Gp rang me this evening as ecg done on Monday shows some small anomalies. Is concerned by my constant high heart rate and obviously my low tsh 0.12 (0.35-5.50) despite my t4 being completely normal 15.2(10.0-20.0) and t3 not tested. I have agreed to go on a beta blocker but not propranolol and he has said he will put me on metropolol 50 mg x3 daily and reduce my levo from 100mcg to 87.5 mcg daily.
When I pick up prescription need to make sure all 3 levo tablets (50mcg 25mcg and 12.5mcg ) are same brand and definitely NOT Teva. I explained that I don't want to take anything that's going to affect my conversion, so will give it a try and they've said they'll retest thyroid in 8 weeks. If the metropolol makes my hear rate really low or has bad side effects, I will make sure the GP is aware. I must admit to being quite apprehensive as having read the side effects, I'm worried they might make my depression really bad again and as I'm sure you're all aware beta blockers are used quite routinely in the treatment of hyperthyroidism and can cause bronchospasm which would be bad for someone with copd and believe it or not the doctor had to ask me was I asthmatic, just shows, he really read my history NOT.
Sorry for long post, just worried about what might happen, anyone had similar issues, your advice and support, greatly appreciated.
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sobs1962
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Oh no!, I have a pillmate pill cutter but it's not very accurate so can't guarantee, I'll get the right dose each time, might not make much difference though. Any tips, as I really don't want to take Teva unless its absolutely necessary and maybe I just thought it was the Teva that was giving me palpitations, dizziness and nausea, but don't want to risk it as wouldn't know if it was the Teva or the metropolol as they both have similar side effects.
It doesn't matter if the halves are unequal. You can also take a 25 mcg tablet on alternate days instead of half a tablet daily. More simply, 100 mcg one day 75 mcg the next day will give you 87.5 mcg daily. You hormone levels will be stable due to the long half life of levothyroxine.
Personally I would not take a beta blocker. I have a high heart rate (consequences of sucessful cancer treatment) they tried several beta blockers.......they all did the same thing lower the conversion rate of thyroid hormones.......not a great plan if you suffer with hypothyroidism. The solution was to go onto a calcium channel blocker. I felt terrible on beta blockers -never again!'
I'm the opposite, fine on beta blocker and no problem with conversion but changed to calcium channel blocker and I don't feel good, I will happily change back to my beta blocker.
Could the heart issue be low T3? I’d stay on current dose and get private test of t4 T3 and tsh to get full picture before changing any meds. It’s possible you need more meds not less.
Problem is, doctors are so obsessed with tsh measurement that they cannot see what is staring then in the face. Will do what they've asked me to do but if not well I will hopefully have proved my pointHonestly they just think they know it all but it is us the patients that are so much more knowledgeable, after all we have the disease, not them.
You’ll see many postson here and replies from people who’ve taken matters into their own hands and tested privately becaus, exactly as you say, some docs are tsh mad. Hope you get well soon.
I went the private testing route that included t3 & it did make my doctor take notice. I think it was a way of reinforcing how poorly I & that I had been desperate to feel well.
I agree with you about private testing but some doctors won't take any notice of private blood tests as presume they haven't been done properly or simply that they know everything and we the patients, no nothing. It's so frustrating and they just think that they're superior to us and that's the reason they don't explain things, because we haven't got the intelligence to understand medical terminology or the diseases we suffer from.
I found printing out thyroid UK’s information helped as did taking someone with me to appointments,but not so easy in the current situation. The brain fog made it impossible to process what was being said.
Lots of good advice here especially getting print outs of blood tests. The folk here are excellent & will help you understand them.
I would ask for a print out of your heart test so you can see what the problems are. You need t3 testing. Also ask to see a cardiologist if t3 is ok. What is your BP? Have you had adrenal testing?
Don't know if I'd understand them even if they did and had adrenal function tested last May Se 9am cortisol conc 249nmol/L(200-500nmol/L) blood pressure 11/08/21 115/70 much lower then previous results which were 130/80 and 140/80 so don't know if that's good or bad, think ideal blood pressure is 120/80. If want t3 tested will have to do it through monitormy health again but shouldn't have to as NHS should do their job properly.
Are you sure you want to reduce levo when free T4 is already only a pretty feeble 32% through range? I wouldn't feel well with it so low. I understand your TSH is low - so is mine, and has been for years now - but in my experience a small reduction in levo doesn't do anything to change TSH anyway, it just lowers free T4 ...
At the very least, I'd want free T3 checking before making such a big decision, as if both "frees" are already low, I'd really not want to reduce meds, but rather be looking at an increase. Many of us need free T4 and free T3 to be at least 2/3 through range, and often higher, rather than down in the lower third
Very unlikely to happen as they're apparently told not to request t3 testing as I think they know it may mean they may have to consider prescribing t3 and as it's ludicrously expensive they don't want to do that and are happy to continue to let us all suffer and feel so ill.
I test my own all the time. I don't care what blood tests the GP does. I now use Monitor My Health as it's the cheapest test kit and it's an NHS lab that processes it.
Personally I would not be reducing my Levo if I were you. Your level is not high enough. You will just feel worse and it takes time to come back up.
How high is your heart rate? Anything up to 100 beats per minute is still in the "normal" range. I have an arrhythmia which gives me a high rate well over 100 so I take the lowest dose of BB I can get away with and live with my HR in the 90's. I'd like it lower, but I won't increase it as my conversion is terrible and even though I have some T3, I'm still low in results and feel tired enough as a result.
According to last week's test results 90 but between 80 and 120 so I think they're panicking unnecessarily, however this week's ecg has shown some small anomalies in my heart, so hopefully it'll all get sorted. I'm not allowing them to destroy my thyroid with their actions though, but the problem is that they tend not to listen and think they know best.
My experience of cardiologists is that they don't know anything about thyroid or it's medications. Don't let them reduce your dose because of a low TSH. Insist on T3 being tested. I hope you get it sorted.
I've decided to go along with them and if I have to make myself really ill in order to get my point across, then that's what I'll do, I've always been the kind of person who cut their nose to spite their face, but that's mostly because of my bpd, but they're not taking that into account, are they? They should try looking at the whole picture, not just bits of it.
Your GP might not want to test your T3, sobs1962, but this doesn’t stop you from getting a test and, if the nhs are unwilling to prescribe T3, your getting the medication yourself. Your health is to some extent in your hands.
I have a similar request right now at the surgery. I need an irregular dose 88mcg like you cannot take TEVA. So requested oral Levo, I am informed this is expensive but I can and they have applied to CCG on my behalf...fingers crossed. It may be worth the go? My USA friends have this and I am frankly sick of begging for decent drugs in the 5th richest nation on planet earth...this has to change!!!
Yes, it's an absolute disgrace and the government need to step up and bring in legislation that prevents companies ripping off the NHS, as a result, it's us the poor patients who ultimately pay.
Beta blockers may reduce your heart rate and blood pressure a bit too much, but I was told when I was prescribed Bisoprolol that I had to take it every day.
Well, I couldn't keep it up! Within just a few days it lowered my heart rate to less than 50 beats per minute and reduced my BP to something like 90/45.
I live on a hill and really struggled to make it to my nearest bus stop, which previous to the BBs had caused me no problem at all.
The first thing I did was to cut my dose in half (without telling my doctor, I must admit, just in case I needed to go back to my prescribed dose for some reason).
I still had problems with a half dose each day so I started taking a half dose just when my heart rate got too high for comfort, which in my case is over 90 or 100. But I have read of some people who get uncomfortable with a much lower heart rate than that, so it must be a personal thing.
I have found that if I take BBs for several day on the trot (which is rare) that I have to slowly reduce my dose lower again. My heart adapts to BBs and my HR can go a bit crazy if I stop them suddenly. So, for me, I always have to make changes slowly.
I stayed on BBs at "half dose when necessary" for 6 or 7 years. Then I realised my problem was getting rather worse just before the pandemic and I started taking "whole dose when necessary". My surgery doesn't appear to have noticed that I am ordering them a lot more often now. (It's on repeat.)
Note for future reference... Low iron is commonly associated with palpitations and tachycardia. It was tachycardia that required me to start taking beta blockers in the first place. My iron was in my boots at the time, but I fixed that myself. It took me a long time, but at least I don't get chest pain any more.
Propranolol will block conversion of T4 to T3. The higher the dose, the greater the block. Metoprolol only has a minimal T4 → T3 blocking effect, even at high doses. Beta blockers also block melatonin production so if you begin to have sleep issues, that may be the cause. Metoprolol is a beta 1 receptor antagonist, which means it has little effect on the lungs, as they primarily contain beta 2 receptors. Propranolol is non-specific so it WILL affect the lungs.
Well that's reassuring, have messaged the GP practice to say I will take 100mcg and 75mcg on alternate days as jimh111 suggested as this seems the best solution as cannot take teva. Hope the metropolol doesn't reduce my heart rate drastically, however, I doubt it as Propranolol didn't have that effect, it slowed it down but not drastically and as I'm virtually constantly stressed due to my bpd and if metropolol can protect my heart in some way, so much the better. All trial and error dr wants bloods repeated in 8 weeks andI will do my best to get them to test ft3 so they can see what my conversion is like. Wish me luck with it all, I'll need it.
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