latest Bloods

[skinner44]

My latest bloods they haven't done T3, I'm still symptomatic Dr told me it wasn't my Thyroid it was neuropathy . Advise would be much appreciated I have attached screenshot of blood results. It will only allow 1 photo so should any other results be required please advise. Many thanks

TSH 3.5 (0.27-4.5) T4 16.1 (11-23)

[skinner44]

Calcium results

Calcium results

[Lalatoot]

The advice that SlowDragon gave you a month ago is still relevant. You are undermedicated and need an increase in thyroxine and vitamin levels need to be improved.

[SlowDragon Administrator]

See different GP and insist on 25mcg dose increase in levothyroxine

Vitamin levels are low BECAUSE you are under under medicated

TSH should be under 2 as an absolute maximum when on levothyroxine

gponline.com/endocrinology-...

Replacement therapy with levothyroxine should be initiated in all patients to achieve a TSH level of 0.5-2.0pmol/L.

NHS England Liothyronine guidelines July 2019 clearly state on page 13 that TSH should be between 0.4-1.5 when OPTIMALLY treated with just Levothyroxine

Note that it says test should be in morning BEFORE taking levothyroxine

Also to test vitamin D, folate, B12 and ferritin

sps.nhs.uk/wp-content/uploa...

Aim is to bring a TSH under 2.5

UK guidance suggests aiming for a TSH of 0.5–2.5

gp-update.co.uk/SM4/Mutable...

Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine

Which brand of levothyroxine are you currently taking

Essential to regularly retest vitamin D, folate, ferritin and B12

B12, folate and ferritin all too low

[skinner44 in reply to SlowDragon]

Thank you, I'm on Accord

[SlowDragon Administrator in reply to skinner44]

So when increasing to 75mcg ….Accord don’t make 25mcg tablets

Request higher number of 50mcg tablets per month and cut a 50mcg tablet in half to get 25mcg dose

[SlowDragon Administrator in reply to skinner44]

Get bloods retested 6-8 weeks after dose levothyroxine is increased to 75mcg,

Always test as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test

You may need further increase in levothyroxine after next test

[skinner44 in reply to SlowDragon]

I have written everything down you have said, this will be my 3rd attempt to get dose increased. If they refuse this time I really don't know what else to do. I always have blood done 1st thing and fast before hand. Thank you for your wealth of knowledge.

[SlowDragon Administrator in reply to skinner44]

If GP won’t increase dose you will need to go over their head and see thyroid specialist endocrinologist

[skinner44 in reply to SlowDragon]

Just to say thank you for your advise. Seen the Dr this morning it was a different one to who I have seen previously. After he tried the are you depressed which was like a red rag to a bull. Which is when the notepad got opened and I started spouting off.....he replied I think you definitely need an increase 😊. He initially said increase to 75 then he said 100 but went back to 75 for now and bloods in 6 weeks. I huge sigh of relief, feel like the battle is over and I can start to feel human again 🤞.

[SlowDragon Administrator in reply to skinner44]

Great…..make sure you get same brand levothyroxine

Or if you got 25mcg extra tablets, suggest you get Mercury Pharma brand or Wockhardt

Avoid/refuse Teva

Come back with new post once you get results after 6-8 weeks

Likely to need further increase over coming months

Meanwhile working on improving low vitamin levels is essential too

[JAmanda in reply to skinner44]

I’d just start taking the extra 25 then when you next see the doc you can say ‘we’ll I was feeling so poorly I experimented and the results you see are me on the higher dose’ and if you’re not over range on t4 they can’t much complain. But in your case I think your doc is keeping you ill and I’d say that to the surgery manager and see if you can see a different one there. If not move surgeries and if that’s too hard buy your own Levo and manage your condition yourself like many on here do. I’d definitely get private tests of tsh t4 and T3 beforehand so you know the full picture. I’m sorry it’s not easy and a bit of a fight for many on here but you’ll get support here and can definitely feel better than you are right now. If do will send you to an Endo that also might help but these things take time - I’d self increase before you see them! I did this repeatedly! Lots of options - none super simple - if only we all had lovely docs. Good luck

[Pastelart in reply to skinner44]

I had the same problem, and, as advised on this forum, I emailed my doctor with the results of test done by monitor my health and a screenshot of Dr Toft’s guidelines and she increased my dose without question.

[SlowDragon Administrator]

Have you started on vitamin B complex and separate B12 supplements

GP should be doing full iron panel test for anaemia now ferritin is below 30

cks.nice.org.uk/topics/anae...

In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency.

You need vitamin D and thyroid antibodies tested

[skinner44 in reply to SlowDragon]

Vit D is 82

[SlowDragon Administrator in reply to skinner44]

So pretty good

Do you supplement

Might be better around 100nmol

[skinner44 in reply to SlowDragon]

No I got told to stop!

[buddy99]

Looks like the doctor is confusing cause and effect. "Peripheral neuropathy has a variety of systemic, metabolic, and toxic causes. The most common treatable causes include diabetes mellitus, hypothyroidism, and nutritional deficiencies." pubmed.ncbi.nlm.nih.gov/203... I would change doctors if at all possible.