Thyroid 6 week results - doctor appointment tomorrow!

[hankpym]

I have been taking 25mcg Levo for 7 weeks now and have just received my 6 week results.

TSH 2.6 ref ( 0.35 - 5.0)

I know your first question and no, the doctor did not request anything else which I find hard to believe and I am really disappointed as I made a point of asking for T4 and T3 as well.

Note on the results were - no further action required.

I have an appointment booked with her tomorrow so I now urgently need some advice on how to approach this. She will undoubtedly say I either need no other treatment or even to cease treatment.

What can I take to put in front of her to make my case?

[SeasideSusie Remembering]

hankpym

Note on the results were - no further action required.

Be prepared to put your case forward.

Do you still have signs/symptoms of hypothyroidism? Print this list and check off any that you are suffering thyroiduk.org/tuk/about_the...

Take the article by Dr Toft (past president of the British Thyroid Association and leading endocrinologist) who stated in Pulse magazine (the magazine for doctors):

"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 article by emailing Dionne at

[e-mail]

print it and highlight question 6 to show your doctor.

Also take the information from pathology.leedsth.nhs.uk/pa... where it says under Thyroxine Replacement Therapy in Primary Hypothyroidism

TSH Level ..... This Indicates

0.2 - 2.0 miu/L ..... Sufficient Replacement

> 2.0 miu/L ..... Likely under Replacement

[hankpym in reply to SeasideSusie]

Thanks for that Susie,

Doctors appointment is tomorrow morning so no time for the Pulse magazine article unless it is available online somewhere - I will have a look.

I will take in a copy of the Leeds Pathology article.

I feel the 25mcg of Levo has helped a bit and there is evidence that things are starting to move in the right direction but I feel there is more to do.

But to be honest I have had enough of the whole nonsense of NHS care, from all I have read about this then I should be moved up to 50mcg tomorrow. If she doesn't agree and I fully expect that to be the case then I will be prepared to stand my ground once and then if I receive no help, I will wash my hands of them and self-medicate - life is simple too short to have to put up with all this fuss.

[hankpym in reply to SeasideSusie]

After the appointment:

The doctor was really happy with the results and said I was now firmly in range so all is fine.

I dug out the articles and paperwork to present my case but she said she was too busy to read it.

I refused to budge and she eventually relented to refer me to a specialist. she Would not up my prescription to 50mg though and only agreed to let me take 50mg on two days a week with 25 mg other days.

[SeasideSusie Remembering in reply to hankpym]

hankpym

Sorry your appointment wasn't very fruitful

But at least you have a slight increase although I doubt it will make very much difference.

Be prepared for your referral to be refused by the endo, many are refusing when results are in range.

Has your GP asked for a retest 6 weeks after your increase? That's normal protocol. In your position what I would do is ensure you get retest at your surgery in 6 weeks' time, and I would also do a test with one of our private labs at the same time. Depending on the results, then you may have more "ammunition" for an increase if your FT4 and FT3 come back low.

If you haven't had thyroid antibodies and vitamins/minerals tested, I would do a private test bundle at around the same time that includes all of them, it's best to get the full picture, so the Medichecks Thyroid Ultravit or Blue Horizon Thyroid plus Eleven both do:

TSH

FT4

FT3

TPO antibodies

TG antibodies

Vit D

B12

Folate

Ferritin

Medichecks medichecks.com/thyroid-func... and code MED99 for 20% discount can be used before end of October

or

Blue Horizon bluehorizonmedicals.co.uk/t...

Both can be done by fingerprick or venous blood draw if you prefer at extra cost.

[SlowDragon Administrator in reply to hankpym]

Strongly recommend you get thyroid and vitamins tested as outlined by SeasideSusie

Getting vitamins optimal is often first step, then TSH rises so that you can get dose increase in Levothyroxine

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I have had a TSH of 5.96 which was marked as normal at the GP surgery. Five months later my rheumatologist saw the result and said it needs checking. What is the point in blood tests if they don’t act on the results?!