I went back to my gp to ask for a repeat on my bloods. I took all the recommended blood work requests but they just did the tsh, even though my last TPO was 1,300 {<30}.
So my tsh was 9.2 {0.4-4} in September on 50 levo. It was 8.9 in November on 75 levo. The result from 5th Jan was 4.5. No further action. I have first endo appointment end of this month.
I have ordered full thyroid blood work via medichecks and awaiting results.
I am still extremely fatigued, weak, bone and muscle ache. Can they really say no further action required?
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Whitney2017
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Your GP doesn't know how to treat patients with hypothyroidism. They are poorly trained and ignorant of dysfunctions of the thyroid gland.
The range is used for diagnosing people if TSH goes above 4.4. In other countries we'd be prescribed levothyroxine but in the UK, they wait till the TSH is 10. When patient's TSH comes down to 'within the range - even the highest (4.4) - they believe the patient is on sufficient and wont increase.
Tell GP you've taken advice of the NHS Choices for help/advice and have been advised you need increases every six weeks of 25mcg levothyroxine until your TSH is 1 or below. Or you can wait till you consult the Endo and I hope it is a successful appointment.
Thank you for this. Hypothyroidism and Hashimotos is struggle enough without having to fight with the gp also. I'm hoping my private results come through soon. Thank you for the info x
Nothing to stop you making an appointment with your GP to request a dose increase. Point out that TSH 4.5 is over range. The goal of Levothyroxine is to restore the patient to euthyroid status. For most patients that will be when TSH is 0.4 - 1.0 with FT4 in the upper range. FT4 needs to be in the upper range in order that sufficient T3 is converted. Read Treatment Options in thyroiduk.org.uk/tuk/about_... Email dionne.fulcher@thyroiduk.org if you would like a copy of the Pulse article to show your GP.
Thyroid peroxidase antibodies are positive for autoimmune thyroid disease (Hashimoto's). There is no cure for Hashimoto's which causes 90% of hypothyroidism. Levothyroxine treatment is for the low thyroid levels it causes. Many people have found that 100% gluten-free diet is helpful in reducing Hashi flares, symptoms and eventually antibodies. 100-200mcg selenium is good thyroid support for Hashimoto's hypothyroid patients.
Thank you for this information. I will wait until I get my private results and take these to my gp and request an increase in levothyroxine. I don't feel like 75 levo is sufficient at all. I'm hoping my endo appointment will provide some support. I'm off work at the minute, the mental and physical fatigue is relentless, as well as the weakness and muscle pain .
It is appalling that this most common disease is so poorly managed and understood
There are over 2,200,000 million people in the U.K. on Levothyroxine. that's 3% of the population, yet medics seem to have no idea how to read a blood test and get levels anywhere near correct.
Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,
"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.
In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l.
Most patients will feel well in that circumstance. But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.
This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."
You can obtain a copy of the articles from Thyroid UK email print it and highlight question 6 to show your doctor please email Dionne: tukadmin@thyroiduk.org
Prof Toft - article just published now saying T3 is likely essential for many
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