TSH 70

[Hele1]

My friend has recently been diagnosed after years of feeling unwell. She started 50 mcg 6 weeks ago and now has a TSH of 12. Her doctor has given her 12.5 increase. This doesn't seem much she has no other results and still feels unwell. She also asked for b12, ferritin, folate and vitamin D test. Her doctor said no. My question is are you entitled to have vitamins tested on the NHS? Thanks

[SeasideSusie Remembering]

I don't think you're entitled to have them tested, my friend was refused some of them. However, a 12.5mcg increase is ridiculous when her TSH is still so far over range.

She is going to feel unwell for some time, even if she had been given an increase of 25mcg, each dose change takes about 6 weeks to be fully effective, and then we have to keep increasing at the same pace u til we feel well, it can take months.

[jimh111]

Not your question but 12.5 mcg is way too little. Her doctor clearly does not understand the relationship between TSH and hormone levels, there is a logarithmic relationship, if 50 mcg reduced her TSH from 70 to 12 another 50 mcg is likely to bring it down to around 2.0 which is closer to a typical treatment level.

[helvella Administrator in reply to jimh111]

In a community-based setting, the relationship between log TSH and free T4 is complex, nonlinear and influenced by age, smoking and TPOAb status.

ncbi.nlm.nih.gov/pubmed/271...

[shaws Administrator]

The starting dose is 50mcg of levothyroxine with 25mcg incremental increases every six weeks and she should mention this to her GP. The increases should until she feels well but many think that when the TSH is 10 or just below they're on enough or 'somewhere' in range.

In fact we need sufficient levothyroxine to bring TSH to 1 or below. Few doctors seem to be aware of this.

She can tell her GP she is a member of the NHS forum for help/advice and all of the vitamins/minerals have to be at optimum level. So needs blood tests to know whether or not she is deficient. If deficient these can also cause disabling symptoms.

[Hele1]

I know! I was surprised at the small increase. A temporary doctor finally tested her thyroid. Her main doctor refused and just subscribed antidepressants. It's now her main doctor refusing any other test and giving such a tiny increase.

I'm sure I've seen somewhere that the NHS should test once a year for deficiencies or is that only after a deficiency is found?

[SeasideSusie Remembering in reply to Hele1]

I don't think the NHS tests for deficiencies once a year per se, I've never, ever had any vitamin and mineral tests with the NHS and I'm a pensioner!

It's possible that some nutrients ought to be monitored at intervals once a deficiency has been diagnosed, but as a general thing we don't get much 'preventive' testing on the NHS.

[ITYFIALMCTT in reply to Hele1]

It depends on your CCG. Even once a vitamin D 'severe deficiency' has been identified, my CCG doesn't fund any follow-up testing at all in primary care but I frequently read of people in other areas who have a follow-up test or monitoring so it varies enormously.

[Hele1]

Thanks for your replies. It doesn't make sense that the NHS spend millions on trying to treat symptoms when so much could easily be resolved by correcting underlying deficiencies. It almost like they are encouraged to keep people ill to keep big pharma happy.

[SlowDragon Administrator in reply to Hele1]

There's no money for the Pharma companies in us improving our vitamin levels and getting better

Was delighted to see Dr Rangan Chatergee interviewed on TV last week about a roll out program to train GP's in functional medicine, nutrition and vitamins

The Government might realise is a cheaper option

[SeasideSusie Remembering in reply to Hele1]

It doesn't make sense that the NHS spend millions on trying to treat symptoms when so much could easily be resolved by correcting underlying deficiencies

And that's probably what's really behind it. Keep us ill and they have to prescribe medication, more meds prescribed, more money for Big Pharma and more kick-backs for the NHS and GPs. Maybe the NHS gets more back in kick-backs than they spend prescribing??? Also, let's keep Big Pharma happy, they sponsor lectures at med school and CPD (Continuous Professional Development), Cynical - moi???? Surely not!