Dose increase

[J1228]

GP has raised my dose of levo from 25mcg to 50mcg tonight due to below results and a retest in 6-8 weeks. I was diagnosed 2012. Thyroid peroxidase 395 (<34) and thyroglobulin 276.1 (<115) they were done privately because previous GP wasn't listening to symptoms. Also being tested for

Ferritin

B12

Vitamin D

Folate

Complete blood count

Iron panel

Rheumatoid factor

Autoimmune profile

Calcium

FSH

LH

Testosterone

Cortisol

Glucose

Prolactin

Is this right. Thanks

TSH 5.01 (0.27 -4.20)

Free T4 12.9 (12 - 22)

Free T3 3.7 (3.1 - 6.8)

[shaws Administrator]

I don't know how you've survived on 25mcg of levothyroxine for five years. It's ridiculous as it is a supplementary dose usually unless you are very frail with a heart disease. Normally 50mcg is a starting dose with incremental dose of 25mcg every six weeks until you feel well with TSH of 1 or below.

Your TSH should be 1 or below.

Both FT4 and FT3 are at the bottom of the range whereas the should be nearer the top.

Do you get the earliest possible appointment, fasting (you can drink water) and allow a 24 hour gap between last dose of levo and test?

Your doctor may be like many who 'think' that once our TSH reaches somewhere in the 'normal' range that we're on sufficient. Not so, as it is important we have optimum T3 as it is T3 which is needed in all of our T3 receptor cells. T4 is inactive and has to convert to T3 but we need opotimum dose.

[J1228 in reply to shaws]

Yes my appointments for blood draw have always been early morning, fasting and I leave 24 hrs between dose and blood draw. TSH has been above range more than once with no increase.

[shaws Administrator in reply to J1228]

That's good. You need an increase to bring TSH to 1 or below. If your doctor has a problem with that email [e-mail] and request a copy of Dr Toft's Pulse online article. He was President of the BTA and highlight question 6. Your FT4 and FT3 should be towards the upper part of the range and when you get the rest of your results post them on a new question.

One of our doctors, deceased, was always at odds with the Endocrinology as he stated often that our clinical symptoms are not given priority but only the blood test, and that we used to be given doses of between 200 and 400 mcg of natural dessicated thyroid hormones and nowadays patients are in a parlous situation by either being undiagnosed despite clinical symptoms and/or being given a very low dose levo.

[J1228 in reply to shaws]

TSH has been 4.5, 4.3, 6.01, 5.2, 33.6, 7.1

[SlowDragon Administrator in reply to J1228]

I hope GP apologised profusely.

Those TSH results, especially 33.6 are proof of negligence

[J1228 in reply to shaws]

I am 29 yrs old, 53.6kg and slim with a history of heart disease in the family

[shaws Administrator in reply to J1228]

You are young but you have to look after your own thyroid gland and ask questions, read and gather up information which will enable to you to have a healthy and symptom free life.

Doctors know very little about treating hypothyroid patients, neither do they know any clinical symptoms which used to be the priority before the introduction of blood tests and levothyroxine.

Levothyroxine is T4 only. (a hormone). It has to convert to T3 (liothyronine). T3 is the only active thyroid hormone required in the billions of receptor cells in our body, the brain and heart requires the most.

thyroiduk.org.uk/tuk/about_...

Before blood tests etc our usual doses were between 200 and 400mcg of NDT (natural dessicated thyroid hormones).

Ask GP to test B12, Vit D, iron, ferritin and folate. If deficient, it can also cause clinical symptoms. Both B12 and Vit D are essential prohormones and deficient B12 in particular can give us neurological problems.

[Nanaedake]

The range of tests sound very good. Your TSH is still too high but as you have just had a dose increase and will test in 6 weeks, you're going in the right direction.. keep going.