Due to an ongoing eye twitch I visited my GP and was told that I needed to reduce my thyroxine to get tsh in range and if it continues after that she would refer me (I was on 125 after convincing another GP to increase my dose from 100 based on how I felt not numbers).
I have been in 100 for 2 months and just got blood results and been told to reduce to 75 and retest again in 2 months. She did lots of other blood tests which are apparently all fine.
It was like getting. Blood out of a stone with the receptionist but I got that my tsh was 0.05, T4 19.7 and T3 4.4. The only range I got was T4 up to 20 (it was hard enough getting this).
I feel rubbish, mega tired, weak achy muscles and light headed and skin/bowel issues are returning and the eye twitch keeps coming back. I have booked to see another GP at the practice but I wanted to know what people on here thought before I go. Am I converting badly? I don’t know what my options will be as all I can get on NHS is Throxine and I can’t afford to go private.
Thanks
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Hypo32
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Well, as you can see, your FT3 is not even mid-range, but your FT4 is top of the range. So, yes, poor conversion.
Poor conversion can be due to many things. Nutritional deficiencies, for example. Have you had your vit d, vit B12, folate and ferritin tested?
Or, low-calorie diets. Or adrenal problems. Or having Hashi's - have you had your antibodies tested?
But, if you can't find anything to do to increase conversion, the only option is to buy your T3 on-line and self-treat with it - you don't actually need a private endo, not likely to be much help, anyway.
However, you're never going to get anywhere with a doctor that doses by the TSH, because once you're on thyroid hormone replacement of any kind, the TSH doesn't give you anything much in the way of information. The important number, whatever you're taking, is the FT3.
Give your GP a copy of the link below. Unfortunately, as the medical professionals are so poorly trained re hypothyroidism, the assumption is that if our TSH goes low we've suddenly become hypERthyroid but that's untrue.
Also inform your GP that the TSH is not a 'Thyroid Hormone' it is from the pituitary gland which rises if our thyroid gland isn't producing sufficient. Any change in dose permits a blood test in six weeks.
We don't feel well if they mess about trying to fit the TSH into the range when 1 or lower is the aim. The following extract is from the link below:-
Dear Thyroid Patients: If you have thyroid gland failure--primary hypothyroidism--your doctor is giving you a dose of levothyroxine that normalizes your thyroid stimulating hormone (TSH) level. Abundant research shows that this practice usually does not restore euthyroidism--sufficient T3 effect in all tissues of the body. It fails particularly badly in persons who have had their thyroid gland removed. TSH is not a thyroid hormone and is not an appropriate guide to thyroid replacement therapy.
The hypothalamic-pituitary secretion of TSH did not evolve to tell physicians what dose of inactive levothyroxine a person should swallow every day. A low or suppressed TSH on replacement therapy is not the same thing as a low TSH in primary hyperthyroidism. IF you continue to suffer from the symptoms of hypothyroidism, you have the right to demand that your physician give you more effective T4/T3 (inactive/active) thyroid replacement therapy. Your physician can either add sufficient T3 (10 to 20mcgs) to your T4 dose, or lower your T4 dose while adding the T3. The most convenient form of T4/T3 therapy, with a 4:1 ratio, is natural desiccated thyroid (NDT-- Armour, NP Thyroid, Nature-Throid).
They will not be able to retest vitamin D (only allowed every 2 years on NHS) which is ridiculous because low vitamin D is strongly linked to hypothyroidism
Vitamin D deficiency is frequent in Hashimoto's thyroiditis and treatment of patients with this condition with Vitamin D may slow down the course of development of hypothyroidism and also decrease cardiovascular risks in these patients. Vitamin D measurement and replacement may be critical in these patients.
Evidence of a link between increased level of antithyroid antibodies in hypothyroid patients with HT and 25OHD3 deficiency may suggest that this group is particularly prone to the vitamin D deficiency and can benefit from its alignment.
Our results indicated that patients with hypothyroidism suffered from hypovitaminosis D with hypocalcaemia that is significantly associated with the degree and severity of the hypothyroidism. That encourages the advisability of vit D supplementation and recommends the screening for Vitamin D deficiency and serum calcium levels for all hypothyroid patients.
Same applies to low B12 - extremely common in hypothyroid patients
All patients who are hypothyroid should have B12 tested
There is a high (approx 40%) prevalence of B12 deficiency in hypothyroid patients. Traditional symptoms are not a good guide to determining presence of B12 deficiency. Screening for vitamin B12 levels should be undertaken in all hypothyroid patients, irrespective of their thyroid antibody status. Replacement of B12 leads to improvement in symptoms, although a placebo effect cannot be excluded, as a number of patients without B12 deficiency also appeared to respond to B12, administration.
Patients with AITD have a high prevalence of B12 deficiency and particularly of pernicious anemia. The evaluation of B12 deficiency can be simplified by measuring fasting serum gastrin and, if elevated, referring the patient for gastroscopy.
Levothyroxine can decrease serum homocysteine level partly; still its combination with folic acid empowers the effect. Combination therapy declines serum homocysteine level more successfully.
I have managed to get rid of a bad eye twitch by taking some magnesium which also seems to have helped my poor sleep too. I would suggest that you try some magnesium before altering your thyroid dose.
Eye twitches are more likely to be related to low B12 or magnesium. If my B12 drops below the top of the range , I get an eye tic. I supplement and it goes away. Low TSH wouldn't give you an eye twitch.
My b12 is 427. GP didn’t think low tsh was causing the twitch as such but she felt that I’d she referred me all that they would say is get my tsh in range first to rule it out. Now I don’t know whether to argue to go back into the dose that o felt good on or try and rude it out so that they will try and figure out why I get the eye twitch so much
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