Thyroid UK
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GP won't increase dose

Hi I am new my GP won't increase dose even though endo recommends it. Diagnosed hypothyroid 2012 and taking 75mcg levothyroxine, feeling unwell with tiredness, hard stool, pins and needles, joint pain, shortened but heavier periods.

Thankyou

TSH 8.3 (0.2 - 4.2)

Anti TPO 107.5 (<34)

Anti TG >1300 (<115)

Free T4 12.9 (12 - 22)

Free T3 3.0 (3.1 - 6.8)

10 Replies
oldestnewest

He is another person who has the cheek to call himself a doctor. He has absolutely no clue of how to treat a patient.

Make an appointment with this man, or write him a letter and drop into surgery to tell him that your treatment is absolutely woeful and dangerous to your overall health. You've taken advice from the recommended NHS Forum for advice on dysfunctions of the thyroid gland Thyroiduk.org.uk.

You have been diagnosed since 2012 - five years ago - and have been kept on too low a dose of levothyroxine. The aim of which is to reduce the TSH to 1 or below. In fact he has not even kept you at the top of the range, i.e 4 but to 10,)- The Range is used for Diagnosing only - thereafter the aim is to get it to 1 or below. Both your Free T4 and Free T3 are bottom of range (T3 below). Both have to be at the upper part of the range.

You need to go gluten-free to reduce your antibody levels. You have an Autoimmune Thyroid Disease, also called Hashimoto's, due to having antibodies. These antibodies attack your thyroid gland and they wax and wane (attacking then not) until you are hypothyroid - which you definitely are. Both FT4 and FT3 have to be towards the upper part of the range.

All of these doctors badly need training. In fact it is their poor, unwell, "don't know who to turn to patients" who have to do the work of the doctors due to inept training and disregard and for causing their patients so much distress and puzzlement of why they are worse on treatment rather than recovering.

You desperately need an increase, every six weeks, of 25mcg levo until your TSH comes down to 1 with FT4 and FT3 in the upper part of the range.

Going gluten-free can help reduce the antibodies which attack the gland.

Next time ask for Vitamin B12, Vit D, iron, ferritin and folate - these should all be at the top of the range not the bottom or middle.

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Thanks the lowest my ferritin has been is 3 (15 - 150) and I needed an iron infusion for this. I also supplement vit D and folate and B12. I have been on them for years, about 4 years

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You also need to get the results and ranges for Vit D, folate and B12. B12 for instance is now recommended to be around 1,000. (have you been diagnosed as having Pernicious Anaemia). Both Vit B12 and Vit D are prohormones so are extremely important that they are optimum.

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Hi yes I have pernicious anaemia.

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We have to make sure our B12 is optimal and that the homocysteine level isn't too high. Rarely is homocysteine tested.

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Can you see a different GP at the practice

This one is either negligent or ignorant. Why is he ignoring thyroid specialists advice?

Your antibodies are very high this is Hashimoto's, (medics in UK tend to just call it autoimmune thyroid disease). About 90% of all hypothyroidism in Uk is due to Hashimoto's

According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)

But don't be surprised that GP or endo never mention gut, gluten or low vitamins. Hashimoto's is very poorly understood and the autoimmune aspect often completely ignored

Essential to get vitamin D, folate, ferritin and B12 to very good levels

If these have not been tested recently, ask that they are

See SeasideSusie excelkent detailed vitamin supplements advice

Eg

healthunlocked.com/thyroidu...

Changing to a strictly gluten free diet may help reduce symptoms, can help gut heal and slowly lower antibodies

thyroidpharmacist.com/artic...

thyroidpharmacist.com/artic...

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

chriskresser.com/the-gluten...

scdlifestyle.com/2014/08/th...

drknews.com/changing-your-d...

Low stomach acid can be an issue

Lots of posts on here about how to improve with Apple cider vinegar or Betaine HCL

thyroidpharmacist.com/artic...

drmyhill.co.uk/wiki/hypochl...

scdlifestyle.com/2012/03/3-...

Other things to help heal gut lining

Bone broth

thyroidpharmacist.com/artic...

Probiotics

carolinasthyroidinstitute.c...

Your dose needs increasing in 25mcg steps, retesting after 6 weeks each time. TSH should be around one and FT4 towards top of range eg 18-20

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

Dr Toft, past president of the British Thyroid Association and leading endocrinologist, 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)."

You can obtain a copy of the article by emailing louise.roberts@thyroiduk.org print it and highlight question 6 to show your doctor.

1 like
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Thanks for reply, GP is ignoring endo's advice because he says I am too thin to be hypothyroid.

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As SeasideSusie woukd say .......FFS

There are loads of hypo patients who are incredibly skinny and struggle to gain weight

You’re thin because your hypo and gut is not absorbing food

Most coeliacs are very thin until they change to gluten free diet Gluten intolerance is the same - there’s just no test

See a different GP

Once you get sorted put in formal complaint

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As SeasideSusie woukd say .......FFS

Oh dear, I'll try and reign it in, I'm getting a reputation :D :D

But I do get extremely exasperated by these idiots who somehow managed to get a medical degree!

D'ya know, I'm just an ordinary Joanna Bloggs with 3 old fashioned GCE O Levels, (and a degree from the University of Life in Household and Husband Management, bringing up kids, and juggling life of a busy mum at one time [although widowed and now old and retired and taking it easy ] :D ) yet without any training in hypothyroidism (except being a victim of it for 43 years and needing to find out how to help myself) I can understand how it works, understand blood test results, see when someone is undermedicated, etc, etc. Where are these doctors going wrong, and they're being paid 6 figure salaries for it!!!!!!!!!!!

5 likes
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That is one point showing how much money the NHS is wasting... on useless doctors!

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