Tight chest

[Shenka]

Have had dreadful cold since new year. Should have had blood test but unable to go. Been on 50 since diagnosed August with tsh 107. Feel really vulnerable tonight.

[Nanaedake]

Hello Shenka, I'm sorry you feel so unwell. I'm sure you should have had a blood test and a dose increase before now if you were diagnosed in August. Your TSH was very high when diagnosed. Did your doctor not tell you to return for a blood test 6 weeks after starting levothryxoine? If not then he/she is very remiss.

No matter how ill you feel, you really must see a GP and get a blood test. If your TSH is still high you will struggle to recover from illness. You must ring for an urgent appointment on Monday, see a GP and get a blood test right away. Take a list of your symptoms to the appointment. If you feel very unwell before then, see the out of hours doctor.

[Shenka in reply to Nanaedake]

I had first test in August. Told to come back in 6 weeks. Then told no. Tsh still dropping. So here I am and was supposed to be tested around Christmas. Unfortunately took ill.

[Nanaedake in reply to Shenka]

Ok, so when newly diagnosed, you should have a blood test every 6 weeks and increase the dose until your TSH reaches around 1 or a little lower which is where most patients feel well. If your doctor has not instructed a blood test in 6 weeks then ring and book it in advance yourself. Your doctor should not have cancelled the 6 week blood test.

Some tips we can share which your doctor might not have told you...

Take your levothyroxine on an empty stomach with a full glass of water such as first thing in the morning and leave one hour before eating or drinking anything except for water. Leave 4 hours before taking any other medicines or supplements.

Always have your blood tests first thing in the morning and fasting (doctors will say this is unnecessary). Take your levothyroxine after the blood test, not before.

You can get online access to blood test results if in England. Ask your GP reception for a password login so that you can access blood test results, not just appointments. Keep a record or print out of all your results and blood tests, amount of medication you are taking, type of levothyroxine so that if you run into problems, you've got a log.

Stick to the same formulation of levothyroxine and find one that suits you. Some people find levothyroxines are not interchangeable although 'officially' they are. If you have problems with any type of levothyroxine make a yellow card report. This helps to maintain quality for everyone.

If your doctor has not tested vitamin levels he/she should do so as patients with thyroid conditions are often deficient. Ask for tests for:

B12

folate

ferritin

vitamin D

Never take the doctor’s word for it that test results are fine. Doctors often say fine when anywhere in range and that does not necessarily make us feel well. So get a print out of all results and post here. Some people have over 20 years’ experience living with hypothyroidism on this forum and can give you excellent advice.

[Shenka in reply to Nanaedake]

I am in N Ireland

[Shenka in reply to Shenka]

I tried to persuade gp to increase from 50 but it seems the policy in the practice is wsit until the tsh stops droppe

[Nanaedake in reply to Shenka]

Well, you're the customer and if it were me, I wouldn't keep waiting because it will then take a very long time to achieve an optimal dose as you were very hypothyroid.

If it were me I would Insist on a test every 6 weeks and dose increase until your TSH is at least in lab range and then you can work on getting it near to 1.

You should also get GP to check for thyroid antibodies.

Can you get a copy of your thyroid test results along with the lab ranges and then post here? You'll get better advice that way.

[Hidden in reply to Shenka]

Please visit another GP practice and become healthy. Can you afford private blood tests these will give you the results that you require for an increase in medication.

[Nanaedake in reply to Shenka]

I don't know if online test results are available in N. Ireland, just ask your GP reception or Google might tell you what your entitlement is.

[TSH110]

Ask fora second opinion from an endocrinologist. This is the strangest approach I have ever heard of to get medication optimised, if the TSH is still elevated after 6 weeks you need a higher dose of medication (25 or even 50mcg Levo) to get it down further towards optimal (TSH BELOW 1!) then another blood test in 6 weeks and 25mcg increase...this is repeated until the TSH reaches below 1, and this is the correct protocol in England anyway. You have a long way to go with a TSH of 107 and I sincerely doubt 50 mcg of Levothyroxine is going to put it right. I needed 125mcg which is quite a low replacement dose (TSH 110 so quite close to yours) everyone varies but I’d think it doubtful you’d need any less than that.

Sorry you are getting such a raw deal and terrible treatment it is not a pleasant place to be to put it mildly.

This link might be helpful:

healthunlocked.com/thyroidu...