When I last had my thyroid levels checked my GP said they were 'fine', I have no idea what the numbers were but I know they only test one thing (maybe T3?).
I'm tired all the time, I'm sleeping 12 hours a night and am still tired. I'm miserable and irritable all the time. Despite very carefully watching what I eat I'm piling weight on. And my periods have become irregular.
I feel I need to tell my GP what to do rather than ask. I used to have an amazing GP who had a special interest in thyroid conditions but since she retired a few years ago my new GP seems very under educated on the matter. (He suggested I come off thyroxine completely because there is no evidence it does any good??!)
My question is, what do I want my GP to do? What tests do it want him to run? How do I interpret the results to ensure my dose is correct?
I currently take 100mcg of thyroxine for hypothyroidism. I've been on Thyroxine since 2010.
Thanks
Written by
DEZEM
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I would expect that if your doctor did only one test, it would probably have been TSH alone. TSH stands for 'thyroid stimulating hormone' and if is above 10 (in UK) we should be diagnosed as being hypothyroid. Mine was 100 and I was still told I had no problems.
You can request a print=out of your results from the surgery. You can then put your results with the ranges onto a new post. Ranges are in brackets after the results and are important for members to comment upon them.
This is the recommended procedure when having thyroid hormones checked:-
1. Blood draw should be at the very earliest possible (even if made weeks ahead).
2. It is a fasting test (you can drink water).
3. If already diagnosed and taking thyroid hormones, don't take hormones before blood test - take them afterwards with one glass of water)and wait an hour before eating.
Also request B12, Vit D, iron, ferritin and folate to be checked too as deficiencies can also cause symptoms.
Thank you. I have requested the previous results and will go from there. I was told I can't get a new test (previous test at least 6 months ago) as they're not going non-urgent tests at the moment 🤷. But at least I'll know what to do when I can get a test.
Do you always get same brand levothyroxine at each prescription
GP’s frequently only test TSH which is completely inadequate
First step is to get hold of most recent thyroid results
You are legally entitled to printed copies of your blood test results and ranges.
The best way to get access to current and historic blood test results is to register for online access to your medical record and blood test results
UK GP practices are supposed to offer everyone online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.
In reality many GP surgeries do not have blood test results online yet
Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up.
Important to see exactly what has been tested and equally important what hasn’t been tested yet
Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine
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 at least annually
What vitamin supplements are you currently taking….if any
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
Approx how old are you?
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
Is this how you do your blood tests?
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
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
TSH should always be under 2 on levothyroxine. Most people when adequately treated will have TSH around or under one. Ft4 near top of range, Ft3 at least 60% through range
All four vitamins need to be at GOOD Levels…..being under medicated thyroid wise frequently causes low vitamin levels
Approx how much do you weigh in kilo
guidelines on dose levothyroxine by weight
Even if we frequently don’t start on full replacement dose, most people need to increase levothyroxine dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until eventually on, or near full replacement dose
Consider starting levothyroxine at a dosage of 1.6 micrograms per kilogram of body weight per day (rounded to the nearest 25 micrograms) for adults under 65 with primary hypothyroidism and no history of cardiovascular disease.
Traditionally we have tended to start patients on a low dose of levothyroxine and titrate it up over a period of months. RCT evidence suggests that for the majority of patients this is not necessary and may waste resources.
For patients aged >60y or with ischaemic heart disease, start levothyroxine at 25–50μg daily and titrate up every 3 to 6 weeks as tolerated.
For ALL other patients start at full replacement dose. For most this will equate to 1.6 μg/kg/day (approximately 100μg for a 60kg woman and 125μg for a 75kg man).
If you are starting treatment for subclinical hypothyroidism, this article advises starting at a dose close to the full treatment dose on the basis that it is difficult to assess symptom response unless a therapeutic dose has been trialled.
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