High TSH what to ask at GP appointment

[Beja]

Hi I am new, I have a TSH of 100.5 mIU/L (0.27 - 4.20) that is not a typo. I have been having symptoms of constipation, fatigue, weight gain, loss of appetite. What do I ask at GP appointment please? Thanks

[SeasideSusie Remembering]

Beja What do I ask at GP appointment please?

I don't think you'll need to ask, your GP should say you have primary hypothyroidism and give you a prescription for Levothyroxine and unless you are elderly or have a heart condition it should be for no less than 50mcg.

You should be retested in 6-8 weeks' time, with an increase of 25mcg, and retesting/increasing dose should be repeated every 6-8 weeks until your symptoms abate and you feel well. The aim of a treated hypo patient generally is for TSH to be 1 or below or wherever it needs to be for FT4 and FT3 to be in the upper part of their respective reference ranges when on Levo

When booking thyroid tests, always book the very first appointment of the morning, fast overnight (water allowed) and leave off Levo for 24 hours. This gives the highest possible TSH which is needed when looking for an increase in dose or to avoid a reduction. TSH is highest early morning and lowers throughout the day. It also lowers after eating. This is a patient to patient tip which we don't discuss with doctors or phlebotomists.

Take your Levo on an empty stomach, one hour before or two hours after food, with a glass of water only, no tea, coffee, milk, etc, for an hour either side as absorption will be affected. Take any other medication and supplements 2 hours away from Levo, some need 4 hours.

[Beja in reply to SeasideSusie]

Ok I haven't been given Levothyroxine or asked to pick up a prescription for it this test was done a month ago thanks

[SeasideSusie Remembering in reply to Beja]

Beja When did you get your results? Have you seen a GP since you've had the results?

[Beja in reply to SeasideSusie]

I got my results just now after going to the practice and not hearing about them but I haven't seen a GP since waiting for them to come back

[SeasideSusie Remembering in reply to Beja]

Beja You should make an urgent appointment with your GP to discuss your results, he should confirm primary hypothyroidism and give you a prescription, there is no reason not to because once TSH hits 10 that confirms hypothyroidism.

[Emyloulou in reply to Beja]

I despair! 🙄

[Clutter]

Beja,

You should ask why the hell someone from the practice didn't contact you to advise you that you are hypothyroid and urgently need to start Levothyroxine replacement.

[spongecat]

I'm speechless that nobody at the surgery had the decency to call you in regards to your blood results that so clearly show something is amiss. Did anybody actually look at the results? You are the one that has been doing the chasing because you hadn't heard back.

I would complain to the practice manager as to why your results and/or contact to patient was overlooked.

[Beja in reply to spongecat]

Thanks on the printout it says abnormal contact patient but I wasn't called and there are no missed calls or voicemail messages left on my mobile which was the number I gave the surgery

[SlowDragon Administrator]

Make an emergency appointment today or for tomorrow latest.

Do not leave the GP practice without a prescription, for at least 50mcg Levothyroxine

Have you also had vitamin D, Folate, ferritin or B12 tested? If so post results and ranges now. Also test for thyroid antibodies

If not ask GP to test these

I would definitely complain to practice manager.

[Beja in reply to SlowDragon]

TG antibodies 810.5 (<115)

TPO antibodies 68.3 (<34)

Done privately with blue Horizon but they didn't say what results meant thanks

[SlowDragon Administrator in reply to Beja]

Your antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).

About 90% of all hypothyroidism in Uk is due to Hashimoto's

With Hashimoto's, until it's under control, our gut can be badly affected. Low stomach acid can lead to poor absorption of vitamins. Low vitamin levels stop thyroid hormones working.

Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten

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

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO 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-...

healthunlocked.com/thyroidu...

Other things to help heal gut lining

Bone broth

thyroidpharmacist.com/artic...

Probiotics

carolinasthyroidinstitute.c...

Importance of magnesium

hypothyroidmom.com/two-vita...