Thyroid UK

comments/ advice on gp advice to me re thyroid meds

Saw my GP today (who has been nothing but supportive so far) and we are working to improve my activity levels by working on my thyroid medication. I have got my tsh down to 1.86 and t4 and t3 almost at correct levels (t4 16.51 and t3 4.02 on 125 mg of thyroxin) and feel a lot better but still not completely right. She says that whilst she may support me to get tsh lower she says that below 1.4 might present health risks including bone density issues.

she also says that the reason that uk gp's do not prescribe Armour (which I am considering trying if energy levels do not improve) as there are safety concerns that would preclude this again I think it was bone density issues and one other which I failed to note down So she is very reluctant to support me in any changeover. Any idea whether Armour or similar is widely prescribed elsewhere eg USA for example by medical proffesionals. Any thoughts comments or info would be very welcome Stewart

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stewartleak What are the reference ranges for your thyroid tests? What are you saying are the 'correct' levels? Your FT3 seems low if the range is what we usually seen on here, but can't say for sure without knowing the ranges for your own tests.

The aim of a 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.

Also, from thyroiduk.org.uk/tuk/about_... > Treatment Options

"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 the article by emailing louise.roberts@thyroiduk.org

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