I had a thyroidectomy 5 years ago now after being diagnosed with thyroid cancer.
Currently I'm taking 100mg of Levothyroxine daily, and 50mg on Sunday only. I Had a blood test with medichecks couple of days ago. My GP says I need to reduce the dose of Levothyroxine to 75mg daily, however the endocrinologist says that I need to take 100mg daily and 50mg on Saturday and Sunday now.
Has anyone got similar pattern of taking Levothyroxine, is this effective? Should I reduce the dose of Levothyroxine as my GP advises?
What additional supplements would you advise to have?
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HLM19
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Why is the GP going against what the endo wants you to take? Endo is specialist, GP is generalist. Endo trumps GP. If your GP insists, then I would contact your endo, tell him what your GP wants to do and if endo says stick with his advice then ask him to instruct the GP that he shouldn't go against what the endo says.
Looking at your results, you do have some problems there with your vitamins and minerals.
Ferritin 28.2 (13-150)
This is low and I would ask your GP to do a full blood count and an iron panel. Ferritin alone is not enough, you could have iron deficiency anaemia, which the FBC would show. You could have a good amount of serum iron but low ferritin so you would have to be careful about supplementing iron in that case.
You can help raise your level by eating liver regularly, maximum 200g per week due to it's high Vit A content, and including lots of iron rich foods in your diet apjcn.nhri.org.tw/server/in...
Folate 4.24 (2.91-50.0)
Although in range, this is low. You're hardly likely to get anything prescribed by your GP because it's in range, so if it was my result I'd be supplementing with a good B Complex such as Thorne Basic B (1 capsule) or Igennus Super B (2 tablets) which contain 400mcg methylfolate which will help raise your level. Also, look into folate rich foods and include in your diet.
Your CRP is high, this is a non-specific inflammation marker. If it continues to be high on further testing then the cause should be investigated.
The problem is that my Endo is not in UK, and my surgery was done back at home and I have been with the same Endo since my surgery. So I suppose because my Endo is not in UK the GP considers he is not qualified enough I don't really know
I just wonder if anyone else takes Levothyroxine in similar pattern, and is it effective? or should I consider GPs advise?
Thank you for advise on Ferritin and Folate, and I will do vit D check separately.
I wouldn't do what either of them suggests. If you lower your levo, you're going to lower your FT3, too, and that's already pretty low, because you don't convert very well. How do you feel on your present dose?
Your GP is cutting your Levo to 525mcg per week, your endo is cutting it to 650mcg per week. That is a substantial difference! At least your endo isn't cutting your level as severely as your GP, who seems to be totally clueless about dosing thyroid patients.
Regarding the pattern of dosing, some people take Levo only once a week and they (apparently) do okay with this. I must admit it wouldn't appeal to me though. Because Levo has such a long half life the pattern of dosing is not so important as it is for T3 (where getting it right is crucial).
I can see why both doctors have said you should cut your dose - it's because your TSH is low and doctors are convinced we will die of crumbling bones and heart attacks if the TSH gets low in range or under the range. It's nonsense though. People on artificial thyroid hormones of any kind shouldn't be treated on the basis of the TSH because it isn't reliable and tells doctors nothing about the actual levels of thyroid hormones themselves.
The most likely outcome of cutting your Levo is that you will end up with substantially lower Free T4 and probably substantially less Free T3. And there is no guarantee that you will end up with a TSH within range, so what will they do then? Cut your dose even further?
If your endo is in another country, can he supply you with a private prescription that you can use in the UK or online? Or perhaps you have friends and/or relatives who could pick up your prescription in the country where your endo is and send it through the post?
Another possibility is that you start treating yourself. In your shoes I would want to lower your Levo dose by a small amount and increase your T3 dose. And I would ignore the TSH (which is a pituitary hormone, not a thyroid hormone) completely.
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
tukadmin@thyroiduk.org
Professor Toft recent article saying, T3 may be necessary for many. Note especially his comments on current inadequate treatment following thyroidectomy
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I don't really know 
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