Latest results and advice before GP appointment please.

[Cn13]

Hi,

These are my latest test results:

Serum free T4 level 11.7 pmol/L [9 - 19]

Serum TSH level 2.19 miu/L [0.35 - 4.94]

Serum free triiodothyronine level 3.5 pmol/L [2.6 - 5.7].

I have been left on 50mcg Levo since October even though I have asked for an increase. The GP is not listening to my symptoms and at the last appointment argued that an increase in Levo would lead to heart problems.

At this next appointment I want to try to insist on an increase to 75mcg. I am just wondering what sort of points could I put across to persuade the GP to increase dose. I don't find this GP helpful so would like to be prepared to meet resistance. Any advice gratefully received.

[Cn13]

Thank you so much reallyfedup,

Yes unfortunately this GP either doesn't care or doesn't seem to believe my symptoms. This will be the third appointment where I have tried to get the dose raised. I already have the Toft paper so I will bring that. I will also search the forum for the research by DR Midgeley.

I was wondering about changing GP practices as I might get listened to elsewhere but not sure. Thank you for your help.

[Saggyuk]

Hi, my endo increased me twice with a tsh like that - first one put me to just over 1 and the second brought me down to under one so it can make just a tiny difference and won't necessarily put your over.

I might suggest that you act really gracious and as if doc is the font of all knowledge and you trust every word doc says and then try and persuade doc to just try on a trial basis for six weeks and retest in six weeks as you just want to see if it will make a difference and that you'll happily decrease your dose immediately should the tsh come back suppressed and won't keep bothering doc after as at least you'll know then????

Hate to suggest that but often works better than confrontation when they won't budge- plus they have the added satisfaction that at least you might stop bothering them about it lol!

Then make sure you leave 24 hours after dose before your next blood test lol.

[Cn13 in reply to Saggyuk]

Hi Saggyuk,

Thank you for that suggestion. I think I will try something like this as this doctor does not seem to like being challenged. Being gracious like you say might work better.

She should really increase based on those results but I'll have to wait and see.

[Saggyuk in reply to Cn13]

Yes sometimes they get defensive if they think you're blaming them which just makes them more stubborn. All smiles and happiness sometimes works with those like that and she's already said no twice so worth a try

[Clutter]

Carmel13n,

You are undermedicated to have TSH 2.19 and both FT4 and FT3 are low in range.

The goal of Levothyroxine is to restore the patient to euthyroid status. For most patients that will be when TSH is 0.2 - 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 [e-mail] if you would like a copy of the Pulse article to show your GP.

[Cn13 in reply to Clutter]

Thank you Clutter. This is what I thought too. Hopefully the GP will see sense and increase my medication.