Hi. New to all this and very overwhelming
I need to teach my GP a thing or two regarding my bloods
A person with an under active thyroid would use thyroxin to raise there TSH level up?
When a person has had there thyroid removed the level would need to be a lower TSH ?
I have no thyroid and he has left me with a TSH if 4.3
No, you take thyroxine to reduce your TSH. A TSH of over 3 is hypo, and it needs to come down to 1 or under. But, he shouldn't be dosing by the TSH. He should be at least doing an FT4, but preferably and FT3, because that's the most important number. 
No, a person with an under-performing thyroid or no thyroid at all, has to take exogenous thyroid hormones in order to optimise levels of FT3 and FT4. When taking l-thyroxine that generally means FT3 in the top half of the reference range and FT3 in the upper quartile. That will have the effect of lowering the TSH. Many of us feel better with a TSH of around 1.0.
Paul
A person who is hypothyroid has a high TSH, it will be above the reference range. Ranges differ but often similar to 0.2 - 4.2
FT4 (the test that measures the amount of thyroid hormone that the body is producing) is low in hypothyroidism.
So someone with hypothyroidism will have a high TSH and a low FT4
To treat hypothyroidism, the aim is to lower TSH and raise FT4. Hypo patients generally feel best when TSH is 1 or below and FT4 in the upper part of it's reference range (along with FT3).
Levothyroxine is the usual prescribed thyroid hormone replacement given to a hypothyroid patient.
You had your thyroid removed which has caused you to now be hypothyroid. You need thyroid hormone replacement (Levo) to reduce your TSH and raise FT4 as described above.
It might help you understand if you have a read through ThyroidUK's main website (this is their forum)
thyroiduk.org.uk/tuk/about_...
Work your way through the purple menu on the left hand side.
As you have no thyroid TSH should be very low
Most important test is FT3, and FT4
Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,
"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 articles from Thyroid UK email print it and highlight question 6 to show your doctor please email Dionne at
tukadmin@thyroiduk.org
Professor Toft recent article saying, T3 may be necessary for many. Note especially his comments on current inadequate treatment following thyroidectomy
rcpe.ac.uk/sites/default/fi...
New NHS England Liothyronine guidelines November 2018 clearly state on pages 8 & 12 that TSH should be under 1.5 when on just Levothyroxine to be adequately medicated
sps.nhs.uk/wp-content/uploa...
Essential to test vitamin D, folate, ferritin and B12 too
These are often too low if been under treated. Many need to supplement to maintain adequate levels. But important to test first
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)
Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 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
Why and when did you have your thyroid removed. If like me you had your thyroid removed because of cancer you should keep your TSH suppressed i.e very low.
Did your GP give you a reason why hes leaving your TSH high and Why did you have thyroidectomy?
Cancer and gp don’t have a clue
After thyroid cancer you should have ongoing care via an endocrinologist
TSH should be kept suppressed (i.e. Almost at zero)
thyca.org/pap-fol/more/tsh-...
How long ago was thyroidectomy?
Many patients after complete thyroidectomy do better with addition of small dose of T3
Hi. Aug. Gp won’t give me T3.
A GP can not prescribe T3 now due to cost
mjauk.org/wp-content/upload...
But first you should have dose of Levothyroxine increased by GP in 25mcg steps until TSH is under 0.5 and FT4 in top 1/3 of range
Bloods retested 6-8 weeks after each dose increase
Vitamin D, folate, ferritin and B12 need regular testing and very often regular supplementing to maintain to optimal levels to improve our ability to use thyroid hormones well
If you still feel unwell after getting TSH low then getting full Thyroid and vitamin testing privately to check what FT3 levels is
If FT3 is not in top 1/3 or range then you need referral to endocrinologist for clinical diagnosis and three month trial of T3
Ongoing care and prescription costs are then transferred to GP after 3 months
Many CCG's refuse to allow prescription, or heavily pressurise endocrinologists not to prescribe
Roughly where in the UK are you?
Thyroid Uk has list of recommended thyroid specialists.
please email Dionne at
tukadmin@thyroiduk.org
If your GP refuses to increase Levothyroxine you will need to go over their head and see an endo
Extremely common that thyroid treatment is inadequate.....hence over 90,000 members on here
But you can get well and make full recovery.
Vitamins are surprisingly important (medics often completely unaware )
Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,
"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 articles from Dionne at Thyroid UK email print it and highlight question 6 to show your doctor
Ok, I had thyroid cancer as well complete thyroidectomy and your suppose to have 1 or less tsh to prevent cancer from coming back (per my treatment plan) are you not allowed to see and Endocrinologist and did you have complete or partial thyroidectomy ? I would run away from this GP person that high TSH makes zero sense after thyroid cancer....why does medical stink so bad its almost as if these people enjoy watching you suffer..
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