Thyroxine change?

[Newlou]

Hi I have had Hashimotos for many years now and lately I've been feeling a bit off. Doc tested all bloods (glucose was low, second test said it was fine? However now she wants to reduce my thyroxine from 125 to 100 for six week. I'm really not convinced I should.. TSH is 0.02 and T4 is 20.9.

I couldn't get to speak to her this was receptionist. Any idea if this sounds right?

[helvella Administrator]

Why slash your dose by 20%?

I'd much prefer the gentlest possible reduction, if a reduction is even appropriate.

See Fine Dose Adjustment in my document. It suggests how a much smoother path of dose change can be achieved.

helvella - Vade Mecum for Thyroid

The term vade mecum means:

1. A referential book such as a handbook or manual.

2. A useful object, constantly carried on one’s person.

Currently has the following sections:

Abbreviations and Acronyms

Alerts Amino Acids Antibodies Elements

Famous People with Thyroid Disease

Fine Dose Adjustment

Hydration: Anhydrous vs. Pentahydrate

Human Hormones

Iodine Content of Thyroid Hormones

Medicine Classifications

Pathology Handbooks

Pharma Contacts

Pharmacy Locations

Prescription Latin

Serious Shortage Protocol (SSP)

Tests (Summary)

Tests – LabTestsOnline

Thyroid Binding Proteins

Thyroid Diseases, Disorders and Syndromes

Thyroid Hormones

Thyroid Hormone Ratios

Thyroid Medicines

Units – Grams, Milligrams and Micrograms

Vitamins X-codes

Yellow Card Reports

Not everything is in this one document - my major medicines document is still separate!

dropbox.com/s/vp5ct1cwc03bl...

[SeasideSusie Remembering]

Newlou

Without knowing the reference ranges for your results we can't really say anything meaningful. Reference ranges vary from lab to lab so we always need the ranges that come with your results.

Also, just testing TSH and FT4 doesn't give full information about thyroid status. Testing FT3 is very important as T3 is the active hormone and it's the FT3 result that tells us if we are overmedicated, have poor conversion of T4 to T3, etc. Unfortunately this test is rarely done.

With a TSH of 0.02 this is classed as suppressed and doctors tend to just look at the TSH level, if it's low they tend to think you're overmedicated and they lower the dose of Levo. Unfortunately, that's not how it should work but most doctors are quite ignorant of how to treat hypothyroidism.

[SlowDragon Administrator]

Welcome to the forum

Never ever agree to dose reduction based just on TSH and Ft4

Have you changed anything recently

Do you always get same brand levothyroxine at each prescription

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

Very important to test vitamin D, folate, ferritin and B12

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

Low vitamin levels common as we get older too

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 and last dose levothyroxine 24 hours before test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

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

List of private testing options

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

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...

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

If TPO or TG thyroid antibodies are high this is usually due to Hashimoto’s (commonly known in UK as autoimmune thyroid disease). Ord’s is autoimmune without goitre.

About 90% of all primary hypothyroidism in Uk is due to Hashimoto’s. Low vitamin levels are particularly common with Hashimoto’s. Gluten intolerance is often a hidden issue too

Link about thyroid blood tests

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

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

List of hypothyroid symptoms

thyroiduk.org/if-you-are-un...

[Newlou]

Thank you so much these responses are fabulous. I always feel they don't listen,even before I was diagnosed at 28 they told me nothing was wrong..until I begged for help. Great I will look into all of this ⭐

[shaws Administrator in reply to Newlou]

I believe 'they' don't listen because they are poorly trained. They seem to put all the emphasis on TSH alone and not concentrating on the patients' clinical symptoms and neither do they test FT3 and FT4.