Beaus Lines in Fingernails

[Karenk13]

Hi guys I'm due to get my next set of bloods as my thyroid seemed to be struggling again on the last blood test I got and both Iron and ferritin were low too. I've noticed the last while that I seem to get horizontal depressions in my nail bed or Beaus lines as they are called as if my body just decides that nail growth is not the priority right now. Does anyone else get these with Hypothyroid and do you think this is something I should make an issue of with my GP if he doesnt increase my does after the next blood test?

Surely it's a sign that my current dose is too low. My TSH was elevated on the last test but he was dissmissive and reluctant to change my dose. He was more concerned about Iron and ferritin levels coming back into range which is understandable.

[greygoose]

The majority of doctors would have no idea that problems with finger nails were connected to any sort of problem in the body. It's really not something they do in med school. So, mention them if you like, but don't be surprised if your doctor just brushes it aside.

[Karenk13 in reply to greygoose]

It's very frustrating at the moment I know myself that my thyroid is struggling I have all the reoccuring symptoms and my TSH was 5.94 in May which I know is way too high when taking thyroxine but GP said he didnt think I should increase my T4

[greygoose in reply to Karenk13]

Your doctor's an idiot. Can you see someone else? Once on thyroid hormone replacement, your TSH should be 1 or under. With results like that, your FT3 is going to be really low, and that's the active hormone. I bet your doctor know nothing about T3! If it were me, I would tell him that if he doesn't increase my dose, I'll buy my own and increase it myself. And, I would lodge a complaint with the practice manager. He is endangering your health!

[Karenk13 in reply to greygoose]

Thanks Greygoose I'm going back next week they only checked Tsh and T4 last time no T3 checked so I will make sure to get that done this time.

[greygoose in reply to Karenk13]

Doubtful if they'd do it - and even if the doctor ordered it, the lab would probably refuse. And, I doubt your doctor would understand the result, anyway. But, with a TSH that high, it's pretty certain your FT3 is going to be low. If he wants to dose by the TSH he should at least recognise that that TSH is too high. He has no idea what he's doing, I'm afraid.

[Karenk13]

I'll just add that on the 8/5/18 my TSH was 5.94 and Free T4 was says 13.7

[SlowDragon Administrator in reply to Karenk13]

See your GP again for a dose increase, or see a different GP.

Your ferritin is low because you are under medicated for thyroid. Likely to have low vitamin D, folate and B12 too

Official NHS guidelines saying TSH should be between 0.2 and 2.0 when on Levothyroxine

(Many of us need TSH nearer 0.2 than 2.0 to feel well)

See box

Thyroxine replacement in primary hypothyroidism

pathology.leedsth.nhs.uk/pa...

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]

[Karenk13 in reply to SlowDragon]

Good news dose was immediately increased yesterday and he said come back in 6 weeks to re check levels on new dose. He was not happy about the other GP not increasing my medication back in May.

[Karenk13]

Ok so got a last minute appointment for later today I'm going to argue my case with one of the more sympathetic GP in the practice and see what happens