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Thyroid UK
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Is the GP right ?

Hi, Yesterday I saw the GP (it's never the same one twice) about resuming injections for my low B12 for which he was reasonably helpful. I also asked about upping my 50mcg of levothyroxine to 75mcg as my tsh is 3.88 (in range but not optimum). He was adamant that to do so would be very risky to the health of my heart (as far as I know my heart is fine). I ventured to say that there is controversy about that and also about upping the risk of osteoporosis and he was NOT happy ! He said 'I'm not bothered about osteoporosis but do you really want to damage your heart ?' I'm due more blood tests (1st appointment for these a month away! ) and will follow all the rules to make sure the tsh is as high as possible but am fearful he'll want to keep me on 50mcg. I've researched his view about heart damage but can't find anything so don't know what to think. Is he right ?

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No he's not right, your TSH is to high and you need an increase. Ask for T4 and T3 to be tested next time as you need to know what those levels are.

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No he's not, is the short answer. I've no idea why he's so worried when your TSH is 3.88 and should be below 1, ideally. If you still feel under par then you likely need an increase in your Levo, do you have T4 and T3 values or does your GP not test those at all? 50 mcg is a tiny dose, you do need a rise. You need to try one of the other GPs, maybe they will be more compliant!

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What about folate level?

If you have injections or supplement B12 sublingual lozenges, then it's recommended to take a good vitamin B complex containing folate

If you start/are taking vitamin B complex, or any supplements containing biotin, remember to stop these 3-5 days before any blood tests, as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

What about vitamin D? Essential to test when hypo

Vitamindtest.org.uk -£28 postal test

High ferritin can be linked to being hypo, especially if have Hashimoto's (I note you have had antibodies tested and negative)

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. This gives highest TSH and most consistent results

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Thanks for this. I don't have Hashimotos but do have high ferritin, foliate is being tested along with b12. Good advice to leave off the b12 supplements before being tested, thanks.

Is there any current research to support GPS view re heart damage ?

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None at all.

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What are his views on why your ferritin is high? Mine is always above the upper lab limit, the report that comes back wth my private blood tests says high ferritin can be linked to inflammation, I haven't discussed it with my doctors (I know I probably should but I can't be bothered explaining why I pay to have my own blood tests) but I've got inflammatory arthritis and IBS among other things so that didn't surprise me.

I don't know much about hypo - I've got Graves which is hyper with antibodies - but I would have thought 50mcg levo was a starter dose. How old are you?

Do you have copies of all of your blood tests and the lab ranges used? If not ask for them, you are entitled to have them. You could post them here along with their lab ranges and see what people who know about those things think.

As for 'not being bothered about osteoporosis'! Well!!!

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This question comes up regularly but it's difficult to retrieve the answers because of the 'search' function: healthunlocked.com/thyroidu...

I know there was a discussion not that long ago that discussed the links that the endocrinologist had emailed a member - but I can't find it.

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Rubbish!!!

Your TSH should be under 1, however mine has been suppressed for 7ears!!!

You are on a starting dose!

Your fee t4 needs to be at the top of the lab range - then you will feel better!

How are your B12, D, folate and ferritin?

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Thanks everyone, what a great forum ! You have all reinforced what I thought but it's easy to feel wrongfooted by a GP.

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