My history and endo recomendation please

[ade1961]

Hi all and thanks for a great site. My history in brief, I was diagnosed sub clinical hypothyroid in March last year - tsh 6.3 (0.3-4.2) I am male and 57yrs. I have titrated levo fom 25mcg to current 125mcg. At my last appointment on 3rd Jan my readings were tsh 2.8 (0.3-4.2) ft4 16 (12-22) ft3 4.9 (4-6.8). My gp took a lot of persuasion to raise dose to 125mcg. I would like to follow recommendations here and get tsh below 1 and frees to top of range. My next app, is in 2 weeks and I suspect gp will not increase dose if required. Fortunately I pay into a private health scheme so will ask for referral. Could anyone recommend an endo who will follow these guidelines and is thyroid good. I live between Birmingham and Worcester, West Midlands. I understand this has to be done by p.m. and would be very grateful, thanks.

[SlowDragon Administrator]

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also extremely important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if Thyroid antibodies are raised

Ask GP to test vitamins and antibodies if not been done

Recommended on here that 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)

Is this how you do your tests?

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or all 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

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 .

Meanwhile email Dionne on Monday at Thyroid Uk for list of recommended thyroid specialists

Anyone who has suggestion of specialists will contact you by private message

[ade1961 in reply to SlowDragon]

Hi SlowDragon, thanks for replying. I have the list from Dionne but there doesn't appear to be any listed near my area.

[SeasideSusie Remembering in reply to ade1961]

Are you willing to travel? If so then ask for feedback by private message about any that you can travel to.

Also, Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states 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).*"

*He recently confirmed, during a public meeting, that this applies to Free T3 as well as Total T3. You can obtain a copy of the article by emailing Dionne at

[e-mail]

print it and highlight question 6 to show your doctor when requesting an increase in dose.

[ade1961 in reply to SeasideSusie]

Thank you seasidesusie. I have that print out and will try it with g.p. I travel to Spain often so I think I will purchase some 25mcg levo just in case. I felt no improvement until 100mcg dose, Now I am seeing a light at the end of the long tunnel and it's uplifting, just want to get to the end and grab the light.

[JAmanda]

Just as a matter of interest, how are your symptoms? I have a similar story witht4 and t3 not at top of range and tsh 1.5 - some symptoms hugely better but others not at all - and each day is different to the one before! Lol - so how are you doing?

[ade1961 in reply to JAmanda]

Hi jamanda, I would say that my mood has definitely improved. I still need a lot of sleep, usually 10 hours a night suffices but if not disturbed could easy do 12. Having said that I no longer need naps during the day which is great. I have gained about 2 stone in weight over 18months which won't move yet. Third of eyebrows missing. I suffered anxiety and this has virtually gone. I suppose the worst continuing symptom is tiredness and lower energy. I understand recovery takes a long time but wish I knew how long and hold hope that a further increase will help. Fingers crossed that levo will do the job. For information my thyroid was underactive (tsh 8.6) five years ago but not treated so it's been a long time and I read that this can effect recovery time.