Referring from Primary to Hosp????

[Minimouse1]

Does anyone know what the threshold is for GPs referring from Primary Care to Endo Consultant at hosp? I'm being treated for hypo hashi but I believe I have a skin rash as allergic to levo, therefore would prefer to see consultant at hospital for management. Last blood test my TSH was 13 & T4 also 13 antibodies high. The GP has already written to consultant at hospital but for advice on management only - the advice was "not on enough levo yet, increase dose & do repeat bloods in 6-8wks including T3" .

[SlowDragon Administrator]

How much Levothyroxine are you currently taking?

Have you had vitamin D, folate, ferritin and B12 tested. If not get GP to test

Often too low and need supplementing

Dairy intolerance is common cause of phlegm with Hashimoto's

If you are lactose intolerant you will need Teva brand of Levothyroxine

Endocrinologist won't want to see you, until a Levothyroxine is increased high enough to bring TSH under 2 and FT4 in top third of range

Hives and Hashimoto's can be linked

thyroidpharmacist.com/artic...

Always take Levo on empty stomach and then nothing apart from water for at least an hour after.

Many take Levothyroxine 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 and some people find Teva excellent

[Minimouse1 in reply to SlowDragon]

Im currently taking 100mg of Activis which I swapped from Teva due to the rash. I've been in touch with the site previously so have followed all advice with regard to vitamins & tests etc.

[SlowDragon Administrator in reply to Minimouse1]

So you will need bloods retested after 6-8 weeks on Activis

Make sure to get vitamins tested too

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

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

Last Levothyroxine dose should be 24 hours prior to test, (taking delayed dose immediately after blood draw).

Dose of Levothyroxine is increased slowly in 25mcg steps upwards (retesting 6-8 weeks later each time) until TSH is under 2 (many need TSH significantly under one) and FT4 in top third of range and FT3 at least half way in range

Always take Levo on empty stomach and then nothing apart from water for at least an hour after.

Many take Levothyroxine 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.