Appointment tomorrow to request an increase in Levothyroxine

[MissSusan]

Can anyone give me some suggestions as to what to say to my dr tomorrow?

My most recent blood results (below) are apparently “satisfactory” and I’ve been told to arrange a blood test for 12 weeks time, although that was 16th August. I don’t want to wait until the middle of November for a possible dose increase when I’m feeling horrible. I’m on 50mcg.

Serum free T4 level 15.9 pmol/L [11 - 23]

Serum TSH level 6.5 miu/L [0.27 - 4.5]

I’ve never seen a dr at this practice before, and I’ve been with them over 10 years, I’ve only ever seen a nurse practitioner. My parents have seen every dr there and have suggested which one to book in with as apparently he’s good if a little sarcastic.

I’m really nervous that he’s going to make me feel like a hypochondriac and I’ll get brain fog and start stuttering!!!

[greygoose]

To combat the brain fog, write everything down.

Your TSH is much too high for someone on thyroid hormone replacement. It should be 1 or under. Your FT4 is too low, it's not even mid-range. It should be at least that.

50 mcg is a starter dose and should be increased after the six week retest. That's the protocol.

You are not a hypochondriac, you are hypo. You are lacking an important thyroid hormone which the NHS won't even test for : T3. That is causing your symptoms. And he can hardly call you a hypochondriac when you've never even been to see him before! It's not as if you're on his doorstep every other day.

[Wildbird]

A serum TSH of 6.5 is not “satisfactory “ at all. It is outside the reference range and I would be surprised if the lab report did not state that you were under replaced on 50mcg. A nurse practitioner is not aware of treatment guidelines if they think that such a high TSH is ok. You are within your rights to ask for an increase in dose until you feel well and that won’t happen while your thyroid is underperforming.

[Aurealis]

I agree write it down before you go. The key points - you feel really poorly - you can’t think straight - you want an increase in dose now - the test results support the need for an increase in dose - you can’t go on like this until November, it’s a waste of your life

That’s it really. If he goes on or gets sarcastic repeat, I’d like an increase in dose now. Don’t stand up until the prescription is in your hand. When your allotted time is nearly up you’ll probably get your prescription. If not you remain sitting and waiting and repeating. Be strong.

Much luck x

[MissSusan]

Success! The first thing I said to the Dr was I think I need an increase in my levothyroxine, she replied that she agrees! She said she'd been looking at my notes and can't understand why it wasn't increased after my last blood test. She's increased in from 50mcg to 75mcg and has booked me in for a blood test in 6 weeks time.

I was pleasantly surprised with her response, she asked me if I'd been symptomatic and really listened. Winner!

[MiniMum97]

Excellent - I'd go back to her next time!

[MissSusan in reply to MiniMum97]

I've made a mental note (and written it down, because...brain fog) to request her in future.

[silverfox7]

Brilliant! Great to hear good news and a sensible GP!