At the end of January I took my Blue Horizon test results to my GP, who agreed to start me on levothyroxine. 25mcg at first then increased "at my own pace" to 50mcg (which was about 10 days in).
My January results were TSH 11 (0.27-4.2) FT4 15.7 (12-22) and FT3 4.96 (3.1-6.8). TPO antibodies were >600 so I have Hashi's.
I have just had my new blood test results in from the GP which were done last week. Results TSH 3.32 (0.35-5.0) and FT4 13.8 (9.0-21.0)
One of the other GPs at the practice (not the one I first saw) has marked these as 'satisfactory', which obviously (to me) they are not. I can't get an appointment with the first (nice) GP until 23rd of March so I'm stuck on 50mcg and still feeling rotten - hardly surprising since my FT4 has actually gone DOWN!
I'm pretty annoyed about this - although tbh I was half expecting it. Can anyone advise me a) does FT4 commonly go down in early weeks of treatment? and b) what is the best way of convincing them to give me a dose increase? eg, NHS information sources ... I hate being put in the position of saying "I read on the internet that...." and I'd rather have solid evidence to back me up.
Thank you 🤗
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Smorzando
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No, your FT4 has risen. Not by much, and it's obviously still too low, but it has risen by 3%. I think you forgot to take the different ranges into account.
Ha, you're right of course, I forgot the ranges. (Still can't say I really understand how these different ranges really work).
But... The fact remains that my results have been marked "satisfactory", and as you and I can clearly see, they aren't. And I'm feeling upset and anxious about possibly having a fight on my hands to get my dose increased. So, just looking for advice on the best way to explain myself to the GP when I finally get to talk to her. I tend to get too upset in those situations and that really doesn't help 😔
Still being hypo doesn't help you to stay calm, so not surprising that you get upset - it is upsetting! But, I'm afraid I can't help you with how to handle doctors. I tend to lose my temper in such circumstances, and that's not advisable, either. So, I self-treat.
As for the ranges, they are set by the laboratories/machine makers, don't really know which, due to the averages of the local population. Totally inadequate way of doing it because the reason these people are having blood test is because they're sick. And doubtless quite a number of them have undiagnosed hypothyroidism or hyperthyroidism, so that doesn't make the ranges very reliable. How you feel should always take precedence over blood test results, but it's difficult to get that across to doctors. Which is why I self-treat.
I'm definitely angry, but it always ends up with me in tears sitting in front of the doctor feeling like a child who's done something wrong. Need to work on some assertive techniques!
I've just about had it up to here with being dismissed, mistreated and patronised by doctors. Going back as far as I can remember. But, rather than letting it eat me up and make me more ill, I need to just keep going, with the support of all the kind and knowledgeable people around here 🤗
Can you email your GP or have an online consultation...seems to be increasingly common option
If not ...Make an appointment with another GP
Request 25mcg dose increase in 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. Teva is the only brand that makes 75mcg tablet. So if avoiding Teva for 75mcg dose ask for 25mcg to add to 50mcg or just extra 50mcg tablets to cut in half
Consider starting levothyroxine at a dosage of 1.6 micrograms per kilogram of body weight per day (rounded to the nearest 25 micrograms) for adults under 65 with primary hypothyroidism and no history of cardiovascular disease.
Thank you. There's no email or online options at my surgery, unfortunately.
I'm currently taking Mercury Pharma brand levo.
I will have a think this evening about whether or not to try and see another gp. I would much prefer to see the one who knows me, of course, and frankly having had numerous bad experiences with other doctors, I am very apprehensive about seeing someone else. I have slightly fragile mental health at times (in large part because of my various battles with doctors over the years) so I am very wary of stirring this up again.
Thank you very much for those links. It really is a great help.
Just one more question: does it make a difference that I was described as "subclinical" hypo when I was started on levo? I'm wondering if they're more likely to be unwilling to increase my dose because of this ?
Hi, I just read your latest post, and then read this one. I recently posted about a similar situation. I managed to get an increase from the GP, not my usual GP, as I made sure I had a list of my continuing symptoms. I also had asked for an ultrasound that had confirmed the chronic thyroiditis diagnosis.
There are many documents you can refer to during a video consultation, (if they have those at your surgery), or even a telephone consultation.
The one here is fairly known to GPs, so you could start with this:
I managed to get a very brief telephone appointment with my GP a couple of days ago and have managed to negotiate an increase to 75mcg although still waiting for the prescription to reach my pharmacy.
I had all my research about dosing by body weight at my fingertips and well rehearsed, although it was in vain as she just talked over me and wouldn't listen!
Disappointingly, she was basically telling me by TSH was in range and therefore "fine" 🙄
I guess she's got rather a lot on her plate at the moment, so not much more I can do for now; I'll just need to see how it goes over the next few months.
Well done to you for managing to persuade your GP. They do have a duty to listen to your thoughts and feelings. It is a very difficult situation, but you will get a greater understanding of your condition too.
I would be interested to know how you get on with 75mcg, and continue to make sure your vitamins and minerals are optimised. All the best.
Thank you! I'll update with a new post when I see how I get on over the next few weeks. I think you're just starting on a 75mcg dose as well, is that right? Likewise, I hope you continue to make progress & look forward to hearing how you're doing.
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