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Thyroid UK
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Advice on what to say in next doctors appointment

Any advice would be greatly appreciated. Was diagnosed earlier this year test results were

June 2017

TSH - 34.52 (0.35 - 5.5)

Free T4 - 4.9 (10 - 19.8)

Was prescribed 25mg levothyroxine

July 2017

Thyroid antibodies - 1300 (0.0 - 60.0)

TSH - 22.41 (0.35 - 5.5)

Free T4 - 9.6 (10.0 - 19.8)

Was prescribed 50 mg of levothyroxine

August

TSH - 9.34 (0.35 - 5.5)

Free T4 - 13.4 (10.0 - 19.8)

Message left from my doctor to pick up 75mg of my tablets, now borderline hypothyroid & to make an appointment in a year for a blood test.

Trouble is I still feel awful, obviously not as bad as earlier this year but not functioning well at all. I'm self employed & need to work to make ends meet but still incredibly difficult.

I've made an appointment to see yet another GP within the same practice to try & get some help with the high pitched continuous noise in my ears (especially the left where I feel I'm losing some hearing) & the dry mouth symptoms. I'm thinking these might be associated with the Hashimotos?

I know they have said they don't test for T3 previously but has anyone been able to persuade them at all?

Thank you for any advice on pointing me in the direction of better understanding test results.

6 Replies
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Well you do need the increase to 75mcg and then retest after 6-8 weeks. Likely to need further increase(s) - 25mcg max at any one time, and retesting after 6-8 weeks

All thyroid tests should be done as early as possible in morning and fasting and don't take Levo in the 24 hours prior to test, delay and take straight after.

Your antibodies are very high this is Hashimoto's, (also known as autoimmune thyroid disease). About 90% of hypothyroidism in UK is due to Hashimoto's.

Hashimoto's very often affects the gut, leading to low stomach acid, low vitamin levels and leaky gut.

Low vitamins that affect thyroid are vitamin D, folate, ferritin and B12. Very Important to test these. If they are too low they stop Thyroid hormones working.

Have these been tested, if not ask that they are. Always get actual results and ranges.

As you have Hashimoto's then hidden food intolerances may be causing issues, most common by far is gluten. Changing to a strictly gluten free diet may help reduce symptoms and eventually start to lower antibodies. Very very many of us here find it really helps and can slowly lower antibodies, improving symptoms

thyroidpharmacist.com/artic...

thyroidpharmacist.com/artic...

amymyersmd.com/2017/02/3-im...

chriskresser.com/the-gluten...

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Thank you SlowDragon, I will have a read of the links provided & see if I can persuade GP to test for vitamins as well. Really made me feel down when they said wait a year for another test. Your advice is much appreciated.

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If your GP seriously thinks that you are now correctly treated then you need to see/find another GP.

But first Ring/see GP and ask for full Thyroid retest and the essential 4 vitamin tests to be done 6 weeks after latest increase.

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I'm not sure why your doctor said you are borderline hypothyroid as you are clearly overtly hypothyroid judging by your previous tests. You need a blood test every 6-8 weeks until your TSH is near to 1.0 or until you feel well. Most people feel well when they reach 1.0 or slightly lower.

Could the high pitched noise in your ear be tinnitus? If so you need to check your B12 levels as it's a symptom of B12 deficiency. You need to check Vit D, B12, folate and ferritin as hypothyroid conditions often go hand in hand with these deficiencies. Levothyroxine won't work well until all of these are optimal. They need to be half way in the laboratory range and B12 needs to be at the top of the range to feel well.

You have thyroid antibodies which means you have autoimmune thyroid disease otherwise known as Hashimotos thyroiditis. You can read up about it on the Thyroid UK website.

Autoimmune conditions sometimes make you more susceptible to other autoimmune conditions and so it would be sensible to rule out pernicious anaemia by getting a B12 blood test result and then investigate further if it is low.

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Thank you Nanaedake, the noise is tinnitus & its constant & driving me mad. I will ask for the test to check for B12 & others, really appreciate your advice on a possible link.

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By the way don't take the doctors word that your vitamin levels are ok, make sure you get a print out of the blood test results that includes the laboratory ranges. Docs often say fine when we are just within NHS range but coasting along the bottom won't make you feel well and you can be B12 deficient even within the lab range. When you get results, post them on this forum and people will help.

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