Question about TSH

[Zoeyk]

I am new when is levothyroxine prescribed for hypothyroid

TSH 100.5 (0.2 - 4.2)

FT4 10.1 (12 - 22)

FT3 3.2 (3.1 - 6.8)

Thank you in advance

[SlowDragon Administrator]

Immediately and urgently

You should have been called in as soon as blood tests back

How long have you been waiting and what has GP said

[Zoeyk in reply to SlowDragon]

Had phone call from GP surgery saying no action needed

[SlowDragon Administrator in reply to Zoeyk]

See a different GP and put in a complaint

[Zoeyk in reply to SlowDragon]

Ok thank you

[SeasideSusie Remembering in reply to Zoeyk]

Primary hypothyroidism is diagnosed when TSH goes over 10. Make an urgent appointment, don't leave without a prescription for 50mcg Levo and arrangements for retesting 6-8 weeks later when you will need a 25mcg increase when test results are back. Repeat retesting/increasing until TSH is around 1 or below and free Ts in the upper part of their ranges if that is where you feel well.

[Mary-intussuception]

Oh dear!

Zoey, what was the date of this test?

Any chance of a typing error? Is that TSH result really one hundred (100.5) or 10.5 ? Either way it is HIGH.

The way you have asked WHEN LT4 is prescribed for Hypothyroidism makes me wonder what you have been told by your GP or Endocrinologist.

My Endocrinologist checked my Adrenals were OK first, before I started my Levothyroxine. It seemed significant to him. However they were OK. He phoned when he had results and told me ok to start.

Do you have any other medical conditions?

Have you had Thyroid Antibodies tested? Nutrients levels?

Has your Doctor explained why you have been diagnosed with Hypothyroidism but are not being treated.

Treatment usually starts with 50mcg of Levothyroxine daily. Then blood tests are repeated every 6 weeks and LT4 is increased by 25mcg at a time until stable, TSH below 2 and symptoms improved.

What are your symptoms?

Were you offered any explantation for your high TSH result? Or any further investigations ?

Have you had an Ultrasound scan of your Thyroid or any other scan ?

What has doctor proposed to do next?

[Zoeyk in reply to Mary-intussuception]

Date of the test was Dec 2017 and not a typing error. Went to GP with list of symptoms had bloods done and have been told no action needed. Haven't had adrenals checked and I have been told my antibodies being positive is not important.

Nov 2017

TPO antibodies 1700 (<34)

TG antibodies 278 (<115)

Haven't yet been diagnosed.

Symptoms are

Weight loss

Sweats

Tremor

Tiredness

Bloating

Loss of appetite

Depression

Puffy eyes

Dark circles under eyes

No explanation of results just no action needed

No ultrasound done on thyroid and had no other scans related to thyroid. Just bone scans

[Mary-intussuception in reply to Zoeyk]

What's the result of the bone scans?

[Zoeyk in reply to Mary-intussuception]

They were just x rays of my hip back in 2007. I had continual hip pain (possible overuse trauma) and I was sent to radiology in one of the hospitals. I was found to have femoral acetabular impingement in my right hip which caused a fraying of a hip tendon. I had to have surgery for it. First corticosteroids that were injected in 2010 (long waiting list and misdiagnosis) and then the surgery 1 year later.

[Mary-intussuception in reply to Zoeyk]

Sounds painful. Is it any better now. 🐤

[Zoeyk in reply to Mary-intussuception]

Yes much better now. Haven't had any problems except for a minor wound infection. Was meant to be on crutches for 2 weeks but felt well enough to be off them in 3 days!

[Mary-intussuception in reply to Mary-intussuception]

That's unusual, for a GP to phone to say no action needed , were they returning a call then?

Is there another GP in the practice you can see?

Make an urgent appointment to see a different GP and take someone with you if possible. Take your list of symptoms and results.

These results reveal Hashimoto's Autoimmune Thyroiditis and Hypothyroidism. QUERY this.

Ask for nutrients levels tests of :

Vitamin D & Calcium

B12 & Folate

Ferritin.

Ask if there are any other blood tests that you need.

Ask for your Diagnosis. You have a right to ask for a diagnosis.

Google search "symptoms of deficiencies in * (each nutrient) on NHS choices" and other sites.

Have you any other Medical conditions? On any medications? Had any other blood tests.

I just don't understand why they do the right tests and then DON'T treat ??

You could ask for an urgent referal to a Specialist and for an Ultrasound scan of your Thyroid. Hope your hospital has got a good Endocrinologist. 🐥

[Zoeyk in reply to Mary-intussuception]

I don't know if GP was returning a call or not. I was waiting for them to call me. I left them my number which was the right one and I had my phone on all day but no calls came through.

Will ask for ferritin, calcium folate, vit D and B12 to be done. No full blood count tests.

Will ask for diagnosis

No other blood tests.

Not on any other medications

I have eczema and hypermobility syndrome (possibly the reason why I had to have the surgery on my hip)

[Mary-intussuception]

Zoey

Are you able to eat well?

No IBD (Crohn's or Colitis) ?

Was wondering about your weight loss. I think most people put on weight with Hypothyroidism but I have "met " a few on here who actually lost weight.

Any IBS?

[Mary-intussuception in reply to Mary-intussuception]

ps

Have you had Full Blood Count blood tests?

[Zoeyk in reply to Mary-intussuception]

Never had one of those

[Zoeyk in reply to Mary-intussuception]

I am able to eat well but I think I have either IBS or coeliac disease.

[Mary-intussuception in reply to Zoeyk]

Please get this investigated. Ask for referal to Gastroenterologist. Ask for the blood tests while you wait to be seen.

[Zoeyk in reply to Mary-intussuception]

Ok I will do this.

[Mary-intussuception in reply to Zoeyk]

About the weight loss, was any of it sudden? For example : 7lbs/3k in a week or less? This used to warrant immediate referal to a hospital medic. Has GP commented on it?

If you have a record of your weight loss take to GP also with list of symptoms.

Take your temperature early morning before food or drink and add to your list of symptoms if ever low (under 36/ 36.5) remember to add one if taking underarm.

A friend of mine has Coeliac Disease . She lost weight and developed other conditions before being diagnosed.

I think you have to eat gluten before the test.

[SlowDragon Administrator in reply to Zoeyk]

Extremely common with Hashimoto's to be gluten intolerant or get false negative or false positive for coeliac

thyroidpharmacist.com/artic...

[helvella Administrator]

Zoeyk,

First, congratulations on having the sense to search and ask your question.

Second, an endorsement of the responses.

Third, a caution that all too many doctors are likely to start you cautiously on 25 micrograms of levothyroxine - and leave you there. Many, including some doctors, believe that starting too low can have negative effects. That small dose can reduce what little thyroid hormone manufacturing capacity you have still further. The suggestion is to start higher, say, 50, and be ready to increase quite quickly if appropriate. Once you have achieved a dose which has started to help - and doesn't leave you running out a few hours after taking it - then go for the slow and careful adjustments with re-tests and reviews.

Fourth, there is a terrible feeling that surges when reading stories like yours. I'd love to put your GP on a medicine that suppresses the thyroid until their TSH rose to 100 or more. Then refuse any treatment. I hate thinking that but cannot help it.

[Zoeyk in reply to helvella]

Ok thank you. Will seek better care from next GP.

[pippan]

TSH 100 no action necessary, can't add to what peeps have said but just totally gobsmacked. Unbelievable.

[Marz]

GP should be sent on Gardening Leave ASAP....

[helvella Administrator in reply to Marz]

Marz,

Far too pleasant...