Advice and suggestions regarding latest blood test

[PottyDotty]

I had my second blood test at the beginning of June and the results are posted below together with the March results. My Dr said my results had improved and therefore I didn't need an increase in Levothyroxine. I gave her an A4 typewritten sheet listing all my symptoms ad also gave her the print out of Dr Tofts paper, with the relevant para highlighted. she accepted the A4 sheet but refused Dr Tofts as she said she didn't need it! I then told her that unless she upped my throxine I would self medicate and had sourced a supply from India at approx £100 for a year's top up. At that she raised her eyebrows and agreed to increase by 25mcg to 175 mcg although I told her I had felt so much better on 200mcg. She said she would test my blood again in three months and if improved, would reduce the dosage again! I would value your advice, can I insist she keeps me at the higher dose, or should i purchase my own supply from India, or somewhere else? I would appreciate any pms with reliable sources if not India.

Results 8 March 18

Thyroid autoantibody level (XE257) 86 IU/ml ( < 100/0)

Serum Free Triiodothyronine (XaERq) 3.3 pmol/L (3.1 – 6.8)

SerunFree T4 level (XaERr) 18.7 pmol/L (12.0 – 22.0)

Serum TSH level (XaELV) (Below Range) 0.14mlU/L (0.3 – 5.0)

Serum creatine level (XE2q5) 66 umol/L (45.0 – 84.0)

Glomerular filtration rate (XSFyN) 81 ml/min 1.73m*2

Total Vitamin D (Serum) 80 nmol?L ( < 50.0)

Serum Vitamin B12 level (XE2pf) 752 ng/l (200.0 – 960.0)

Serum Ferritin level (XE24r) 213 ng/ml (20.0 – 350.0)

Serum Folate level (42U5) Above range >20.0 ng/ml (3.0 – 18.0)

Results 6 June 18

Serum Free Triiodothyronine (XaERq) (Below Range) .0 pmol/L (3.1 – 6.8)

SerunFree T4 level (XaERr) 15.5 pmol/L (12.0 – 22.0)

Serum TSH level (XaELV) 0.85mlU/L (0.3 – 5.0)

Many thanks in advvance.

[SlowDragon Ambassador]

Hi PottyDotty

The result of FT3 from June just says below range, but no result. Can you add it, if you have it

Obviously June results are too low. FT3 below range and FT4 barely above bottom of range

You will need blood retested in 8 weeks on increased dose. Make sure you always get the same brand of Levothyroxine each time

All thyroid tests should be done as early as possible in morning and fasting and don't take Levo 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)

If after this increase, your results are still on low side and you have symptoms. You can try to request further increase from GP, perhaps even 175/200 alternate days. Otherwise you can again suggest you will self medicate or see endo to investigate prescribing addition of small dose of T3

[PottyDotty in reply to SlowDragon]

Sorry. Thought I had posted it. 3.00 pmol/L. (3.1 - 6.8)

Thanks for your advice. I will book another blood test in August then.

[SeasideSusie Remembering]

PottyDotty

I think your GP needs to go to Specsavers. How can she say your June results show improvement when FT4 and FT3 are lower and TSH is higher than in March?

Has your GP not noticed that your T4 to T3 conversion is poor and that you would benefit from the addition of T3?

Your antibodies are high in range so I would suspect Hashi's too.

Can you see a different GP? Maybe ask for referral to an endo (although not always helpful). You could email Dionne for the list of thyroid friendly endos

[e-mail]

You certainly seem to need thyroid hormone replacement in the form of Levo plus T3 or maybe NDT although you have a fixed amount of T4 and T3 in NDT so not as flexible as Levo plus T3 where dosing is concerned.

[PottyDotty in reply to SeasideSusie]

Thanks SeasideSusie. Unfortunately I live in a little village and our Dr has three morning surgeries, if I tried another Dr it would be from the same practice main surgery so the Dr would probably be the same.

I am not sure if my rights when it comes to demanding medication. Can I demand an increase or is that a non starter?

[SeasideSusie Remembering in reply to PottyDotty]

No, you can't demand an increase but could suggest a trial after pointing out that your results were worse in June than in March.

When there was a decent doctor at my surgery (long gone unfortunately) I used to say that if I could try an increase I would be sure to come straight back if I had any signs of overmedication and she accepted that.

[PottyDotty in reply to SeasideSusie]

I have already tried that when my dose was dropped from 175 to 150. She wouldn’t accept that at all!

[SeasideSusie Remembering in reply to PottyDotty]

So it looks as though you have 2 choices

1) Referral to thyroid friendly endo

2) Source your own thyroid meds

I would try Choice 1 first.

[sandandsea]

Where do I find Dr. Tofts paper?