Saw GP - he refused to up my meds - said risk of stroke - sent me away with sick note for depression n anxiety 🤬😭
However did agree to T4 / and antibodies test
Any tips for how to actually cope with work - I’m going back Mon - can’t have more time off - risk of losing my job / mind you probs just at risk being there cos can’t cope with the electronic paperwork / reports etc need to do 🤷🏻♀️My manager does have u thyroid but they medicated yrs ago and seem to be doing brilliantly !
Open to any suggestions - long term thinking maybe do less demanding / stressful job ??
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Troya18
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ok wait for bloods next week .. but honestly it's incompetent that they didn't agree to an increase today . the TSH at 2.8 is high enough to show the need for an increase .. ( re- read and use the references given in your last post recommending GP's to keep TSH between 0.5 and 2 ish )
With TSH 'in range' is no concern AT ALL for Atrial Fibrillation (which is where 'the risk of stroke' comes into it , AF leads to increased risk of stroke)
The TSH range usually goes from 0.4 ish to 4.5 ish ...and unless TSH goes below range there is NO suggestion from ANY guideline that risk of AF is increased. ( and even if TSH does go slightly under range , the evidence for these 'risks' is rather dubious and needs to be looked at in context)
I bet your manager isn't 'managing well' on just 50mcg levo ..... most of us need something like 1.6mcg /kg bodyweight ... that is the NHS guideline amount for dosage . (in reality this roughly equates to somewhere between 75 /150mcg for most adults )
When they give you the fT4 result next week .. make sure you find out the lab range used ie [12-22] or something different.
Take last dose of Levo 24hrs before blood test , and try very hard to get early am test (TSH is highest early am )
Then insist on "a trail increase to 75mcg to see if it improves your symptoms without taking your bloods out of range."
They do NOT know what your TSH /fT4 will be on 75mcg .... so they can't say it will take your TSH under range .
Explain to your manager your GP is useless and has left you on 50mcg Levothyroxine for 5 years despite clear results showing that you’re under medicated
You’re getting new blood tests before seeing an endocrinologist (privately if necessary)
Meanwhile ring receptionist and get ranges on lab Ft4 results
This is a new practise I’ve had to relocate due to various seroiys circumstances in my life so they are all just saying it’s cos of stress etc I will complain that the doc didn’t explain even though again for me
a I’m deaf and b my thinking processes are extremely slow - he spoke so fast - and then said never mind when I said I’m not following you can you repeat - Very poor ! I’m thinking bout taking my brother with me next time
I even told them I fell suicidal - just sent me away with that sick note - I was crushed when saw the reason on it - why can’t they put thyroid issues 🤷🏻♀️🤷🏻♀️🤷🏻♀️The other reason for not upping the meds was it would mess up results next week ! ?
So I’ve asked for the range - for the TSH 2.8 so far
I think you need a new doctor. Get private tests done via Medichecks or other company of T3 t4 and tsh and post results here. But if your tsh is as high as mentioned, you definitely need a dose increase. I just unilaterally started my dose increase and sourced extra meds. You can definitely feel better than you are feeling. x
I complained about the docs “ oh never mind “ when asked him to repeat stuff 🤬She even asked if I felt paranoid my God how I kept cool I don’t know !! ?
Need to change my profile name to “ Have to be like a dog with a Bone “
Battled to get things sorted for my Deafness - Access to Work etc - this is just another !
Hi I don't know if your local hospital do blood tests. If so many hospitals now offer online booking appointments. It might be more convenient to go there?
I live exactly half way between my surgery and the hospital but prefer the hospital as they offer a better range of appointments, especially early morning ones, vital for those wanting a dose increase, before 9am. And more phlebotomists, so less waiting.
Remember to stop taking vitamin supplements a week before if possible, especially any containing biotin. And fast before you go, nothing, except water and no Levo before the test.
That's odd, if they put the blood tests on the system then you can have them done there, at least where I live. In fact my surgery prefers patients to use the hospital where possible as it frees up blood tests for those who can't get there for whatever reason.
I can really empathise with you regarding your hearing. I have increasing hearing loss now, and it can lead to all sorts of difficulties. I lip read which helps me in most situations. I feel that you are having a very raw deal at present and that won't help you with how you are feeling emotionally. Your boss clearly isn't very understanding of your problems and it doesn't help that he is on thyroxine himself, because he is assuming that everyone is as fit as he is! Yours is clearly a different situation. You have already received a great deal of information from others on here who know far more than I do, so I won't try to offer anything further, but try to stay strong and be persistant where your doctor and tests are concerned. I wish you the very best of luck.❤️
I am sorry you have had this experience. Life is hard enough with any limitations we experience without the insensitivity of a G P who should know better Just a thought have you thought of contacting your local PALs? ( Patient liaison service deals with issues complaints ) if you are in England this service is available. They look into issues complaints from patients regarding treatment and staff attitude.
I have used them in the past and had a resolution of a complaint. This is impartial better than raising issue with receptionist .
unfortunately that time is when TSH will be at it's lowest. it won't be very much lower , but it might just make a difference if you are arguing for a dose increase. What time was your previous 2.8 taken ?
If they do another TSH test and the result is less than 2 you have lost your trump card of TSH 2.8 to use as an easy lever to get dose increase ... they could say "those articles say keep it under 2 and it is now so you don't need an increase"... and unfortunately most GP's have no idea that TSH is lowest between 1-3pm so they'll say time doesn't make any difference.
So getting a lower TSH result this time won't be the end of your argument , but it might make it harder.
They won't be willing/allowed to do another TSH for several months after this one , unless they increase your dose(then they are allowed to redo TSH after 6-8 weeks to check new dose )
My surgery if they offer blood test at a time don't want .. i just fib and say sorry i can't come at that time due to work commitments .. i can only get here before 9 am "(or whatever)
but this does mean i might have to wait weeks for a blood test slot . And it means the receptionists think i'm a nuisance ... but it does mean i get what i need.
Ok so it's probably worth the hassle... last thing you need now is a lower TSH result ..
don't have breakfast this time .. breakfast probably doesn't make much difference either (if any ), but u never know ... if you're lucky it might even be a bit higher .. which will make the 'increase' argument easier.
In truth It's always a bit of an unknown what TSH or T4 /T3 will actually be because as well as a baseline secretion they are also released in a pulsatile fashion . little spurts every 46 mins or so .. but you might as well stack the odds in your favour by doing what you can.
If you're hoping for a dose increase early morning is better. And TSH is always lower during the day and after meals. If you could stand to wait a bit longer and try and get an early morning appointment whilst fasting, it would be a true reflection of your thyroid status. It would be a shame to get a blood test after all your efforts and not get a accurate result.
Hi fingers crossed. Remember don't take Levo until after your test and if you do have to wait till 1.30 it would help if you didn't eat anything. Food lowers TSH and you don't want it low. Best stick to just water as well.
being pedantic here .. but the main study that provided this evidence for 'food lowering TSH' is a bit sketchy ... they tested TSH, then gave them breakfast, then tested TSH again.. and it was lower .. but it would be wouldn't it .. cos by the time they've eaten their breakfast it was later in the morning .... (Cant find the link now . think Jimh111 has it )
But despite being dubious about the effect ,i still don't eat anyway ..
partly just in case it does ... and partly because it's easier to be consistent with test conditions ....rather than trying to remember what i had for breakfast last blood test .
Ok thanks , Tattybogle my dizziness awful now with added stress of all this ! Anyone read “ feed your thyroid” recommend it ? or any other useful self help stuff ? ? Private Doc I’ve contacted won’t enable me to continue with medical exemption card so that’s out the window now
As Sparklingsunshine says, if you are diagnosed hypothyroid and need thyroid hormone, you are entitled to a medical exemption.
That won't help if your private doctor is writing private prescriptions. But an NHS GP should issue an exemption regardless of whether you are seeing them for thyroid. The requirement is based on diagnosis rather than who is managing the case.
Nonetheless, I wouldn't be at all surprised for it to end up a tug-o-war. (Which it shouldn't.)
Email Thyroid UK for list of recommend thyroid specialist endocrinologists...NHS and Private
tukadmin@thyroiduk.org
Most endocrinologists (even if seen privately) will write to GP and instruct GP to increase levothyroxine dose slowly upwards maintain TSH around or under one
But before considering booking any consultation you need TSH, Ft4 Ft3, both thyroid antibodies and vitamin D
Hi ok - suppose if I faint in the surgery would help 🙄🙄maybe would be classed as urgent then 🤷🏻♀️Isn’t feeling suicidal and risk of losing my job urgent 🤷🏻♀️🎡
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
A starting levothyroxine dose of 1.6 μg/kg/day (rounded to the nearest 25 μg) is recommended for adults under 65 years old with primary hypothyroidism and no history of cardiovascular disease
Approx how old are you
A starting levothyroxine dose of 25-50 μg/day with titration is recommended for adults aged 65 and over and adults with a history of cardiovascular disease
But different labs have different ranges eg 7-16…..9-21 …etc etc
Before starting levothyroxine
Dec 2017 - Ft4 13.9
After starting on 50mcg levothyroxine
Feb 2018 - Ft4 15.6
October 2018 - Ft4 14.1
June 2019 - Ft4 11.5
Jan 2020 - Ft4 11.8
On levothyroxine Ft4 should be at least 60-70% through range minimum
You can see Ft4 has been reducing at each test
You can see your Ft4 result from January 2020 is lower than before you started treatment
Levothyroxine doesn’t “top up” failing thyroid…..it replaces it
That’s why almost everyone on levothyroxine ends up on full replacement dose of at least…1.6mcg per kilo per day
So ….if you weight approx 10 stone = 63 kilo
63 x 1.6mcg levothyroxine = 100mcg levothyroxine per day
Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,
"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.
In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l.
Most patients will feel well in that circumstance.
But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.
This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."
You can obtain a copy of the articles from Thyroid UK email print it and highlight question 6 to show your doctor
Thanks Slowdragon - I think I was against it today A male doc who didn’t like me bringing in info in front of his student His dismissal of my request for repeating of his rushed attempt to explain why he thought my 2.8 was ok was unacceptable and frankly rude and uncaring - hence my complaint
Out of interest could I get a stroke or something else if left under medicated for any longer ???
When he said why was I so sure that it’s the thyroid and not depression and other things in life - I should of answered cos my niece n new phew are doctors He also kept trying to get me to say what was the worst symptom - 🤷🏻♀️ - and that only when he sees the clinical evidence that he would consider upping my meds ! Any ways onwards to getting the bloods and seeing a different GP
I feel your pain, honestly. I have been in the thyroid battlefield for over forty years. I’ve had doctors tell me I must be getting up in the middle of the night “snacking”. Another doctor says to just get on the treadmill more often. On that occasion I went into his office with a cast on my foot (surgery) after waiting over two hours for my appointment. Talk about feeling like an idiot and being chastised for wanting to be at a healthy weight. Honestly, I feel if some of these doctors went through what we go through… things would definitely change and for the better. I do hope you get things sorted. Don’t let him fob you off. It’s his job to explain things clearly to you. If he can’t do it, maybe he should think of another vocation. Best of luck x
Hypothyroidism results are a mirror image of the cardiovascular symptoms and signs in hyperthyroidism.
Cardiac output is reduced, owing to decreases in heart rate and stroke volume. SVR is increased, with a reduction in blood volume, resulting in a narrow pulse pressure and reduced tissue perfusion.
In severe cases there may be a fibrinous pericardial effusion. Hypothyroidism results in elevated LDL (reduced hepatic clearance) and apolipoprotein B levels in up to 90 per cent of patients. CRP and diastolic BP may rise and contribute to an increased risk of coronary atherosclerosis.
Replacement therapy with levothyroxine should be initiated in all patients to achieve a TSH level of 0.5-2.0pmol/L.
In older patients with a higher risk of coronary artery disease, a lower starting dose and a slower titration rate is advised, although evidence to suggest that replacement precipitates coronary artery disease is poor.
Request cholesterol levels tested
High cholesterol is linked to being under medicated for thyroid
If you have an underactive thyroid (hypothyroidism), treatment may be delayed until this problem is treated. This is because having an underactive thyroid can lead to an increased cholesterol level, and treating hypothyroidism may cause your cholesterol level to decrease, without the need for statins. Statins are also more likely to cause muscle damage in people with an underactive thyroid.
I have a thyriod problem as well, and it was only by chance that I new about it because my GP was away at the time and a new doctor come on from a different practice to take over and mentioned to me that I had a problem with it....I went to a private consultant to be able to get my medication, so I was put on 50mg Levothyroxyn, this is in 2005.......As my GP kept saying there was nothing wrong with my thyroid and upto date my GP will not send me for proper tests
I know that my heart problem is related to my thyroid as I was told when I had the pacemaker fitted last year that my heart blocked was contributed by not having the correct medication.
Speak to your manager and show them the Thyroid Uk forum.Hopefully they will then understand what your up against with the doctors?
Today I finished up in my job.Must be around my 7th 8th in three years plus the months I’ve taken off trying to recover.This morning all buzzy hyper and then crashing after taking my meds.Laying here feeling like Mike Tyson’s bunch bag and feeling scared (obviously cortisol)
It’s not a nice feeling and I totally sympathise with you.But then I come on here and read these posts and that gives me hope to keep going.Oh and realising after reading your post that maybe I should have spoken to my bosses about it first ooops! I will get it right sooner or later
About time we found some Legal Firm(s) who are willing to take on these GP's now. No doubt the incompetence is costing people their relationships, jobs, wellness & mental health. Before being diagnosed with hashi's i was sent away from GP's & A&E.Anti Depression pill culture is rife in this field of Hashimoto's / Hypothyroidism.
Hey, I can't give any more useful info than what already has been said but just wanted to offer a big Internet hug- it feels so insanely invalidating and horrible to be constantly gaslit by GP's who can't do their job properly.
I wish you the best and hope you get a good outcome soon.
Had bit of scary night developed pains - like indigestion then stabbing back pain , jaw n neck and ear - called 111 who said needed to send an ambulance
My brother came I took aspirin n a spray which helped with pain
So I cancelled the ambulance as looked like was gonna wait all night
My heart been racing all night - don’t feel right at all - seeing GP at 3 pm now and if get any worse call 999 again 😑😑😑
My GP refused to up my meds as well. After looking on their website I noticed another dr at the same practice specialises in women’s health. She has a lot more understanding, and she has increased my dose. May that be possible where you are? Or change to a different practice?
I was kept a zombie for decades by under-educated docs/endocrinologists. Please get the book called, "Stop the Thyroid Madness" by Jane Bowthorpe. She has a website also. This book saved my life because I was headed into extreme adrenal failure due to docs just prescribing me levo only. The book is more knowledgeable and helpful than several Endos put together including the lame one I saw at Stanford in California. This book explains a lot about testing/results. Don't wait to get this book. This book will help educate you so you can guide your doctor. They don't like being told a book is better than their skimpy knowledge on the subject but you might have to get tough and insist on testing/treatment or find a new practitioner. Please pass this knowledge about this book along. It is life-changing.
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