I have been getting nowhere with my 'borderline' hypo with the GP over the last few years and symptoms have become worse over last 6 months (fatigue, aches, weakness, low energy, feeling cold, occasional numbness/tingling in fingers, memory problems, poor quality sleep). Menopause was blamed last year as my periods had become slightly irregular and I had 3 months trial of HRT, but no difference, so stopped it (periods are now regular again). I saw a different GP last week and as with previous GP, I did all the talking with very little response/questions, so I said that when you're getting nowhere, you're forced to go online and everything was screaming at me that I have a thyroid problem. I handed her my Medichecks printout and she reluctantly prescribed 25 mcgs of Levo and asked me to repeat TFT bloods in 3 months and see her for a review. I'm unsure if 25mcg is going to make much difference, but at least it's a start! My results are:
TSH 12.7 (0.27 - 4.20)
Free Thyroxine 13.5 (12 - 22)
Free T3 4.42 (3.10 - 6.8)
Thyroglobulin Ab <10 (0 - 115)
Thyroid Peroxidase Ab 10.2 (0 - 34)
She was quick to say my T3 and T4 are normal and there are no antibodies. So confused with the reluctance to treat - what is that all about? Happy to give HRT though based on symptoms alone!
Thanks in advance
Written by
advoash
To view profiles and participate in discussions please or .
I do sometimes wonder what's wrong with some doctors. If she doesn't already know, it's very easy for her to find guidelines or Clinical Knowledge Summary that tells her that a TSH over 10 is Primary Hypothyroidism and that the starting dose of Levo should be 50mcg unless the patient is a child, elderly or has a heart condition when it would be 25mcg.
If she wasn't happy with your Medichecks results, she could have done the tests herself.
She can also find the Clinical Knowledge Summary for Initiation and titration
Your 25mcg will possibly not help much, you may even feel worse to start with. It will reduce your own natural thyroid hormone output but it wont be enough to replace it with an increased amount.
Leaving you on 25mcg for 3 months is too long. You need repeat tests in 6 weeks, a dose increase of 25mcg, another repeat test 6-8 weeks later, another increase of 25mcg, and repeat until your levels are where they need to be for you to feel well. If that was me I'd just book a test for 6 weeks then book an appointment to see her. If she queries it then show her the NICE CKS information about Initiation and Titration.
The aim of a treated hypo patient generally is for TSH to be 1 or below or wherever it needs to be for FT4 and FT3 to be in the upper part of their respective reference ranges when on Levo if that is where you feel well.
When booking thyroid tests, always book the very first appointment of the morning and fast overnight (water allowed) . This gives the highest possible TSH which is needed when looking for a diagnosis, an increase in dose or to avoid a reduction. TSH is highest early morning and lowers throughout the day. It also lowers after eating. Also, take your Levo after the blood draw because if you take it before then your FT4 will reflect this and show higher than what is normally circulating. We usually advise 24 hours between last dose of Levo and blood draw so if you take your Levo in the morning then delay until after the test, or if you take it at night then delay that dose until after the test. These are patient to patient tips which we don't discuss with doctors or phlebotomists.
Take your Levo on an empty stomach, one hour before or two hours after food, with a glass of water only. Leave 2 hours between Levo and any other medication, some need longer, some need opposite ends of the day. Also leave 2 hours between Levo and supplements, some need 4 hours. Absorption of Levo will be affected if timing of other supplements and medication is too close to taking Levo.
Did you have Vitamins and Minerals tested while you were doing the Medichecks test - Vit D, B12, Folate, Ferritin - these are all important and need to be optimal for thyroid hormone to work properly.
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
Medichecks results - help in interpreting please
Please help interpret my blood test results 
How to interpret results
Medichecks results 
