Advise required re levothyroxine increase

[beandrummo]

Hi all, just returned from my prescription review, our GP only tests for TSH, only ever says its in range. Have been on 75 mug for years. Had blood test 2/3 month ago as felt unwell, TSH then was 2.6, today was told its 1.86. When I questioned it, GP informed me that my more thyroxine was being produced by my brain so the lower figure is an improvement. Told her I’m tired, joints ache, have arthritis everywhere. She then increased dose to 100mcg for a month to see if I feel better. Also reduced amitriptyline to 10mg from 25. Can I have your expert opinions please? (Other than change GP!)

[greygoose]

Your brain is producing more thyroxine? Did your doctor do anatomy in med school? I wonder what she thinks the thyroid is for if thyroid hormone is produced in the brain?

One month is not long enough to feel the full effect of an increase. It should be at least six weeks. Sounds like she's setting you up to fail.

[SeasideSusie Remembering]

beandrummo

You need 6-8 weeks for a dose change to stabilise your results and see if you feel any improvement, I don't think a month is enough.

If not already done, then ask for Vit D, B12, Folate and Ferritin to be tested. Your joint aches may be due to low Vit D.

Were your blood tests done at the same time, fasting? Time of day, and eating will affect TSH. TSH is highest early morning and lowers throughout the day, eating can lower TSH. So unless conditions were the same both times, you can't accurately compare your result.

It's your thyroid gland that produces thyroxine. The puituitary looks to see if there is enough hormone, if not then it sends the signal TSH for the thyroid to produce some.

[beandrummo in reply to SeasideSusie]

Hi both tests were taken as early as possible at Surgery, 8.30 a.m. fasting from 6p.m the previous evening and took levothyroxine at 6.00 the morning before blood test. For the first test I had feritin VitD and foliate test, was told everything ok but would not give actual numbers despite my insisting.

[SeasideSusie Remembering in reply to beandrummo]

beandrummo

You'll have to see how you go on your new dose but if I were you I would stretch the next test to 6 weeks if you have enough tablets.

If you ever have FT4 tested, then it's important to take your Levo after the blood draw not before. This is because Levo peaks in the blood up to 6 hours after taking it, and testing after taking your dose means that the result will reflect the fact that you've taken your Levo, not what's normally circulating in your blood, and will give a false high FT4. It doesn't affect TSH so it's fine for your current test, but just a heads up if you do get FT4 tested in the future.

You are legally entitled to your test results under the Data Protection Act. Don't ask your GP for them, ask at the reception desk for a print out. Don't accept verbal or hand written results as mistakes can be made, get a print out. If they are reluctant, remind them that you are legally entitled to them and you're sure nobody there would wish to break the law.

[Aurealis]

Following a dose increase when taking Levo I used to feel well within three days. I know it’s not usual and the improvement didn’t last if I needed another increase. So there may be a difference quite quickly....

Your GP maybe needs to go back to medical school, or use google more often

[Aurealis]

PS I don’t 5hink there’s a linear relationship between tsh and T4