So following on from my test results, I’ve had a telephone consultation with my doctor. He questioned me as to why my Vit D and folate had been tested? I re-lies that from the little I knew these were signals towards an under active thyroid
He then questioned why was in pain with my neck as thyroid issues never cause pain.
He now wants to do his own set of blood tests.
He doesn't sound as if he knows much about thyroid disease and the comment about thyroid disease not causing a pain in your neck speaks volumes. I presume he will just test the TSH and nothing else when you really need a full thyroid function test which means TSH, T4, T3 and antibodies. You also need an ultrasound of your thyroid if you are in pain because you could have a goiter like me. Just to add my goiter sometimes feels painful and I can choke on food if am not careful.
It’s just all depressing that you need to fight so much for help
Sounds clueless
When are these blood tests being done....ASAP?
GP’s can be awkward and want to run tests themselves
Your vitamin D is extremely deficient
You need LOADING dose prescription
B12 and folate very low
Have you started on levothyroxine yet?
Yes I’m on 50mcg dosage. The bloods are being done on Monday and then I’m speaking to him after that.
So make sure to get blood test as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test
Hypothyroidism is more common after breast cancer treatment and breast cancer may be slightly more common if we have Hashimoto’s
pubmed.ncbi.nlm.nih.gov/53602/
thyroid.org/patient-thyroid...
When was Hypothyroidism diagnosed, before or after breast cancer?
Your vitamin levels are terrible because you are extremely under medicated for Hashimoto’s
50mcg is only a starter dose
Bloods should be retested 6-8 weeks after EACH Dose increase
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.
nhs.uk/medicines/levothyrox...
All four vitamins need to be optimal
Even if frequently we don’t start on full replacement dose of levothyroxine, most people need to increase dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until on full replacement dose
NICE guidelines on full replacement dose
nice.org.uk/guidance/ng145/...
1.3.6
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.
gp-update.co.uk/Latest-Upda...
Traditionally we have tended to start patients on a low dose of levothyroxine and titrate it up over a period of months. RCT evidence suggests that for the majority of patients this is not necessary and may waste resources.
For patients aged >60y or with ischaemic heart disease, start levothyroxine at 25–50μg daily and titrate up every 3 to 6 weeks as tolerated.
For ALL other patients start at full replacement dose. For most this will equate to 1.6 μg/kg/day (approximately 100μg for a 60kg woman and 125μg for a 75kg man).
If you are starting treatment for subclinical hypothyroidism, this article advises starting at a dose close to the full treatment dose on the basis that it is difficult to assess symptom response unless a therapeutic dose has been trialled.
A small Dutch double-blind cross-over study (ArchIntMed 2010;170:1996) demonstrated that night time rather than morning dosing improved TSH suppression and free T4 measurements, but made no difference to subjective wellbeing. It is reasonable to take levothyroxine at night rather than in the morning, especially for individuals who do not eat late at night.
BMJ also clear on dose required
bestpractice.bmj.com/topics...
Ask/insist on ultrasound scan of thyroid too
Thank you. I had a double mastectomy and reconstruction two years ago so that makes sense. I was diagnosed afterwards. About 6 months ago in fact
It just so pisses me off that you have to fight this battle. I was misdiagnosed with my breast cancer and 18 months later- whoops!
I don't think you need a whole day off to miss out on 'the thyroid knowledge' Scrumbler, maybe he just popped out for a fag ?
Class 😂😂
Feeling confused 
What a difference a day makes (and a change of GP surgeries)
Confused and angry .
