Hi, posted the other day re dramatic drop in TSH from 5 weeks ago which was >150 and Free T4 of 3.1 sorry no ranges, new results with ranges are
FT4 13.6 (9 - 24)
TSH 4.98 (0.3 - 6)
I'm on 50mcg levo doc said this is normal and no action required, any advice before I call doctor please
Thanks in advance
Doctor is wrong - 'normal' isn't sufficient. We need optimal and that means a TSH of 1 or lower with FT4 nearer the upper part of the range. (They know little I am sorry to say).
You will be symptomatic if he doesn't increase your dose by 25mcg every six weeks until TSH is 1 or lower.
Dose of Levothyroxine should be increased in 25mcg steps, retesting 6-8 weeks after each dose increase
This continues until TSH is around one and FT4 towards top of range and FT3 at least half way in range
Extremely important to also test vitamin D, folate, B12 and ferritin
These are often very low when hypothyroid and need testing and then supplementing to improve
Have you also had thyroid antibodies tested?
See a different GP and request 25mcg dose increase in Levothyroxine
Always take Levo on empty stomach and then nothing apart from water for at least an hour after. Many take early morning, on waking, but it may be more convenient and possibly more effective taken at bedtime.
verywell.com/should-i-take-...
Other medication at least 2 hours away, some like HRT, iron, calcium, vitamin D or magnesium at least four hours away from Levothyroxine
Many people find Levothyroxine brands are not interchangeable.
Once you find a brand that suits you, best to make sure to only get that one at each prescription. Watch out for brand change when dose is increased or at repeat prescription.
Many patients do NOT get on well with Teva brand of Levothyroxine. Though it is the only one for lactose intolerant patients
All thyroid tests should be done as early as possible in morning and fasting and don't take Levo in the 24 hours prior to test, delay and take straight after. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, GP will be unaware)
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
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.
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 .
Link about thyroid blood tests
thyroiduk.org/tuk/testing/t...
Link about antibodies and Hashimoto's
thyroiduk.org.uk/tuk/about_...
thyroiduk.org.uk/tuk/about_...
List of hypothyroid symptoms
thyroiduk.org.uk/tuk/about_...
NHS guidelines saying standard starter dose is 50mcgs and that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine. Dose increased slowly over many weeks/months. Retesting each time
beta.nhs.uk/medicines/levot...
Official NHS guidelines saying TSH should be between 0.2 and 2.0 when on Levothyroxine
(Many of us need TSH nearer 0.2 than 2.0 to feel well)
See box
Thyroxine replacement in primary hypothyroidism
pathology.leedsth.nhs.uk/pa...
You might find this post about TSH levels in a healthy population of interest :
healthunlocked.com/thyroidu...
Although in that thread I mention elderly people in the post as the impetus for writing it, the links I provided apply to adults of any age.
There is no way that a TSH of 4.98 is "normal" for the vast majority of the healthy population. And most people with thyroid disease need a TSH lower than that of healthy people to have any chance of feeling well.
Thank you all so much. I'm really anxious about speaking to the doctor and also about being left feeling the way I do. There are only 3 gp's in the practice and they don't like being "questioned" so I'm really unsure about how to approach this - can I ask to have the meds increased? What do I do if they say no, I'm "normal" 
One suggestion I would make is that you take a sympathetic partner, friend or relative (preferably male) with you to any appointments. They don't have to say anything unless you want them to. And make sure that you don't take anyone who might undermine you. They are just there as a witness to keep the doctor polite and to reduce the risk of you being bullied.
I have only been taking my husband with me to doctor and hospital appointments for perhaps 6 years or so, maybe less. When I realised what a difference it made I wished I'd started doing it decades ago.
I resent the necessity of doing it, and the fact that it implies I'm a wimp. But as someone who has been shit on from a great height by doctors most of my life, I don't really care any more. I just want them to be polite and I want them to at least pretend to take me seriously.
You are also legally allowed to secretly record your appointments without permission and without telling them. Bear in mind that they (doctors) record all their appointments on CCTV without ever mentioning it to their patients.
Suggest you print out the list of hypothyroid symptoms in my post above
Go see the GP and underline how unwell you feel
Say you understand you are only on starter dose
Ask for 25mcg dose increase in Levothyroxine.
Ask for vitamin and thyroid antibodies testing to be included at next blood test
Thank you, feel like such a child, ridiculous scenario to be in
Anxiety is a classic sign of being hypothyroid
Would agree absolutely with humanbean the addition of a supportive friend or family member, especially if male, can dramatically improve how your Doctor listens to what you say.
It's wrong, but sadly still true.
Many Doctors still don't take women seriously.
I even have a female friend who's a Doctor who said exactly the same thing, with utter exasperation.
that is very sad to hear
mmm well according to the doctor my dramatic drop in TSH is probably due to being hypo for many years and my brain creating the hormone for me or something and I am to stay on 50 mcg for another 4 weeks as I am well within the normal range...*sigh* also he chuckled when I said I had been doing some reading, why are they so patronising, do we not have a brain or the right to be informed about our health! makes me angry...
Suggest you get full testing of thyroid and vitamins privately via Medichecks or Blue Horizon
If vitamin levels are low you can help yourself by self supplementing
thank you, have ordered tests!
Come back with new post once you get results.
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