Endo or well informed GP in Sheffield please!

[Laundretta]

This is my first post, but I’ve been following and reading others on here for about 6 months - it’s been a great help with self help, so thank you all!

I was hoping somebody could recommend a great endo or GP for Hypothyroidism in Sheffield.

I was diagnosed subclinical about a year ago (TSH 6.6) GP was actually pretty good and agreed to medicate because I was symptomatic.

t4 was in range (low end), t3 never tested, no antibodies in serum test at time of testing. I’ve had 2 dose increases - the first to get back ‘in range’ and the second 8 weeks ago as tsh had jumped back up to 6.5 again. I’m now on 100mcg Levo.

Symptoms have abated to an extent, but I’ve never been completely asymptomatic, and the GP will not increase my dose while it’s ‘within range’ so at the last test (got the results today) I was tsh 2.4.

Although I am generally feeling better than before I was medicated, I have issues with ‘crashes’ after exercise - especially hiit and weights, and it’s horrible and can last 3 or 4 days. I have read and researched and concluded that if I was managed closer to the lower end of the tsh range - ie up to 1, I’d have a more robust reserve to see me through workouts.

For reference, I’m 42, always exercised regularly and although I’ve put weight on thanks to being hypo, my bmi is about 25. It’s a struggle to keep it this way and can only eat 1600-1800 Cals a day whereas 2200 should be ok to maintain my weight with current activity levels.

I’d be interested to hear your thoughts and advice!

Thanks

[SeasideSusie Remembering]

Laundretta

You can email Dionne for the list of thyroid friendly endos

[e-mail]

Any that you can get to, I would ask on the forum for feedback. Replies will have to be by private message as we can't discuss individual doctors on the open forum.

What you really need is for TSH to be around 1 or below with FT4 and FT3 in the upper part of their reference ranges, that is where most treated hypo patients feel best and what is recommended by leading endocrinologist and past president of the British Thyroid Association Dr Anthony Toft, who wrote in Pulse Online 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 article by emailing Dionne at [e-mail] print it and highlight question 6 to show your doctor.

Your crashes after exercise are most likely due to low FT3. Hard exercise uses up T3, and with your TSH at 2.4 then your FT4 is probably low and your FT3 is likely to be as well. If you can't get the full thyroid tests done by your GP then I suggest you do what hundreds of us here do and that is private testing with one of our recommended labs. If you've not had vitamins and minerals tested then go for either Medichecks Thyroid UltraVit or Blue Horizon Thyroid Check Plus Eleven. Vitamins and minerals need to be optimal for thyroid hormone to work and many of us Hypos find we have low levels or deficiencies.

[Laundretta in reply to SeasideSusie]

Hi Thanks, I'll be going back better informed. Had a little review of my blood tests... I have been tested for Coeliac disease (although I have no symptoms... and I'm negative)

I thought I'd been tested for Hashimoto's antibodies, but these are the other results:

TSH receptor Ab. < 0.3 iu/L [< 0.9]

Please note that TSH Receptor Ab results are now reported numerically

in response to requests from users. The previous equivocal range is

equivalent to 1.0 to 1.5 IU/L. This assay does not differentiate

between blocking and stimulating antibodies.

This is a test for Graves, isn't it???

[SeasideSusie Remembering in reply to Laundretta]

Laundretta

Yes, it's a test for Graves. It's Thyroid Peroxidase and Thyroglobulin for Hashi's.

[Laundretta in reply to SeasideSusie]

So pretty incompetent of the GP then!

[SeasideSusie Remembering in reply to Laundretta]

No surprise there then, I don't think many GPs know much about hypothyroidism.

[silverfox7]

Hi. I'm in the area but don't go there but someone posted a few weeks back about a new chap Dr John Newell-Price so made a note of the name. Maybe if you put his name in the search if will give you the name of the poster so you can send her a PM asking for more info.