New guidelines for GP's!

[Dobby]

Hi is anyone else having trouble with the blood test results. My GP would only do a TSH test this time because apparently that is the new guidelines. The results have come back and the lab have said I should reduce my levothyroxine to 100mg even though my TSH level has been constant at 0.02 for years. My previous blood test showed my free T4 & T3 were in range and my GP at the time said to stay at 125mg. Because the lab now is suggesting I should reduce my meds, my GP will not go against their decision, not sure if she is just covering her own back?! Any thought on what I can do? Many thanks xxx

[Clutter]

Dobby,

The lab has made a suggestion. Your GP is not obliged to follow the lab's suggestion. I suggest you tell your GP you are not overmedicated, TSH has been suppressed for years and FT4 and FT3 were always within range. Perhaps say you are only prepared to reduce dose if FT3 is over 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.

[Dobby in reply to Clutter]

Really appreciate your reply. It is odd, when I got a copy of the blood test results, it stated 'Serum TSH level over treated reduce to 100mg. When I have had blood tests in the past they have never stated what it should be reduced to.

I will email thyroidUK to request a copy of the pulse article.

Many thanks x

[diogenes Remembering]

A biochemist is not medically qualified, and therefore knows nothing of the patient or the patient-doctor relationship. All he/she is is a number supplier. Also they can make the statement in or out of range, but no more than that. The GP has the right to admonish whoever made that statement as acting above their competence. It unfortunately is too much the case that biochemists get above themselves and start diagnosing without medical knowledge.

[Dobby in reply to diogenes]

Really appreciated your help, I am compiling a letter to the GP to see if I can get any joy. xx

[SlowDragon Administrator]

If you feel fine and not over medicated, simply refuse to consider changing dose without full testing.

If FT3 and FT4 are in range then you are not over medicated

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 at

[e-mail]

Professor Toft recent article saying, T3 may be necessary for many otherwise we need high FT4 and suppressed TSH in order to have high enough FT3

rcpe.ac.uk/sites/default/fi...

[patash]

Many thanks for all the information you have given me. I will look into everything and see what else the Dr has to say. Very much appreciate your help.

[Dobby]

Really appreciate everyones help and advice....It is so frustrating we are all having to spend so much time battling with our Gp's, along with spending time doing our own research. Bless you all xxx