Arguing with Dr for 40 minutes over ranges, and increasing meds from 75mcg to 100mcg.
Dr told me his final decision is "sertraline" and in other words telling me my symptoms are in my head.
I've had history of PTSD from serving in the armed forces and over seas on operational tours, and I know the difference between "depression" and what's going on physically.
Then again I'm now in self doubt, so hard to deal with all this.
My symptoms are brain fog, drunk feeling, shortness of breath.
Argued saying if it's not thyroid then check all my other levels, antibodies etc.
He won't budge because they've tested everything already, multiple times over the last few months.
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J35U5
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Can you not see someone else? This man is never going to make you well, his head is much too far up his own backside!
Did you ask him if he's a qualified psychiatrist, capable of making psychiatric diagnoses? If he's just a GP, he isn't. And, he's obviously not capable of treating thyroid disorders, either. One wonders what he is good for - apart from looking at his computer screen and writing prescriptions for the wrong drugs!
Don't doubt yourself, doubt him! Your TSH is much too high, which means that one of your Frees is much too low to make you well. Although you haven't given a range for that FT3, and no mention of FT4, which are both essential for evaluating conversion rates. The TSH is probably within the so-called 'normal' range, but, the amazing thing is that this man doesn't know that a truly 'normal' TSH is only around 1, and that hypos need it to be lower. So, can you cut your losses and find a new GP? It's probably the only way to go - apart from self-treating.
What's the range for that TSH test ? I bet 4.3 is barely even within it. When treated with Levo they should ideally be aiming for around 1
Don't doubt yourself....been there , done that, bought the T-shirt....... it just wastes years... until you eventually realise you were right all along and you did know the difference between 'in your head' and in 'how your body is working' ... or rather not working
There is no reason to refuse increase dose with a TSH of 4.3.
Do you have the range for that fT4 test ?
15.1 could either be mid range or top /over range depending on the range used with the test.
If fT4 is well within range then there is absolutely no reason to refuse dose increase.
If fT4 is at top of range that might explain GP reluctance to increase.
P.s. If fT4 is within range, i suggest you ask GP for a reason in writing why he is not willing to increase dose to lower TSH ...... it would be interesting to see his answer , because he'll have to invent one .
sounds like a good plan.fT4 range needed as in..... 15.1 [ ? -? ] some ranges are [12-22] some are [7.9-14] and several others can be used, depends on which machine was used to test sample.
So 15.1 could be over range on one test which would give GP an excuse not to increase dose. But most common ranges go much higher than 15, there's only one that has 14 as upper limit.
ranges come from lab with the test result and are specific to that test. GP will have ranges on record even if they didn't tell you with results.
This is the LIKELY dose of levothyroxine you will need dose increased up to (in 25mcg steps, retesting bloods 6-8 weeks after each dose increase)
Suggest you ask GP to explain why they are NOT following clear guidelines by NICE, BMJ and GP Online on prescribing increase in dose of levothyroxine up to 100mcg.
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.
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.
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