Is thyroxin a lot more expensive than depressio... - Thyroid UK

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Is thyroxin a lot more expensive than depression medicine.

richie296 profile image

Taking 150mcg thyroxine at present. Age 68 12 stone 5ft 8" My recent tsh result is 0.61 m1U/L (0.3-4.5) I have felt fatigued, can sleep 15 hours a day, upset stomach, and a little fuzzy headed feeling as if I have headphones on pressing just above my ears. I have felt like this for over 18 months just put up with it as doctor will only prescribe depression medication. To which I refuse to take. Had severe problems with thyroid undiagnosed 2 years through an ignorant doctor who took my blood pressure and pulse and said I was perfectly healthy after telling him my symptoms to now I know are thyroid related. Thyroid problems 15 years now was on 150mcg for most of the time then increased to 175mcg 3 years ago during that 18months on 175mcg I had never felt better then it was reduced to 150 mcg again 18 months ago hence my problems now. Doctor says they don't want me to go overactive. I have asked if I can take 175mcg And 150mcg alternate days. They refuse. I have asked for more tests but told they are following gov guidelines and that's that. Any advice would be appreciated. Richie

12 Replies
SeasideSusie profile image
SeasideSusieAdministrator

richie296

Presumably only TSH is being tested?

If so that doesn't give a picture of our thyroid status. TSH is a pituitary hormone, not a thyroid hormone, it's FT4 andFT3 that are the thyroid hormones and tell us whether we are optimally medicated, FT3 being the most important. Low T3 causes symptoms regardless of how high FT4 is.

The fact that you are fatigued and need so much sleep can suggest that you are undermedicated, regardless of your TSH. I expect if TSH, FT4 and FT3 were tested your FT4 might be at a reasonable level but I expect your FT3 will be too low.

Fatigue can also be low ferritin or iron deficiency or deficiencies in key nutrients so it's worth testing

Vit D

B12

Folate

Ferritin or iron panel

It doesn't sound as though your GP is going to be helpful with these tests - and he could do them if he wants to, he is making it up about the guidelines - but you can do these yourself and that's what I suggest you do.

Looking back at your posts from 2 years ago, this was all discussed then.

You also posted your Vit D result which was 33nmol/L I asked you at the time what dose of D3 your GP had prescribed and mentioned that important cofactors were needed and that I would further advise if you came back with your D3 dose. I also asked about your results for B12 and whether or not your ferritin and folate had been tested. You never responded to any of the questions or suggestions that SlowDragon and I made.

I expect Levo is cheaper than antidepressants.

Thankyou for your reply. To my knowledge D3 was never mentioned by the doctor and I wasn't prescribed D3. I cannot recall reading any reply on this site regarding D3 it's the first I have heard it mentioned.I was told low in b12 to which I was told to purchase over the counter to which I did and it did help. I read a lot of the Posts and replies on this site and find it very useful. But approaching a doctor with the comments just draws a blank. May as well bang your head against a brick wall. Cheers richie

SeasideSusie profile image
SeasideSusieAdministrator in reply to richie296

richie296

Here is your post from 2 years ago where you stated

Doctor advised vitamin d sups been taking 6 weeks.

healthunlocked.com/thyroidu...

and my response was

"Doctor advised vitamin d sups been taking 6 weeks."

What dose D3 has your GP suggested (presumably not prescribed)? What exactly are you taking? D3 has important cofactors. Please say what you are taking so that further advice can be given.

Sorry must be a spelling mistake. It was definitely b12 to which I am still taking now. I have never been prescribed or taken anything other than thyroxin. Or advised to take anything other b12 tablets to which I purchase from chemist. Thank you for your reply. Richie

SeasideSusie profile image
SeasideSusieAdministrator in reply to richie296

You did mention B12 separately

Doctor advised vitamin d sups been taking 6 weeks. I still complained advised vit b12 been taking for 7-10 days.

so it looks like you were definitely talking about the two separate things, taking Vit D for 6 weeks and B12 for 7-10 days.

My response about your B12 was

What was your test result for B12? Presumably self supplementing? What are you taking? Are you taking B12 plus a B Complex to balance all the vitamins?

As I said, you never came back with answers to any questions.

I am wrong. My wife just hit me on the head with the plastic container D3. She has it in her bag to replenish. Ps I have been taking them daily alongside b12 daily, multivitiman tablets and cod liver oil capsules. I am going to blame thyroids for the confusion on my behalf I might add. Thankyou richie

SeasideSusie profile image
SeasideSusieAdministrator in reply to richie296

OK, so I think the best thing to do is get full thyroid and vitamin testing. You need up to date levels for your nutrients, if necessary adjusting dose to achieve optimal levels. Nutrients are best tested once a year.

Also do the full thyroid testing so we can see where your levels are and provide you with some evidence, if necessary, to take to your GP.

Best tests are

Medichecks ADVANCED THYROID FUNCTION medichecks.com/products/adv...

Check this page for details of any discounts: thyroiduk.org/getting-a-dia...

or

Blue Horizon Thyroid PREMIUM GOLD bluehorizonbloodtests.co.uk...

Check this page for discount code thyroiduk.org/getting-a-dia...

Both can be done by fingerprick at home or if you prefer to arrange venous blood draw this will cost extra. If you want to do the fingerprick test I can provide tips to try to ensure the best outcome, just ask.

As for your supplements, multivitamins aren't recommended here. They contain too little of anything to help low levels or deficiencies, tend to contain the cheapest, wrong form and least absorbable forms of the active ingredients. They also often contain things we need to test first before considering supplementing, eg iron, calcium, iodine. When they contain iron this affects the absorption of everything else as iron needs to be taken 2 huors away from all other supplements. If the contain Vit C and B12 again this is a problem, Vit C keeps the body from using B12 so they must be taken 2 hours apart.

Just for info:

Supermarket and high street brands are generally low quality. Best brands are generally found on the internet. We are always happy to make suggestions.

D3 tablets are poorly absorbed. Best D3 supplements are oil based softgels, the oil aids absorption, they are pure and tend to contain no excipients other than the oil. Any other form of D3 needs to be taken with dietary fat (cheese, full fat yogurt, or the fattiest meal of the day. Oral spray D3 is OK but has lots of excipients.

When taking D3, we need magnesium and Vit K2-MK7. D3 aids absorption of calcium from food and Vit K2-MK7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems such as hardening of the arteries, kidney stones, etc. K2 is also fat soluble and needs fat to be absorbed. Magnesium helps D3 to work. We need magnesium so that the body utilises D3, it's required to convert Vit D into it's active form, and large doses of D3 can induce depletion of magnesium. So it's important we ensure we take magnesium when supplementing with D3.

When taking B12 we need to also take a good quality, bioavailable B Complex to keep all the B vitamins balanced.

Cod liver oil tends to have a high dose of Vit A and low dose of Vit D. Both of these are fat soluble vitamins and excess is stored rather than excreted. We have to be mindful of too much Vit A leading to toxicity.

PS - I hope your head doesn't hurt too much :)

shaws profile image
shawsAdministrator

Welcome to our forum richie296.

On your personal page you've only given your name. I would copy and paste the above and put it into your 'page'. This will enable members, in future, to look on your 'page' so that you don't need to answer the same question often and they will also have some knowledge of your background..

When we give results, also post the ranges. The reason for the ranges is that labs use different machines and may have different ranges. The ranges enable members to respond.

Ask GP to test both Free T4 and Free T3 - both should be optimal - but many doctors seem to think if they are 'somewhere' in the range we're on a sufficient dose. Some may not test them but there's private labs that do home pin-prick tests.

Levothyroxine (T4) is an inactive hormone and is supposed to convert to T3 (liothyronine)

Liothyronine (T3) is the 'active thyroid hormone' and is needed in all of our millions of T3 receptor cells. Brain and heart contain the most.

You could tell your GP that T3 can also be prescribed for 'depression' as it is more probable that you cannot convert T4 to sufficient T3.

Always get your blood test for thyroid hormones at the very earliest (even if you have to make it weeks ahead) and allow a gap of 24 hours between last dose of thyroid hormones and the test and take it after blood draw.

Also request B12, Vit D, iron, ferritin and folate too as everything has to be optimum.

Put your results on a new post.

I also state I'm not medically qualified but had to diagnose myself, two hours after GP phoned to tell me my blood test results were fine (this was before being diagnosed but quite unwell). I cried but you can click on my name, if you wish, as I've put my journey into my page.

I am now well.

helvella profile image
helvellaAdministrator

As a very direct answer to your subject line question: No.

Levothyroxine is a pretty inexpensive medicine. You can follow the link below to see the current NHS costs for it:

bnf.nice.org.uk/medicinal-f...

As a comparison, Citalopram:

bnf.nice.org.uk/medicinal-f...

Or Fluoxetine (Prozac):

bnf.nice.org.uk/medicinal-f...

As Helvella said, but I think GPs get funding points for prescribing anti-depressants (mental health) but they get nothing extra for thyroid patients

SlowDragon profile image
SlowDragonAdministrator

Do you always get same brand levothyroxine at each prescription

If not you should do

Which brand of levothyroxine are you currently taking

Do you always take levothyroxine on empty stomach and then nothing apart from water for at least an hour after

No other medications or supplements within 2 hours

No vitamin D within 4 hours

Strongly recommend getting full thyroid and vitamin testing done

Just testing TSH is completely inadequate

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested.

Also EXTREMELY important to test folate, ferritin and B12 at least annually

When supplementing vitamin D, retest twice year

Low vitamin levels are extremely common, especially with autoimmune thyroid disease (Hashimoto’s or Ord’s thyroiditis)

About 90% of primary hypothyroidism is autoimmune thyroid disease

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)

Is this how you do your tests?

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

List of private testing options

thyroiduk.org/getting-a-dia...

If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off down to £26.10 if go on thyroid uk for code thyroiduk.org/getting-a-dia...

monitormyhealth.org.uk/

NHS easy postal kit vitamin D test £29 via

vitamindtest.org.uk

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins by DIY fingerprick test

bluehorizonbloodtests.co.uk...

Thriva Thyroid plus antibodies and vitamins By DIY fingerpick test

thriva.co/tests/thyroid-test

Come back with new post once you get results

SlowDragon profile image
SlowDragonAdministrator

gov.uk/drug-safety-update/l...

If a patient reports persistent symptoms when switching between different levothyroxine tablet formulations, consider consistently prescribing a specific product known to be well tolerated by the patient. If symptoms or poor control of thyroid function persist (despite adhering to a specific product), consider prescribing levothyroxine in an oral solution formulation.

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