a copy of the following:-
Thank You, that's really helpful. I think I will try going back to Gp first... However if they still say they wont increase my dose , I may look into the private gp route.
They have no idea how it feels when important thyroid hormones (they drive our whole metabolism from head to toe) are too low when they should be optimal. Optimal means that the patient feels well with no clinical symptoms.
They are badly trained. We need old-fashioned doctor who could look at a patient without the need for blood tests and diagnose them due to their symptoms.
Your TSH is far too high and FT4 just about mid-range. The aim of a treated hypo patient generally is for TSH to be 1 or below or wherever it is needed for FT4 and FT3 to be in the upper part of their respective reference ranges if that is where you feel well.
'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.'
The book was written by Dr Anthony Toft, leading endocrinologist and past president of the British Thyroid Association. Available from pharmacies and Amazon for about £4.95.
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)." '
If you would like a copy of the article email louise.roberts@thyroiduk.org.uk and print it off to show your GP, highlighting question 6.
It would also be an idea to test vitamins and minerals, optimal levels are needed for thyroid hormone to work properly
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