Trying to reduce my Levo

[Loobs39]

I have just received a letter from my local surgery stating that I need to reduce my Levo following a recent blood test. They only tested TSH and it was 0.28 (0.3 - 5.6) - I refused and threatened to buy the top-up privately - was I right?? I am currently only on 75 mcg anyway, that would have put me onto 50 which I always thought was a starting dose?

[SeasideSusie Remembering]

Loobs39

I would refuse too. If they kick up a fuss, I would ask them to test FT4 and FT3 and I would only reduce is FT3 was over range.

They just don't seem to understand that dosing by TSH is wrong and they need to look at the actual thyroid hormone levels. I despair that this information will ever get through to doctors in my lifetime.

[Loobs39 in reply to SeasideSusie]

Thanks - just had a phone call from the surgery saying that they won't reduce my levo. The practice nurse had called me in to do a review of medication last week and reducing the levo wasn't mentioned but she decided to double my blood pressure medication (Amplodipine). However, I have just got my new prescription and it is the same as before - I think there was/is a muddle somewhere?? Again, I would prefer not to double that - bp was 150/75 so not good - but seems to have slipped through the net anyway.

[MaisieGray]

Well, I'm not sure that threatening to buy one's own meds is generally going to be a good tactic to obligate a Dr to maintain or increase our dose, but you were definitely correct to challenge his "dosing by TSH" approach. Are you able to have a full set of thyroid tests carried out by one of the private labs, so that you can present him with the evidence of your true thyroid hormone status, rather than the level of only a pituitary hormone?

[Loobs39 in reply to MaisieGray]

Fair point but in this case it seems to have worked.

[Marz]

Time to educate this GP

[SlowDragon Administrator]

High blood pressure can be linked to being hypothyroid

75mcg is a low dose of Levothyroxine

Just testing TSH is completely inadequate

Suggest you get full Thyroid and vitamin testing. Either push GP to test or get private testing

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 or vitamins

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 special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random

All thyroid blood tests should ideally be done as early as possible in morning and fasting. Do not take Levothyroxine dose in the 24 hours prior to test, delay and take immediately after blood draw. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

NICE guidelines saying how to initiate and increase. Note that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine

cks.nice.org.uk/hypothyroid...

Would suspect you have low vitamin levels

[Loobs39 in reply to SlowDragon]

Thanks for advice, I have actually just arranged a full blood test and will be seeing a private endo (off the TUK list) in the next couple of weeks.