GP keeps changing my dose

[Nattee]

I am newly registered. My GP keeps changing my dose of levothyroxine before the 6 weeks of each dose change is up and she adjusts in more than 25mcg increments. I don't know whether my body is coming or going and I am getting more pain in my back, headaches, dizziness, tinnitus, feeling colder. I was diagnosed 2012, current dose from 100mcg to 175mcg.

Thanks for reading.

[shaws Administrator]

You've been treated by a GP for seven years - so now it's the Seven Year Itch and you will have to take your own health into your own hands.

Tell her you are now a member of the NHS Choices for information and Advice, Healthunlocked Thyroiduk.org.uk and adjusting doses to keep your results 'in range' is wrong.

The aim is a TSH of 1 or lower and an optimum dose of levo to bring your FT4 and FT3 towards the upper part of the range. They rarely test these but if you can afford it you can get your own and they are home pin-prick tests and we have two recommended labs.

Ask GP to test, TSH, T4, T3, Free T4, Free T3 and thyroid antibodies. B12, Vit D, iron, ferritin and folate. (she should definitely do TSH and T4 and maybe T3 and all vitamins.minerals.

She or lab may not do the Frees. She should do all others.

First the blood test has to be at the very earliest possible, fasting (you can drink water0 and allow a gap of 24 hours between your last dose and the test and take afterwards. This keeps your TSH at its highest and that's all they know - the TSH.

Get a print-out from now on from the surgery with the ranges and post if you need comments/advice.

[Nattee in reply to shaws]

Thanks most recent results show undermedication

[shaws Administrator in reply to Nattee]

It would be helpful if you could post your results with the ranges.

[Nattee in reply to shaws]

In another post

[helvella Administrator Thyroid UK]

Nattee,

I am sure others will pile in to ask:

Do you always have your blood drawn as early as possible in the morning?

Do you ensure you do not take levothyroxine in the 24 hours before a blood draw?

Do you ever get Free T4 tested (as well as TSH)?

Do you have access to your results (including reference ranges)?

Would you post your results going back a decent way?

In my view, even 25 micrograms a day is too large an increment for some. I am under-dosed on 100, over-dosed on 125. Goldilocks says 112 is just right for me!

Larger increments should only be used in more extreme situations. For example, starting at 50 micrograms is a special case.

[Nattee in reply to helvella]

Thanks for reply, I have blood drawn early morning and I leave 24 hours between levo and blood draw. How far back do you want results? I have Frees and TSH done and I have recorded all blood results in a table

[shaws Administrator in reply to Nattee]

You can post the table and members will respond.

[helvella Administrator Thyroid UK in reply to Nattee]

Well, as far back as your doses have been subject to change by someone who sounds like a mad yoyo-ist.

[silverfox7]

You must not retest before the 6 weeks is up!!! With each dose change it takes 6 weeks to fully get that dose into your body and it slowly builds up so acting on results before that time and at worst be dangerous and at best stupid!

It doesn't take much of an increase to make a difference but testing early could mean you are already in a dose which after another few weeks would give you a higher reading and then increasing by more that 25 mcg on top of that could be leaving you feeling terrible with hyper like symptoms which would then have your doctor dropping down to a lower dose again! This leaves you feeling dreadful and goodness knows what you doctor would do next. Thyroid UK run this forum so have a read at their site, lots of good info and then tell your doctor you have taken advice from Thyroid Uk who are recommended by NHS Choices for thyroid dysfunction. Keep in touch and let us know how you get on