Advised now over prescribed??

[Jr1885]

Hi

I just had a call from GP. Advising they think I am now in too much Thyroxine.

They put me up to 100mg 6 weeks ago and I had blood test on Thurs. This has now come back as TSH 0.15 and T4 22

I feel fine and back to normal. As I did a year ago when 75mg took it to 0.25.

Is there a dose between 75 and 100. I'm worried they will reduce amount and I'll feel worse again.

They have advised to carry on on 100 and go back in 3 weeks for another blood test

[helvella Administrator Thyroid UK]

I have some suggestions about achieving "in-between" doses in this document:

dropbox.com/s/sllu21khbeyth...

The dosing of thyroid hormones is usually in micrograms (mcg) - not milligrams (mg).

The document linked below says it all, I hope:

dropbox.com/s/q00vyt5703f4u...

I am sure others will discuss how long between taking your tablet and having your blood drawn, etc.

[SeasideSusie Remembering]

Jr1885

Please add the reference ranges for your test results and we will be able to comment accurately.

Your TSH may be below range but it is not suppressed, a suppressed TSH will be <0.1

Your FT4 may or may not be in range, ranges vary and we often see 7-17, 9-19, 11-23, 12-22, etc, so we need to know ranges with results.

If your FT4 is over range then you will only know if you are overmedicated if FT3 is tested, if that is over range then you would be considered overmedicated, but FT3 is rarely tested, unfortunately most doctors tend to dose by TSH alone which is wrong.

It's possible to achieve any dose of Levo by splitting tablets or alternating doses. So you could achieve a dose of 87.5mcg by alternating 100/75mcg Levo. If you are happy on your current brand and don't want to muddy the water by adding a different brand which may not suit you, then to achieve 87.5mcg you would need to take 350mcg over 4 days, so 3 days at 100 and 1 day at 50mcg.

When doing thyroid tests, we advise:

* Book the first appointment of the morning, or with private tests at home no later than 9am. This is because TSH is highest early morning and lowers throughout the day. If we are looking for a diagnosis of hypothyroidism, or looking for an increase in dose or to avoid a reduction then we need TSH to be as high as possible.

* Fast overnight - have your evening meal/supper as normal the night before but delay breakfast on the day of the test and drink water only until after the blood draw. Eating may lower TSH, caffeine containing drinks affect TSH.

* If taking thyroid hormone replacement, last dose of Levo should be 24 hours before blood draw, if taking NDT or T3 then last dose should be 8-12 hours before blood draw. Adjust timing the day before if necessary. This avoids measuring hormone levels at their peak after ingestion of hormone replacement. Take your thyroid meds after the blood draw. Taking your dose too close to the blood draw will give false high results, leaving any longer gap will give false low results.

* If you take Biotin or a B Complex containing Biotin (B7), leave this off for 7 days before any blood test. This is because if Biotin is used in the testing procedure it can give false results (both Medichecks and Blue Horizon advise to leave Biotin/B Complex off).

These are patient to patient tips which we don't discuss with doctors or phlebotomists.