Hi.
I had my latest results in today. I am on 150 mcg of Levothyroxine. My doctor wants me to drop it down to 100 mcg. ( New doctor). I have never gone that low. I think it sounds too much of a drop. It’s not that high so I would have thought 125 mcg and then re test 2 month. Any advice much appreciate.
Serum free T4 24.2. (12-22)
Serum TSH 0.26mu/l (0.27-4.20)
Thank you 😊
How do you feel? Has this test been replicated to make sure it’s not elevated due to test error? Did you take thyroxine before the test? If so it may be unnecessarily elevated.
Do you feel like you need a reduction in dose? GP is suggesting a massive reduction of 33%, which is very likely to make you feel very poorly. You could reduce to 125 or to alternative days of 150/125 for a more gentle reduction if you feel this is needed.
Having test results in range is a vastly overrated characteristic!
I had a reduction of 50 a few years ago after which I could barely function, I felt so Ill and weak I could barely put one foot in front of the other, i saw another GP in the practice months later and she upped it by 25 which helped a lot. Don't accept such a massive reduction and get a retest, it's your body and GPs need to pay more attention to the patient and less about the numbers.
In your place I would refuse this new broom's sweeping proposition until he's tested your FT3. You are only over-medicated if your FT3 is over-range.
I feel pretty much fine apart from a bit more tired than usual. I had taken my tablets about 1 1/2 hours before the bloods where taken. I was thinking of reducing 150/125 like you said but wanted to check if someone else was thinking the same. Dropping 50 mcg I know will be a very stupid thing to do.
Wouldn't reduce at all as only 1 1/2 hours since last dose! Should be 24 hours. I'd schedule another blood test, am, fasting and make sure to take last Levo 24 hours before test... Then take it after.
Right, so that's what happens when you don't leave the 24 hour gap. Your FT4 goes over-range because all you've tested is the dose you've just taken, not what is normally circulation in your blood. So, if I were you, I wouldn't reduce anything at all. Reducing your levo will also reduce your FT3, and as you don't even know what that is, it's taking rather a risk with your well-being to reduce your dose.
However, taking your dose before the blood draw will not affect your TSH, only the FT4. The TSH is affected by the time of day. It's highest early in the morning. So, what did you have yours done?
My results were like yours many years ago. I had asked my GP to test my T3, as I was beginning to realize there was more to thyroid issues than having a TSH test. I was proved right, as my T3 was below reference range but T4 was over, just like yours and TSH was low, indicating I was not converting T4 to T3. My GP said he was not allowed to prescribe T3 but was happy for me to see an endocrinologist privately, which I did. He prescribed T3 and I have taken it with T4 ever since, via my GP on the NHS.
Of course it is now not as easy to get T3 from the NHS (see lots of info on this site) but you need to get the test first, along with ferritin, serum iron, B12, Folate and Vit D. It may be that you are not converting well because these are low. That was the case with me. Thyroid patients seem to have trouble with all of these, possibly because we do not absorb nutrients well.
First you need the tests and I hope you have an amenable GP. If not they can be done privately, so check out info here on private testing. But definitely try persuading your GP first.
I would refuse to reduce until had FT3, antibodies and vitamins tested
Request these from GP
For full Thyroid evaluation you need TSH, FT4, FT3 plus TPO and TG thyroid antibodies and also very important to test vitamin D, folate, ferritin and B12
Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or vitamins
thyroiduk.org.uk/tuk/testin...
Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have money off offers.
All thyroid tests should ideally be done as early as possible in morning and fasting. When on Levothyroxine, take last dose 24 hours prior to test, and take next dose straight after test. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, GP will be unaware)
If antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).
About 90% of all hypothyroidism in Uk is due to Hashimoto's. Low vitamins are especially common with Hashimoto's. Food intolerances are very common too, especially gluten. So it's important to get TPO and TG thyroid antibodies tested at least once .
If you had to reduce (which is unlikely) then just a tiny reduction to say 125/150 alternate days
Maximum dose should be ever be decreased by is 25mcg in one go
The fact your GP wants to reduce by 50mcg shows they know Sweet FA about how to treat thyroid patients
What time of day was your blood drawn? It needs to be as early in the day as possible, i.e. around 8am.
Looks to me like this is a knee jerk because of the TSH being .01 under range which is pathetic. These Drs are treating bloods as though they are an exact science when the TSH alone is not the 'gold standard test' they promote it to be. How about testing FT3 - that might be a better indicator of how well you are! More importantly, how do you feel? If you feel fairly well, you wont when he drops the dose. Please research as much as you can and try and convince him to either do another test in a while or test FT3. Dropping your dose is just plain wrong.
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