Will you be my medical advisor?

[mouldylocks]

To begin with I have low self worth. I put up with, tolerate, don't expect, more than most - which is why I am only just exploring the possibility of feeling better, at 70. With reasonably good general health it seemed a great shame to feel so bad, and waste the few good years left to me, but it was the increasing lack of concentration and muddled thinking that scared me into taking action.

I sent off for tests and followed instructions from here - fasting, early morning etc. They came back as: TSH 4.32 (0.27-4.20) FT4 13.2 (12.0-22.0) T4 81.5 (59.0-154.0) T3 3.91 (3.10-6.80) TG Anti 11.9 (0.0-115.0) TP Anti 13.3 (0.0-34.0). I didn't get the vitamin test.

I had read the posts outlining the consistently poor GP responses to Thyroid problems, but was confident my wonderful GP would prove to be the exception. I showed him the test results, the Thyroid Symptom Questionnaire (nearly full), and my family history (mother hypothyroid). However, he wanted to address or explore each symptom in isolation, e.g. possibly sleep apnoea causing tiredness, rheumatoid arthritis causing muscle and joint pain and weakness, old age causing hair loss, dry skin and drooping brows (even though I've already had them surgically corrected and they came straight back) etc. etc.

Looking for other causes, he has sent me for a full blood screen (no results yet) and agreed to include testing for B12, D, ferritin, folate etc., as recommended by posters.

This is my question - whether or not he agrees to medicate, I am minded to try NDT as a first resort, plus any vitamin/mineral supplementation indicated by the tests, and to avoid gluten. Having read some of the articles suggested, I thought I could start at 100mg equiv. having no heart/blood pressure problems.

Does this sound reasonable to you well informed readers? I fully understand that it will be an opinion only, and that no one can be accountable for any decisions I may make.

[Clutter]

Mouldylocks,

TSH is mildly over range and FT4 and FT3 are low in range. Thyroid antibodies are negative for autoimmune thyroiditis (Hashimoto's). If you had Hashimoto's gluten-free diet would possibly be helpful but as you don't there's not likely to be any advantage in adopting gluten-free unless you have digestive issues.

It's unlikely you will need more than 50mcg Levothyroxine or 3/4 grain NDT with TSH 4.32. As you are over 60 25mcg would be the recommended Levothyroxine starting dose or 1/2 grain NDT (30-32.5mg). Dose can be increased at 6 week intervals until TSH is 0.2 - 1.0.

[mouldylocks in reply to Clutter]

Clutter, can you answer another question that puzzles me? Why would my test results be 'sub-clinical' (or mild at best) when the frequently quoted optimal levels to achieve euthyroid status are the lowest TSH in range and the upper third of FT 3 and 4 ranges?

[Clutter in reply to mouldylocks]

Mouldylocks,

Subclinical hypothyroidism describes TSH between 4.20 - 10.0 with FT4 and FT3 in normal range.

Overt hypothyroidism is when TSH is >10.0 and FT4 &/or FT3 is below range.

[mouldylocks in reply to Clutter]

That does apply to me, even if only just but why, then, do they medicate to a much lower level to achieve wellness?

[Clutter in reply to mouldylocks]

Mouldylocks,

Thyroid hormone replacement needs to be introduced gradually and increased until thyroid hormone is in the upper ranges and TSH is low. Have a look at the dry sponge analogy in thyrophoenix.com/adjusting_...

[mouldylocks in reply to Clutter]

All clearer now - thanks Clutter

[humanbean]

I don't have thyroid antibodies, nor do I have coeliac disease, however, I have benefited enormously from going gluten-free. It would be worth a 2 or 3 month trial, in my opinion. You can always go back to eating gluten if it doesn't help.

[trelemorele]

I'm pretty sure your GP will not give you thyroid hormones replacement based just on your results itself but also because he "sends you off to explore other problems" and because people with obvious hypo results are refused treatment in the UK.

Having said that I'm not saying you shouldn't be medicated and if you feel confident you should explore NDT to see if it helps.

Good luck ☺