Do GPs aim for TSH 2 on thyroxine?

[Sarah5-5]

Hi I’ve been bad and not had tests since 2017. Meanwhile my test results have taken a downturn. I was breathless, hair falling out, which took me back to the GP but had assumed anaemia, but bloods were fine, thyroid tests weren’t.

2017 on levo 75mg

Tsh 2.46

(Can’t find any t4 results)

Oct 2019 on 75mg

Tsh 4.51 (0.27-4.2)

T4 10.8 (12-22)

I’ve had 25mg added so now on 100. Still breathless and have put on about ten pounds this year. I’ve been told to repeat blood test after 3 months which seems a long time?

My question is, I’ve read on here that tsh should be below 2 whilst on thyroxine therapy. Is this general knowledge amongst gps? Just wondering if they get my tsh under 4.2 I’ll be classed as normal and won’t have any additional levo 25mg rises? Or is it common practise to get you down below 2, without having to argue the point?

Any experiences shared of GPs approach to tsh levels whilst on therapy will be most welcome!

Thanks everyone!!

Sarah

[Sarah5-5]

Also, anyone else have breathlessness? And who here is hypo but doesn’t have Hashimotos? I didn’t have the antibodies back in 2015 when first diagnosed. Is it possible to develop hashimotos and antibodies or oils it have shown up in 2015?

[Aslangal]

Hi Sarah

‘Normal’ ranges for TSH are 0.4 to 4.0 however, what is ‘normal’ for me might not be normal for you. With the symptoms you describe, there is clearly something going on.

I am no expert but in the middle of a drastic, unexpected change in my own symptoms and have decided to be my own advocate in my treatment. GPs don’t know everything.

Others will no doubt jump in here with very sound advice so hang in there. 😀 (I just popped on to ask advice myself on private testing 😉)

Lynn 😀

[Nanaedake]

What were your other test results? Normal isn't the same as optimal. Low folate may cause breathlessness, for instance.

[greygoose]

Depends very much on the individual doctor and his knowledge and préjudices. They all have their own pet theories. None of them have much knowledge.

Three months is too long. It should be 6 to 8 weeks.

I am very breathless and no idea why. I take 75 mcg T3 only daily. I supplement iron - ferritin is the thing to test - so I don't think that's low. It's a problem I've had from a child. I couldn't run around freely like the other kids, very soon out of breath. And, it's got worse and worse with the years. I find that N-Acetyl-L-Cysteine and oregano help, but don't get me breathing easily when moving. Some doctors say I have asthma, some say I don't. My personal opinion is that I do, but I don't think that's the only problem. I just don't know.

[humanbean]

My question is, I’ve read on here that tsh should be below 2 whilst on thyroxine therapy. Is this general knowledge amongst gps?

Based on posts I've read on here, different GPs have different targets they aim to achieve when it comes to TSH. Some have clearly aimed for just inside the top of the range. Some go for middle of the range. It's rare for a GP to aim for the lower half of the range, particularly below 1.0. They often view anything below 1.0 as "hyper", which is usually nonsense for someone who has a history of hypothyroidism. Such people can be over-medicated but they can't become hyperthyroid.

People who are truly hyperthyroid will have a TSH of possibly 0.01 or below.

...

Take a look at this link :

pathology.leedsth.nhs.uk/pa...

Then find the section entitled "Thyroxine Replacement Therapy in Primary Hypothyroidism", then look at the table immediately below.

It's an NHS pathology link so your doctor shouldn't completely dismiss it.

...

For more info on TSH in healthy people with healthy thyroids, see this link :

healthunlocked.com/thyroidu...

[humanbean]

I was breathless, hair falling out, which took me back to the GP but had assumed anaemia, but bloods were fine, thyroid tests weren’t.

I would be interested in seeing the results and reference ranges that were apparently fine. It would be unusual (but not impossible) to have acceptable results for nutrients, for example, if your thyroid results are so poor. It would also be good to find out which other tests your doctor actually did.

Low iron and/or ferritin (iron stores) makes me breathless. Low vitamin B12 can make people breathless too.

[Maramonro]

It all sounds like hypo to me. I was also short of breath most of the time until I came closer to a normal range. Thyroid regulates everything in the body so if it doesn’t work properly nothing else would work as well. It’s essential to fix your thyroid issue before you move to something else.