doctors phone call

[wendypartridge]

i feel dreadful, my t4 is 18(9-19) my tsh 0.67 t3 -3( 2-98-5) I spoke to my doctor who claims everything is normal. I disagreed with him and told him I needed t3 as its pointless loading up with t4 when its not converting to t3 , he then told me you cant get t3 on the nhs i then said' i need a referral to a private endro ?? silence from him ' no you must not go private they would outside medical ethics . I will refer you to an NHs endro he may give you t3 .. came his answer. I asked so what do i do till then? well nothing really .. I said i wanted to reduce the levo as its just piling up and not converting he said ' no do nothing .. advise, please

[shaws Administrator]

Well, wendy - we do rely upon doctors to do their best to heal us but those on this forum know better now. They are very poorly trained and don't know one disabling clinical symptom.

We are diagnosed when TSH reaches 10 in the UK, in other countries it is when the TSH is 3+.

Many doctors do not understand that many of us do not improve at all on levothyroxine - even though others find it is o.k. for them.

I think you'll have a long wait as all Endocrinologists in the UK have been told to no longer prescribe as it has a price which has risen astonomically. Some Endos may do so but it is truly astronomical at present. Two new T3s were introduced and we were hoping against hope it was reasonably priced - but not at all as the three have a price which is practically the same and ordinary people couldn't afford it at all. TUK have a Petition at present:-

thyroiduk.org.uk/

Many feel an improvement when T3 is added to a reduced T4 but you'd have to source your own. If you wish, put up a new post asking for a private message to be sent to you of where to source.

I immediatley felt better when T3 was added - it was as if my body could now absorb oxygen. Research has also shown that many do well on a combination T4/T3.

[rosserk in reply to shaws]

Shaws do you know which Countries diagnose hypothyroidism with TSH3+? Are the ranges the same? It’s something I said to my Doctor after reading it on TUK and he all but accused me of lying! Would be good to name a few next visit.

[humanbean]

I imagine your doctor is worried that a private consultant will prescribe T3 and then you'll expect him to prescribe it too.

Private doctors don't have different ethics and/or different rules compared to the NHS in the UK. They are all supposed to be singing from the same hymn sheet. However, many medical "rules" are a matter of interpretation. Private doctors may interpret the rules differently to NHS ones.

Incidentally, the private doctors you are considering seeing are endos, not endros.

[SlowDragon Administrator]

As you have Graves are you on strictly gluten free diet?

amymyersmd.com/2017/02/3-im...

chriskresser.com/the-gluten...

For full Thyroid evaluation you need TSH, FT4, TT4, FT3 plus TPO and TG thyroid antibodies. Plus vitamin D, folate, ferritin and B12.

Essential to test thyroid antibodies, FT3 and FT4, plus vitamins

Low vitamins are extremely common and must be corrected BEFORE adding any T3

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies

thyroiduk.org.uk/tuk/testin...

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have money off offers.

All thyroid tests should ideally be done as early as possible in morning and fasting.

If on Levothyroxine, don't take in the 24 hours prior to test, delay and take straight after

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, GP will be unaware)

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]

Also request list of recommended thyroid specialists, some are T3 friendly

Professor Toft recent article saying, T3 may be necessary for many

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

Clear legal outline

healthunlocked.com/thyroidu...

[silverfox7]

Good advice from SlowDragon. I had a conversion issue like you and takings the Vits etc I was low in got them optimal and was stable after. I was them able to change to NDT after with no problems. I'd been on NDT when first diagnosed over 30 years ago and always preferred it but changed over to Levo when a strike stopped my NDT. But test the four as suggested and then work at getting them optimal. Doesn't happen overnight as that depends on how low things are but it worked for me.