Hello..I was diagnosed with hypothyroidism at the turn of the year..I'd had a raft of symptoms for years but I have avoided doctors for years and just tended to ignore my health concerns..but my partner finally cajoled me in to visiting a doctor...cue my diagnosis.
Now 5 months in, on levothyroxine and 3 thyroid function tests later I feel halfway ok.
My must recent test came back as TSH 7.6 and FT4 16.4...what with covid 19 I received a text from my doctor yesterday saying that the blood test indicated a stable thyroid picture and recommend continuing on the dose prescribed/test a year from now.
I then checked "normal levels" on this site.
Recommended TSH 0.4 to 4.5 and FT4 0.7 to 1.4.. (Although TT4 range seems to indicate 4 to 11..which seems to make more sense in terms of my level of 17).
I still have certain symptoms too..Although there's definite improvements.
Do I go back to my GP, site the above range..and ask for an increase from 50mg (present dose) of levothyroxine?
Thanks in advance
v
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vivvov
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My must recent test came back as TSH 7.6 and FT4 16.4
Did you get a print out of your results?
Can you please post exactly what it says like this:
TSH: 7.6 (range xx - yy)
FT4: 16.4 (aa-bb)
Or edit your above post and add a picture of your print out (to edit click MORE, then ADD A PICTURE, upload your picture then click SUBMIT).
Recommended TSH 0.4 to 4.5 and FT4 0.7 to 1.4..
Are these the reference ranges that came with your results? Or have you found them somewhere else, maybe here or on Thyroid UK's website? That doesn't look like a normal FT4 reference range.
(Although TT4 range seems to indicate 4 to 11..which seems to make more sense in terms of my level of 17).
Something seems to be wrong here.
What test result are you saying is "17".
TT4 is Total T4 not Free T4 (FT4).
I received a text from my doctor yesterday saying that the blood test indicated a stable thyroid picture and recommend continuing on the dose prescribed/test a year from now.
Then your doctor hasn't got a clue, he should at least know that TSH needs to be in range.
The aim of a treated Hypo patient on Levo, generally, is for TSH to be 1 or lower with FT4 and FT3 in the upper part of their reference ranges.
You need an increase in your dose of Levo immediately, retest in 6-8 weeks, keep repeating until your levels are where they need to be for you to feel well.
Isn´t this about measurement units? The reference ranges for my current lab are 0.7-1.5 ng/dL for FT4. My previous lab used pmol/L and the reference ranges for FT4 were 10-22.
Possibly, partly. But vivvov has got things mixed up and using TT4 range for her FT4 result (presumably). She has taken the example ranges from ThyroidUK's website which say
Free Thyroxine (FT4):
10 - 24 pmol/L
0.7 - 1.4 ng/dL
Total Thyroxine (TT4):
50 - 160 nmol/L
4 - 11 μg/dL
So we need clarification of her own ranges so that we can interpret the results accurately and help further.
Hi SeasideSusie..added the text (excluding personal info) received from the GP.
It's all they sent...get the feeling I should change possibly clinics...and get on top of self advocating and looking after my health more in the process.
If so please ask the receptionist at your surgery for a print out of your results, we are legally entitled to them without question or charge.
As I said in my second reply (further down, below Lalatoot's reply), you appear to have taken reference ranges from ThyroidUK's website which are not appropriate for your own test, the lab will have it's own ranges and it's those that we need to be able to help you further.
7..6 is far too high for TSH - it should be around 1 or lower when on levo. Your FT4 result - this is the T4 circulating in the blood which gets convert into T3 (the hormone that cells use) should have a range following it. The range is based on the norm for local populations and for the testing method used by the lab so you need to know the range for your result. 50mcg is a starting dose and you do need an increase of 25mcg. Wait 8 weeks after increase and test bloods again.
To get the best out of levo it is important that folate, ferritin, B12 and fit D levels are into the top half of their ranges so you would be advised to get those tested too. If deficient don't take a multi vitamin as these don't target what is lacking enough and may give you things you don't need leading to an imbalance.
I really am a luddite when it comes to forums..and also have fat fingers (thyroid related?).I've replied to a couple of very helpful people..but thought it best to reply to you to..
Seaside Susie recommended I obtain a print out..I did. I'd photo and paste it but I can't see how to..
I'm vaguely unsure about how forum's work..so thought I'd send info direct...
I've just had the telephone consultation with my GP and took him to task over the blood test results.
I'm not sure who wrote the GP note under the Test results (''Stable subclinical hypothyroidism , suggest annual review'') but it doesn't seem to have been this GP doing the consultation as I immediately barrelled through to 'asking' for an increase in my levothyroxine medication... because my Serum TSH level clearly indicated at 7.6 mu/L that I was way over the 0.3-4.2 recommended range. This GP didn't even metaphorically blink..so presumably had not read the notes/forgotten his own notes.
We then had a bit of a 'discussion' in which he stated he wasn't going to increase my levothyroxine to 100 (from present 50)..because he viewed the serum free T4 level to be 16.4 pmo/L which was far more important than the Serum TSH level...and didn't want me to enter Hyperthyroid range....He begrudgingly upped the dosage to 75 levo during the week and 50 Fri/Sat/Sun.
...and I told him I'd be coming in for another Thyroid Function Test ...he said August...
I didn't even attempt to ask for antibody and Vitamin tests..as we were on the point of loggerheads.
..Kept my calm though.
I'm completely new to all this so would appreciate people's thoughts on his use of Serum free T4 as an indicator and it being 16.4 pmol/L..mid range for the test guidance (12.00-22.00 pmol/L.
Also..should I still be looking to change my GP?
Apology if you're receiving this twice..on forum and directly to you.Regards
OK, I see now where you have got the reference ranges from. They are from ThyroidUK's website and they are not the ranges that came with your results.
You can only use the ranges that the lab which does your test supplies. Ranges vary from lab to lab so you can't take a result from one lab and use a range from a different lab. The information on ThyroidUK's website clearly states:
The table below shows examples of approximate reference ranges and measurements used for the various tests:
Example Reference Ranges and Measurement Units
(Note that reference levels/ranges may vary from lab to lab)
If you have a Free T4 result (FT4), you can only use the FT4 reference range with it, you cannot use the Total T4 (TT4) reference range.
So if you can provide the reference ranges that came with your result we can help you further.
I have just received the text..that snippet only..received no information on reference ranges...I'll contact the surgery but (and this must sound positively idiotic) what exactly am I requesting from them re printed information?
"Can you please arrange for me to have a print out of my thyroid test results for the test carried out on xx date xx"
You don't need to give a reason but if you feel compelled to just say it's for your own records. If you are in the UK you are legally entitled to them and they cannot charge.
This is utter garbage. If your GP did write that then I'd find another doctor quickly.
You have a diagnosis of Primary Hypothyroidism, you wouldn't have been diagnosed and prescribed Levothyroxine months ago if you weren't hypothyroid. Your TSH would have been over 10 at the time of diagnosis.
The aim of Levo is to bring your TSH down into range, as previously mentioned.
Your TSH is still over range so
(1) you are not "stable" and
(2) you can't possibly have a diagnosis of Subclinical Hypothyroidism because you already have a diagnosis of Primary Hypothyroidism.
Why on earth does your GP think this was written:
TSH FT4-(ac10777) -abnormal -contact patient.
Serum TSH level 7.6mu/L 0.30-4.20mu/L
if everything was OK.
I'd run away from this jerk ASAP and find a doctor who has at least a tiny bit of understanding about hypothyroidism and understands how to treat a Hypo patient.
You can use the following information to educate your GP and get your increase in dose:
Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine (the magazine for doctors):
"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l. In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l. Most patients will feel well in that circumstance. But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l. This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l).*"
*He recently confirmed, during a public meeting, that this applies to Free T3 as well as Total T3.
You can obtain a copy of the article by emailing Dionne at
tukadmin@thyroiduk.org
print it and highlight question 6 to show your doctor.
You can also refer to NHS Leeds Teaching Hospitals who say
I seem to think tsh originally was (possibly ) 20 comes to mind...possibly 17? It seemed high at the time when I googled the norm.
I think I'll get another GP..my mother's GP probably..means a trip but we see each other often..(my mother not her GP).
Half the problem is I'm over 6ft..Northern, stoic and working class..it's why I avoid power constructs like Doctor patient scenarios..because..and in situations like this I switch from stoic to blunt and furious quite quickly..the inwardly buried frustration of being treated disrespectfully..which clearly I am in this situation...a switch gets flipped and I bluntly plough forward at startling speed..always a shock never a pleasure..for me or the recipient.
I'm vaguely unsure about how forum's work..so thought I'd send info direct...
I've just had the telephone consultation with my GP and took him to task over the blood test results.
I'm not sure who wrote the GP note under the Test results (''Stable subclinical hypothyroidism , suggest annual review'') but it doesn't seem to have been this GP doing the consultation as I immediately barrelled through to 'asking' for an increase in my levothyroxine medication... because my Serum TSH level clearly indicated at 7.6 mu/L that I was way over the 0.3-4.2 recommended range. This GP didn't even metaphorically blink..so presumably had not read the notes/forgotten his own notes.
We then had a bit of a 'discussion' in which he stated he wasn't going to increase my levothyroxine to 100 (from present 50)..because he viewed the serum free T4 level to be 16.4 pmo/L which was far more important than the Serum TSH level...and didn't want me to enter Hyperthyroid range....He begrudgingly upped the dosage to 75 levo during the week and 50 Fri/Sat/Sun.
...and I told him I'd be coming in for another Thyroid Function Test ...he said August...
I didn't even attempt to ask for antibody and Vitamin tests..as we were on the point of loggerheads.
..Kept my calm though.
I'm completely new to all this so would appreciate people's thoughts on his use of Serum free T4 as an indicator and it being 16.4 pmol/L..mid range for the test guidance (12.00-22.00 pmol/L.
Also..should I still be looking to change my GP?
Apology if you're receiving this twice..on forum and directly to you.Regards
It hasn't come directly to me, it's come as a post on the forum which is the best thing to do so that other members can also offer suggestions.
because he viewed the serum free T4 level to be 16.4 pmo/L which was far more important than the Serum TSH level.
This gives a glimmer of hope - a doctor who things the actual hormone level (FT4) is more important than TSH level (not a thyroid hormone)
and didn't want me to enter Hyperthyroid range
and here's where it disappoints. If this GP thinks going over range means you are hypERthyroid then he is sadly mistaken. If you are diagnosed hypOthyroid there is no way your thyroid can regenerate and then become overactive. He needs to understand that there is overmedication, which will take your levels over range, but this is not the same as being hypERthyroid.
He begrudgingly upped the dosage to 75 levo during the week and 50 Fri/Sat/Sun.
That's better than nothing but it should have been a 25mcg increase across the board, so seven days a week rather than just five. Dose increases should always be in 25mcg increments, retesting after 6-8 weeks which gives hormone levels time to stabilise. Book your next test for 10th August, no later than 9am, have nothing to eat or drink except water before the test, take last dose of Levo 24 hours before test, take that day's Levo after the test.
I'm completely new to all this so would appreciate people's thoughts on his use of Serum free T4 as an indicator and it being 16.4 pmol/L..mid range for the test guidance (12.00-22.00 pmol/L.
As mentioned previously, the aim of a treated Hypo patient on Levo, generally, is for TSH to be 1 or lower with FT4 and FT3 in the upper part of their reference ranges. And yes, the hormone levels - FT4 and FT3 - are the important tests. TSH is useful for diagnosis, after that it really has no place in determining dose of Levo for optimal health.
I have given above the article from Dr Toft and the table from Leeds Teaching Hospital, both of which clearly indicate where your levels should be. You should use these to "educate" your GP.
If you decide you wish to change your GP, ask around locally to see if anyone has any recommendation for a GP who understands how to treat hypothyroidism properly.
Hi All..thanks for the replies so far..as you can gather I really haven't a clue..about using GPs correctly (just always have avoided them) or my hypothyroidism or the tests or the medication.. the whole shooting match...and clearly need to start getting in control of it all.
I've re edited my initial post..included the text received from my GP surgery...my mistake on writing '17'..meant to write '16.4'
Not got a clue really at the mo..all I can see is trees/no wood.
OK, so you have taken your FT4 result and used the Total T4 range from ThyroidUK. At least we've cleared that up
We just need the reference ranges that came with your results now, as explained.
However, with a TSH of 7.6 that will be over range and your GP should know that you need to bring that down into range and should be giving you an increase in Levo as explained in my original reply.
Standard starter dose of levothyroxine is 50mcg (unless over 65 years old).
The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many patients need TSH significantly under one) and most important is that FT4 is in top third of range and FT3 at least half way through range
NHS guidelines on Levothyroxine including that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine.
Also note what foods to avoid (eg recommended to avoid calcium rich foods at least four hours from taking Levo)
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 you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies
Ask GP to test vitamin levels and thyroid antibodies
Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .
Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)
Is this how you do your tests?
Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins
GP started on me on 25mg. .after a non specific blood test was undertaken when I attended the surgery for a (what i thoight was) a singular unrelated issue symptom..turned out it wasn't unrelated..along with a raft of other symptoms I'd been ignoring for years..minimal tests and was informed I have hypothyroidism..upped the dose to 50mcg on my 2rd visit in March 20.
..and now informed I'm stable..maintain present lexothyroxone dose of 50mcg. via brief text uploaded in my edited first post.
Just gone to the surgery for a print out (as recommended by Seaside Susie)..States following
You need next 25mcg dose increase in levothyroxine
TSH FT4 (ac10777) abnormal contact patient.
Serum TSH level 7.6 mu/L
0.30 - 4.20 mu/L
Serum free T4 level 16.4 pmol/L
12.00 - 22.00 pmol/L
The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many patients need TSH significantly under one) and most important is that FT4 is in top third of range and FT3 at least half way through range
NHS guidelines on Levothyroxine including that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine.
Also note what foods to avoid (eg recommended to avoid calcium rich foods at least four hours from taking Levo)
Bloods should be retested 6-8 weeks after each dose increase
All four vitamins need to be regularly tested and frequently need supplementing to maintain optimal levels
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 you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies
Ask GP to test vitamin levels and thyroid antibodies
Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .
Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)
If/when also on T3, make sure to take last third or half of daily dose 8-12 hours prior to test, even if this means adjusting time or splitting of dose day before test
Is this how you do your tests?
Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins
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. Teva contains mannitol as a filler, which seems to be possible cause of problems. 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
No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap. Some like iron, calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away
Physicians should: 1) alert patients that preparations may be switched at the pharmacy; 2) encourage patients to ask to remain on the same preparation at every pharmacy refill; and 3) make sure patients understand the need to have their TSH retested and the potential for dosing readjusted every time their LT4 preparation is switched (18).
Levothyroxine is an extremely fussy hormone and should always be taken on an empty stomach and then nothing apart from water for at least an hour after
Many people take Levothyroxine soon after waking, but it may be more convenient and perhaps more effective taken at bedtime
I'm vaguely unsure about how forum's work..so thought I'd send info direct...
I've just had the telephone consultation with my GP and took him to task over the blood test results.
I'm not sure who wrote the GP note under the Test results (''Stable subclinical hypothyroidism , suggest annual review'') but it doesn't seem to have been this GP doing the consultation as I immediately barrelled through to 'asking' for an increase in my levothyroxine medication... because my Serum TSH level clearly indicated at 7.6 mu/L that I was way over the 0.3-4.2 recommended range. This GP didn't even metaphorically blink..so presumably had not read the notes/forgotten his own notes.
We then had a bit of a 'discussion' in which he stated he wasn't going to increase my levothyroxine to 100 (from present 50)..because he viewed the serum free T4 level to be 16.4 pmo/L which was far more important than the Serum TSH level...and didn't want me to enter Hyperthyroid range....He begrudgingly upped the dosage to 75 levo during the week and 50 Fri/Sat/Sun.
...and I told him I'd be coming in for another Thyroid Function Test ...he said August...
I didn't even attempt to ask for antibody and Vitamin tests..as we were on the point of loggerheads.
..Kept my calm though.
I'm completely new to all this so would appreciate people's thoughts on his use of Serum free T4 as an indicator and it being 16.4 pmol/L..mid range for the test guidance (12.00-22.00 pmol/L.
Also..should I still be looking to change my GP?
Apology if you're receiving this twice..on forum and directly to you.Regards
We should only increase dose upwards in 25mcg steps...otherwise it’s too much too soon
So dose should have been increased to 75mcg per day
But you better do as GP says and start with alternate 75/50mcg
Get weekly pill dispenser
Bloods should be retested 6-8 weeks after each dose increase
Remember to do any thyroid testing as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 Hours Before blood test
Suggest you get vitamin D tested now via NHS postal kit
Even if we don’t start on full replacement dose, most people need to increase dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until on full replacement dose
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.
Welcome, fellow luddite with unexpected blunt shouty tendancy towards disrepectful Gp's. You are not alone.
And dont worry about being lost in the woods, there are lots of experienced folk with knowledge sitting these trees. I wish i'd wandered into this wood years ago. And not only do i now know enough about my thyroid test results to shout at my Gp with authority..... i have also learned how to do ' ' on my keyboard.
Your Gp really should know that for someone being treated on Levothyroxine, a TSH of 7 is not ok, (even without the lab telling him !, funny he forgot to include 'Abnormal -contact patient' in his text to you, or do anything about it ) the correct response should have been a) ASK patient how they feel now !!!
b) increase by 25mcg retest 6+ weeks.
Feel free to shout at him.......
and always get your results and ranges (in print not verbally) and keep a record of dose changes and how you feel. Also keep note of any brand changes when you pick up tablets. many find it makes a difference, and insist on same brand BEFORE leaving chemist.
I'm vaguely unsure about how forum's work..so thought I'd send info direct...
I've just had the telephone consultation with my GP and took him to task over the blood test results.
I'm not sure who wrote the GP note under the Test results (''Stable subclinical hypothyroidism , suggest annual review'') but it doesn't seem to have been this GP doing the consultation as I immediately barrelled through to 'asking' for an increase in my levothyroxine medication... because my Serum TSH level clearly indicated at 7.6 mu/L that I was way over the 0.3-4.2 recommended range. This GP didn't even metaphorically blink..so presumably had not read the notes/forgotten his own notes.
We then had a bit of a 'discussion' in which he stated he wasn't going to increase my levothyroxine to 100 (from present 50)..because he viewed the serum free T4 level to be 16.4 pmo/L which was far more important than the Serum TSH level...and didn't want me to enter Hyperthyroid range....He begrudgingly upped the dosage to 75 levo during the week and 50 Fri/Sat/Sun.
...and I told him I'd be coming in for another Thyroid Function Test ...he said August...
I didn't even attempt to ask for antibody and Vitamin tests..as we were on the point of loggerheads.
..Kept my calm though.
I'm completely new to all this so would appreciate people's thoughts on his use of Serum free T4 as an indicator and it being 16.4 pmol/L..mid range for the test guidance (12.00-22.00 pmol/L.
Also..should I still be looking to change my GP?
Apology if you're receiving this twice..on forum and directly to you.Regards
Hello again vivvov, Well done for keeping calm.. you don't want to give them any ammunition to call you 'internet health obsessed' or 'hysterical'......
Should you change GP ?..... I don't know how good a doctor he is....... but he's not very good at maths is he ! 16.4 is not quite 50% through an FT4 range of [12-22].... so what does he think the other 50+% of the range is there for?
He really should wait to see if he can get your TSH down to at least within the reference range ! , before he starts 'flapping' about overmedication (using the term 'hyperthyroid range' just confirms his lack of comprehension i'm afraid)
I think you should probably 'stick while you are ahead' for now , and take the 75 for 6+ weeks until August blood test. Then your'e not being 'difficult'..... you may need to be 'bloody difficult' later on, so maybe keep your powder dry for now!
Actually i'd agree with him (!) ,it's sensible to go up in 25mcg increases anyway, and retest again on that dose , before going to 100.
Even though you could probably go straight to 100, it makes it harder to tell whats going on , for him and you both. And if you rush it at this point , you may have to waste months later on, (at a reduced dose and feeling rubbish) in order to prove to them that a lower dose isn't resolving your symptoms.
p.s I really cant see why he's messing about with 75x5 / 50x2 instead of 75mcgx7days?
unless you are a very small child or a frail geriatric with heart problems.?
Telephone appointment arranged with surgery for Monday first thing.
I now understand that I have been treated incredibly shabbily from reading all your informed replies...am now angry and piqued..fight side of flight/ fight routine.
I'm glad it's a telephone appointment.
I have more of a tendency to react calmly when NOT presented with inappropriate/disrespectful body language but as soon as I'm in this state, the first roll of an eye (based on privileged power construct) will trigger a response from me..I know it will...so relieved it's a telephone I'll be staring at..or most likely out the window.. as I tear a strip of this so called professional.
I don't know about anyone else but telephone dialogue let's me be far more whimsically focused and cutting, as opposed to face to face split second, through all the gears, large northern furious blunt force of nature. (Hate it. Like a enraged Christopher Ecclestone ..Necessary part of repertoire but so distressing for all concerned).
I've also started asking friends in the locale if any of them have received decent, respectful dialogue from any surgeries in the area...and will be moving surgery..this is a given.
I have left it so long that certain comorbid conditions seem to have been created (subsequently looked into clinical research)..for example I have developed Dupuytren's contracture mainly on my left hand...and surprisingly the collagen plaques seem to be breaking down/dissipating since starting taking levothyroxine...even at the initial inadequate dosage. So the quicker I get heading to a TSH reading of 1 or there abouts..the better to see if the D.P. completely disappears.
...and thank you for the information in regards to the wider implications of private testing, hypothyroidism tailored vitamin intake..all the specific and precise information provided that I can take forward and act upon.
I've found just by taking the dosage I'm on I have energy that I simply haven't had for such a long time , that is propelling me into sorting out my related chronic ongoing health issues.
I've just had the telephone consultation with my GP and took him to task over the blood test results.
I'm not sure who wrote the GP note under the Test results (''Stable subclinical hypothyroidism , suggest annual review'') but it doesn't seem to have been this GP doing the consultation as I immediately barrelled through to 'asking' for an increase in my levothyroxine medication... because my Serum TSH level clearly indicated at 7.6 mu/L that I was way over the 0.3-4.2 recommended range. This GP didn't even metaphorically blink..so presumably had not read the notes/forgotten his own notes.
We then had a bit of a 'discussion' in which he stated he wasn't going to increase my levothyroxine to 100 (from present 50)..because he viewed the serum free T4 level to be 16.4 pmo/L which was far more important than the Serum TSH level...and didn't want me to enter Hyperthyroid range....He begrudgingly upped the dosage to 75 levo during the week and 50 Fri/Sat/Sun.
...and I told him I'd be coming in for another Thyroid Function Test ...he said August...
I didn't even attempt to ask for antibody and Vitamin tests..as we were on the point of loggerheads.
..Kept my calm though.
I'm completely new to all this so would appreciate people's thoughts on his use of Serum free T4 as an indicator and it being 16.4 pmol/L..mid range for the test guidance (12.00-22.00 pmol/L.
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