Ask GP for an increase. As we all know we expect doctors to know more than us, but sometimes they do not. Doctors seem to put all the emphasise on the TSH alone. We also know that, for those of us with hypo, that is insufficient.
As you do not have a print-out yet of the last blood tests it might be difficult to respond but we learn as we go along but members are willing and the majority are very helpful.
If our TSH is low they jump to the 'assumption' that we're becoming hyperthyroid but we're not.
Tell GP you've are now a member of from Healthunlocked Thyroiduk and the recommendation is for the TSH to be 1 or lower (and NO you will not become hypERactive as many doctors seem to think) with FT4 and FT3 that should be in the upper part of the ranges (they rarely test both Frees and the results of these are more informative than T4 and T3.)
You can also tell the GP you are aware you have the commonest form of hypothyroidism because there is antibodies in your blood and it is called Hashimoto's. I doubt GP will know very much as they seem to believe that if the 'TSH is "somewhere' within the range that the person is on a sufficient dose.
You are also aware that you have Hashimoto's and that the antibodies wax/wane until you are hypothyroid.
As SeasideSusie has mentioned, you actually need a print-out of results along with the 'ranges'.
Labs differ in their machines and so do the ranges unfortunatley but in order to give as accurate a response the ranges are important.
I am aware GP may not have done so but tell your GP that you need a Full Thyroid Blood test and that is TSH, T4, T3, Free T4 and Free T3 athough 'FT4 and FT3 - 'free t4 and 'free t3' to enable members to respond. You can get a home blood test and there are several labs as I believe GPs will not test all of them.
It is a big learning curve I'm afraid but don't be disapointponded as you are both suffering with the same autoimmune disease. I had to diagnose myself after GP phoned to tell me I had nothing wrong with me due to the blood test. He failed to acknowledge that my TSH was 100. So, in fact, I had to diagnose myself but Thyroiduk and now with this forum, we are able to help others reach a place where their symptoms will resolve and they feel well again.
Thyroid hormones run our whole metabolism, from head to toe and we need T3 (liothyronine and the active thyroid hormone needed in our T3 receptor cells (converted from T4 - levothyroxine).
To help reduce the antibodies in your blood going gluten-free for a while may be helpful.
p.s. I typed the wrong word above and I have now changed it to 'If our TSH is low they jump to the 'assumption' that we're becoming hyperthyroid but we're not.'
As the dose is slowly increased FT4 and FT3 should increase and clinical symptoms resolve.
This is a quote re Liothyronine as levothyroxine is usually the only prescribed medication for those who're hypothyroid. Millions seem to do o.k. on levo but there is a section of society that cannot on T4 (levo) alone. I am one of them.
I must state I'm not medically qualified but, like many on this forum, we eventually learn more than the majority of GPs. I will not repeat what one GP told me and I said 'I'm sorry doctor but that is not the case'. He was so completely wrong so couldn't carry on with the conversation.
I've just read the following and the majority of GPs don't really understand much about hypo or hyper thyroidism except to keep the TSH ' somewhere in range. i.e. T4 and T3 are prominent hormones.
T4 (levothyroxine) being inactive and has to convert to T3 (liothyronine) being the Active hormone .
"Liothyronine Sodium Tablets (T3) are a form of thyroxine which is quick acting and long lasting.
Thyroxine (T4) is a hormone produced by the thyroid gland in the neck which controls many body functions
I am not to sure about the statement about T3 although it states 'a form of thyroxine' and that it is 'long lasting' but compared to levothyroxine (and I am not medically qualified) it is not long-lasting compared to T4. I have found that my one dose of T3 lasted about three days altogether and I didn't want to prolong my experiment. The most important is that I feel well, I feel I have normal health and symptom-free.
Can you post your latest blood results (and lab ranges) so we can make specific suggestions, please? Just being "in range" isn't good enough - you both want "optimal" - but it's difficult to go further without the actual results
But to answer your other question - no, you're not alone. It's not impressive just how little GPs (and most endos) know about thyroid, esp given that levo is the third most prescribed medication in the UK
But to answer your other question - no, you're not alone. It's not impressive just how little GPs (and most endos) know about thyroid, esp given that levo is the third most prescribed medication in the UK
That’s my point it’s getting me down keeping on to them.
My wife will not say anything to the doctor
So I’m trying for the two of us.
They disregard everything I say!.
And I know I will have a hard time again tomorrow.
We can’t sit in front of them because of covid I’m in South Wales.
I can’t show them anything or links grr!
They just say you are in range and dig in
It’s depressing me thinking about it again.
I understand you need to be optimal
But I need help with telling my doctor about this.
How can I achieve this with out them playing up all the time
Hi, I had a similar problem to you regarding trying to get a dose increase, and I received this reply from a helpful member several years ago,
TSH of people on medication is usually comfortable just above or below 1.0 with FT4 in or towards the top 75% of range ie 19.0. Scroll down to Guidelines and Treatment Options to read Dr. A. Toft's comments in Pulse Magazine thyroiduk.org.uk/tuk/about_... If you want a copy of the full article to show your GP when you ask for a dose increase email louise.warvill@thyroiduk.org.uk
I did print of the letter and showed it to me GP, you could always see if you could email it to GP or post it to the surgery. After my very reluctant GP read it, he upped my dose. So its worth a try. Fingers crossed you both get the help you need. I don't know if Louise still on the site, but if you have trouble finding article, put Dr Tofts name in the search bar on this site.
Its frustrating and makes me angry! Why do they insist on underdosing us? It is easier to get it out of the body than put it in! Do they think we are going to explode in great red blobs if we go up a dose?
As a suggestion, ask for a trial at a higher dose. This implies it is a tempory thing to the GP and they are more willing to do a short term thing. They then forget it is a trial and congratulate themselves when you feel better.
Or say you have been reading up on the subject, and would like to add T3 for you both. This will put the fear of God in him, so it looks like upping your T4 is a simple step.
Or go full out monster and tell him you are going to start taking NDT and would like a prescription for that. He wont do that of course, but by now a simple increase in T4 looks like an easy solution.
We should not have to play mind games - sigh! There is also the push for the patient and practitioner to "work in partnership", with us poor souls taking responsibility for our own health. This is fine until we do it, then the medical profession throws a hissy fit.
Good luck, and I hope it goes OK. Hug to both you and your wife.
South Wales here as well and my treatment with more than one gp over the years has been dire so I don’t think it’s just yours. Even to the point of an endocrinologist phoning me at 7.30pm one night and telling me to change my doctors. Next one was almost as bad though. Good luck for tomorrow and when they say your in range ask who’s range that might be as it’s made up of a lot of peoples results and yours must be in a different place to whoever provided that particular one. Be firm but fearless.
I’m so sorry. Can you request their objections in writing maybe. They could even realise while writing how idiotic they sound. Ask for their decision in writing. More than one way to skin a cat. Good luck
My gp are doing face to face now but has to be something that simply can’t be done over phone. I don’t go if I can possibly help it as I find them next to useless. Last time I spoke to one was when I phoned to book my b12 jab beginning of pandemic and they said I would have to go on tablets. I told them not to bother sending prescription as I would self inject. They ended up giving me my jab in the car park. When you request the decision and reasoning writing do it in a letter and ask for it to be added to your medical records. Have you had private bloods don (can’t remember sorry) if not I would get some done. Monitor my health do basic Tsh ft3 and ft4 for £29 or £26 with thyroid uk discount. We also have a fb thyroid group in wales if you want to join. Called thyroid Warriors wales. Look it up and you would be welcome. X
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