Re test after reduction in levothyroxine

[Gym4me]

Two months ago I posted my test results

TSH - 0.03 (0.35 - 5.00) mu/f

FT4 - 24.2 (9.0 - 21) pmol/l

FT3 - 4.4 (3.0 - 6.0) pmol/l

Which resulted in my level being reduced from 100 to 75 mcg as stated that I was overtreated. Retested last week following advice from here ie early morning, no levo for 24 hrs and no supplements for 3 days. I spoke to a GP on the day of the test to report how bad I had felt since the reduction. His attitude was appalling. He said that no Endo in the land would dose by anything other than TSH when I questioned conversion from T4 to T3 and got really annoyed. I explained that in the past I had been treated for my symptoms. He dismisses how unwell I felt and only grudgingly agreed to test for ferritin.

Today I received the results. Ferritin 50 (24-155). Classed as normal.

Thyroid test only shows TSH 0.71 (0.35-5.00) despite previous tests as above. Normal.

I am now wondering if he only requested TSH because I questioned T4/T3 conversion.

Advice please.

[Mary-intussuception]

Hi.

As far as I am aware the lab will only test TSH for GPs. Doesn't matter what they request (usually Tfts ). I think a while back it was T4 also but no longer. Now it seems to be a case of an annual TSH and that's it.

They may test FreeT3 for hospital Consultants.

Given that you have symptoms of Hypothyroidism and so unwell, I would ask for an urgent referal to an Endocrinologist. Look up NHS or NICE(?) guidlines for treatment of Underactive Thyroid.

I would also ask GP to test the nutrients levels : Vitamin D, B12, Folate and Ferritin. ( Say - as you've never had them tested before . . . )

When did you last have any other bloods done? Bone (Calcium and Phosphorus ) Kidney, LFT & FBC?

I'd keep asking.

[Gym4me in reply to Mary-intussuception]

I live in Scotland and on my previous test both T4 and T3 were tested so that is why I query whether the GP specified only TSH this time because I had questioned conversion. He was most dismissive when I mentioned it. I have type 2 diabetes and had bloods done two months ago. GP will not request other blood tests and only grudgingly agreed to ferritin test because I stated that I wanted to ensure that a deficiency was not the cause of my extreme exhaustion. I have previously had all these tests done. He was just not interested in how I felt!

[Mary-intussuception in reply to Gym4me]

Is there a different GP at the practice you could see? Try them all? Is there anyone you can take with you for a bit of moral support?

Based on your symptoms I'd still insist on a referal to an Endocrinologist. Go in prepared with a list of your symptoms.

[Gym4me in reply to Mary-intussuception]

Thanks, I do intend trying to get an appointment with a different GP but appointments are difficult. I had a GP for 30 years in the practice who treated me for my symptoms and kept me well but unfortunately he has retired. I can take my husband with me next time; however he has some health problems at the moment and awaiting a hospital appointment.

[Mary-intussuception in reply to Gym4me]

We had one retire - he was the most likely to do what you asked - referal, tests etc. He retired young.

Another has retired young, I think it might be the stress.x

[Gym4me in reply to Mary-intussuception]

Yes my GP took early retirement. I think that too many good GP’s are retiring because it no longer seems to be about patient care and well being and more about savings, rules and paperwork. This must lead to stress when they are committed to their patients first!

[SeasideSusie Remembering]

Gym4me

They really haven't got a clue. If only they were hypothyroid and still suffering too, their attitude would be much different.

Ferritin 50 (24-155). Classed as normal.

Normal because it's within range. However, for thyroid hormone to work (that's our own as well as replacement hormone) ferritin needs to be at least 70, preferably half way through range.

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...

It really is essential to have the other vitamins and minerals tested, they all need to be optimal for thyroid hormone to work, and especially if you are considering adding T3. so yo need

Vit D

B12

Folate

whether you do them privately or your through your GP.

TSH 0.71 (0.35-5.00)

The reduction in Levo has succeeded in raising your TSH, your GP must be very happy (sarcasm ). What a pity you couldn't have FT4 and FT3 tested. I expect your FT4 has probably dropped into range and your FT3 has possibly lowered as well.

If I were you, if you can't get these tested with your GP, go for the full thyroid/vitamin panel with Medichecks (Thyroid Check UltraVit) or Blue Horizon (Thyroid Check Plus Eleven) and then take it from there.

[Gym4me in reply to SeasideSusie]

I am not a meat eater, so may have to supplement ferritin as I have had to do in the past. I am so angry at not having T4 and T3 tested this time and am convinced that this GP has requested that only TSH be tested because of his insistence that only TSH level was relevant. I realise that private testing is the only way so will look into it but not sure if I can afford it as I have a small pension. Thanks for your advice.

[shaws]

Doctors need training. Their knowledge is mainly woeful. If they do step out of the rules then there is retribution for them.

Your doctor needs a refresher course like the majority of the specialists. You could give him a copy of the following from an American Hormone Specialist.

hormonerestoration.com/

If we want to recover our health, we have to read questions and answers on the forum. Learn as much as you can and you will be able to resolve your problems. It is not a quick fix as it has taken a long time for our hormones to gradually diminish but it can be achieved. Also if we do it ourselves we can select what we would like to try.

[Gym4me in reply to shaws]

Thank you. I have downloaded the article and copied the section on thyroid replacement therapy. Interesting article which should be read by all GP’s etc.