Reduction of medication

[Lizbeth1]

I saw Dr Skinner over a number of months as I was unhappy with my medication of 125 mcg of levothyroxin.

It was increased slowly finding an optimum of 200 mcg Levo and 40mg of liothyronine. My go agreed to this.

Approximately 3 months ago the practice refused to continue

As the Leicestershire medical dept took T3 off their list. I offered to pay for a private prescription but was refused. I said I would try Levo only until I could find an alternative. I asked for 225mg which was accepted.

But now leics thyroid register has taken blood results of

TSH <0.05(0.3-5.0) and free T4 20(10-25)

To mean that my levothyroxine should be reduced to 200mcg

Quote' our aim is to maintain patients TSH within the range

0.3-5.0 with a normal T4'

No discussion of conversion to T3 and without talking to me I thought once you were on levothyroxin TSH was always negative I have a phone all with my doctor on Wednesday any suggestions? Thank you

[Jazzw]

It varies, but the fact remains that TSH becomes an inaccurate indicator once you're on thyroid hormone replacement. Your FT4 is not overrange, ergo you aren't overmedicated. Resist any reduction in dose!!

Would be interesting to know your FT3 but I suppose they're not testing that? You could try insisting on an FT3 test ahead of any debate about reducing levo?

[shaws]

They state a load of rubbish. Read and highlight the part on the British Thyroid Association's advice when on T3 and probable removal and send to the Endo.

Excerpt:

Clinical approach to patients on LT3



For patients who are established on LT3 and are considered to be stable,

a change to LT4 monotherapy should not be implemented without discussion with the patient.

In such cases change of treatment may result in significant instability of thyroid status and potentially undesirable clinical outcomes, which may prove more costly than continuation with LT3 therapy.

I think everyone whose T3 has been withdrawn should get and inclusive method of suing the NHS for removing it when you've been well. Also there are other T3s which cost less and can be prescribed on a named-patient basis.

british-thyroid-association...

.

[SlowDragon Administrator]

Highly likely your vitamin levels have crashed through the floor as a result.....then results appear to show adequate or over treatment.....but you are in fact very hypo

Get vitamin D, folate, ferritin and B12 tested ASAP.

Post results and ranges when you have them

Do you have autoimmune thyroid (high antibodies)

see Patients Association assessment too

patients-association.org.uk...

Suggest printing this and the BTA one too out - taking to GP and firmly asking for it to be reinstated. At same time insist on vitamin testing, if very low....also insist on coeliac testing ...or reinstatement of T3

Also that you will be writing to MP, jeremy Hunt etc

[silverfox7]

The aim when in Levo is to get both your FT4 and FT3 in the top third of their respective ranges. So your FT4 is now at the lowest point it should be i.e. 2/3 of the range so lowering that will make you under medicated. I would insist not change without know where FT3 is and if that is low insist of testing of Vit D, B12, folate and Fermin as these help conversion from T4 to T3. This can be addressed by getting those 4 optimal but it does take months rather than weeks if very low.

[shaws]

They are wrong. The TSH range is o.k. for initial diagnosis but once on replacement hormones, the aim is 1 or below. email [e-mail] and ask for a copy of Dr Toft's online article and highlight No.6.

Did you have your blood test at the very earliest time (fasting - you can drink water) and allow a gap of 24 hours between last dose of thyroid hormones and the test?

Dr Toft was President of the BTA.

[Lizbeth1]

Thank you for all your comments