Doctors dropping my dose from 200mg to 50mg

[tmh66]

I have recently had my full bloods done and also my thyroid, my bloods i have done as I am on methotrexate and they were fine but apparently my thyroid result was low. I had a call from the doctors saying they want to reduce my thyroxine to 50 instead of 150, this confused me as I have been on 200 for a long time now and I told them this. My question is, why if my results are low do they put my thyroxine down and not up? I am already putting weight on and am very tired and achy so thought I might need to up my dosage. I am confused?? I also have pernicious amaemia, coeliac disease and sera negative rheumatoid arthritis. What am I to do??

[SlowDragon Administrator]

Refuse to drop dose

Can you add your most recent thyroid test results and ranges

TSH, FT4 and FT3 plus do you have high Thyroid antibodies? (Hashimoto’s)

Sounds likely as you have other autoimmune diseases

Vitamin D, folate, ferritin and B12 results and ranges very helpful too

How often do you get B12 injections

[tmh66 in reply to SlowDragon]

They haven't given me the test results, just had the receptionist saying he wants me to drop down to 50mg. No one has said I have hashimoto's but when I started on Levothyroxine the doctor said it was because of my immune system. I must sound really thick but I just do as I'm told by the doctors and don't question it. Just this time going down from 200mg, which they didn't reaslise I was on though it was them that put me on it, to 50mg it seems a pretty big reduction. I suppose I should make an appointment for the doctor and get to the bottom of it.

[tmh66 in reply to SlowDragon]

ok, just rang doctors again and asked for more details. TSh is 0.05 and T4 is 20. This means absolutely nothing to me but the tsh range she said should be 0.27 to 4.2 so I can see this is low. If you can explain more to me then great. Does this also mean I will put more flippin weight on as just recently i have gone up two stone and my eating habits have not changed. Plus I am exhausted.

[Clutter]

Tmh66,

If you post your thyroid results and ranges we can tell you whether you are overmedicated or adequately dosed.

Dose adjustments should be gradual, usually in 25mcg dose increments every six weeks with follow up blood testing.

Refuse to decrease dose and insist on a second opinion from another GP. I don't think your GP knows what s/he is doing.

[tmh66 in reply to Clutter]

ok, just rang doctors again and asked for more details. TSh is 0.05 and T4 is 20. This means absolutely nothing to me but the tsh range she said should be 0.27 to 4.2 so I can see this is low. If you can explain more to me then great. Does this also mean I will put more flippin weight on as just recently i have gone up two stone and my eating habits have not changed. Plus I am exhausted.

[Clutter in reply to tmh66]

Tmh66,

Suppressed (low) TSH simply means the pituitary senses sufficient T4 so has switched off producing TSH. I would need to see the lab ref range (the figures in brackets after results) to determine whether T4 20 is within range or over range.

Suppressed TSH doesn't mean you are overmedicated if your FT4 is within range. 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.

Having low TSH will not cause weight gain. Massively reducing your dose will.

There is absolutely no need for your dose to be reduced by more than 25mcg if your GP's aim is to raise TSH into range.

[diogenes Remembering]

Never, but never, allow anyone to change doses as drastically as you report. The reason is simple. You've been on a particular dose of T4 for ages. Your body function has, to put it simply, got set in its ways (whether for good or bad). It simply cannot change violently as if you could switch off the ignition as with a car. Everything has to be done gently and slowly, if at all, with the realisation that nothing will appear to happen for a while until your body gets used to the new conditions and resettles into a new pattern. For some people this takes over a year, depending on the degree of change you want to happen.