New endo refuses to oversee my care because I want to continue NDT, he only supports Levo, HELP!

[JAE69]

My TSH is 0.18 mU/L & has been since 2009. T3 4.2 pmol/L & T4 11.4 pmol/L (within normal range). My new endo is not happy with the TSH result and uses this as a reason not to prescribe NDT. He states research proves no benefit in taking NDT over Levo and it causes atrial fibrillation. Are these blood results concerning?

Thanks

[greygoose]

I'm afraid you need to give the ranges for those results for us to be able to interpret them. Ranges vary from lab to lab, so we need those that came with your results.

[JAE69 in reply to greygoose]

Thank you for your reply greygooseTaking ERFA Thyroxine Blood results

TSH 0.18mU/L (0.3-4.5normal)

Free Thyroxine 11.4 pmol/L (10.0-22.0 normal R)

Free T3 4.2 pmol/L (3.1-6.6 normal R)

Are these results concerning😜

[greygoose in reply to JAE69]

Not concerning, but I think you're slightly under-medicated. Your FT3 - the most important number - isn't even quite mid-range. Most hypos need it up in the top third of the range.

[diogenes Remembering]

I do like these "experts" plucking certainties out of the air. There is research proving---- (whatever they want to use to justify their decision). If it were me I'd would gently ask "Oh could I have a copy of that?" If the answer is no then I think I would chide the endo for issuing ideas unsupported by evidence. In reality there is evidence that those who need it, like NDT or T3 better than T4, though it doesn't matter for most (but NOT all) patients. And there's no evidence of it causing AF (since it hasn't been used as far as the literature is concerned for a long time). You can't accuse a treatment of being dangerous if there's no papers showing it is.

[shaws Administrator in reply to diogenes]

They do pluck a lot of nonsense from seemingly 'mid air'. Thank goodness we have, on this forum, proper doctors/researchers who aim to restore health .

Just like my GP who phoned to tell me that : TSH is too low. T3 is to high and T4 is too low.

My response to GP. My TSH is low because I take T3 only. T4 is low because I take none.

His response was:- T3 converts to T4. (me - I'm sorry doctor you are wrong).

[JAE69 in reply to shaws]

Excellent reply shaws. It’s so insulting to be quoted wrong info. Thank goodness people like you can defend yourself against the GP’s info 👏

[JAE69 in reply to diogenes]

Thank you for reply diogenes. My endo has passed me onto another Dr, who lectures medical students. I think he’s done that so this Dr can persuade me to take Levo?

[diogenes Remembering]

Also if you want a well written paper that blows apart his ideas about low TSH on therapy here it is:It is downloadable or TUK will have it in their archives.

Thyroid

. 2017 Apr;27(4):484-490. doi: 10.1089/thy.2016.0426. Epub 2017 Feb 6.

Biochemical Markers Reflecting Thyroid Function in Athyreotic Patients on Levothyroxine Monotherapy

Mitsuru Ito 1 , Akira Miyauchi 1 , Mako Hisakado 1 , Waka Yoshioka 1 , Akane Ide 1 , Takumi Kudo 1 , Eijun Nishihara 1 , Minoru Kihara 1 , Yasuhiro Ito 1 , Kaoru Kobayashi 1 , Akihiro Miya 1 , Shuji Fukata 1 , Mitsushige Nishikawa 1 , Hirotoshi Nakamura 1 , Nobuyuki Amino 1

PMID: 28056660 PMCID: PMC5385443

PDF downloadable here researchgate.net/publicatio...

[edited by admin to include PDF link]

[JAE69 in reply to diogenes]

Brilliant I’ll chase this up for my appointment with thes 2nd new Endo Dr.

[shaws Administrator]

I am very sorry to tell you that those 'experts' we rely upon to be truthful and knowledgeable are NOT - I don't mean your Endo but what they have been commanded (in the UK) to do by those who should know better and whom we'd expect to be knowledgeable about all thyroid hormone replacements, from NDT, to T3/T4, and to T3 alone.

NDTs have been withdrawn - even though they were the very first replacement hormones that saved lives from 1892 and onwards - without the need for blood tests at all. The expertise of the doctors were all that was required, i.e. they know the clinical symptoms and diagnosed due to symptoms.

The majority of whom we imagine are knowledgeable, seem to have failed at the last post. i.e. they have to follow guidelines which are supposed to be made by 'experts' but seem to be made by non-experts at all. The information they issue could be accepted if it made sufferers well again but, unfortunately, the opposite happens and the patient is most probably prescribed antidepressants rather than having their FT4 and FT3s checked.

[JAE69 in reply to shaws]

I quite agree shaws

[serenfach]

Have a read of these too, and throw the titles at the Endo -

In one of the only studies comparing desiccated thyroid extract to levothyroxine, doctors from Walter Reed National Military Medical Center in Bethesda, MD, compared the results when 70 people with hypothyroidism took each medication for 16 weeks. Afterward, 49% said they preferred the extract, 18% preferred levothyroxine and 33% had no preference. “Patients who preferred DTE [desiccated thyroid extract] lost approximately 4 pounds …compared with L-T4 treatment. In addition, their general well-being and thyroid symptoms were significantly better,” the researchers report.

And in a 2014 study in the Journal of Endocrinology, Diabetes & Obesity of 154 women and men who didn’t feel better while taking levothyroxine, 78% who switched to a thyroid extract said they preferred it. Side effects were minor.

. “The discovery of thyroid replacement therapy. Part 1: In the beginning.” Slater S. Journal of the Royal Society of Medicine, 2011: 104: 15–18. URL: ncbi.nlm.nih.gov/pmc/articl...

Being over or underdosed can cause atrial fibrillation no matter what thyroid drug you take. Remind him people with thyroid problems did well on NDT for over 100 years, before they made Thyroxine.