Need to ask GP for increase

[Wob58]

Still digesting all the info provided on my results which I am grateful for. Still unsure how to get GP to increase meds. Have to do everything by E consult. They won't see me face to face for this. Can I quote Thyroid UK as a reference or will this be inappropriate. I will of course post my latest results to them so that they can see my FT4 and FT4 are low. Any more advice welcome.

[waveylines]

Wont they talk to you on the phone either? Id send in a copy of the results and ask for a phone consultation. Tell them about all yout signs and symptoms and the fact that your thyroid hormobes are still low and you would like an increase as you are struggling.

[SlowDragon Administrator]

Ask for “trial” increase in levothyroxine

Do the guidelines on dose by weight work in your favour

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

NICE guidelines on full replacement dose

nice.org.uk/guidance/ng145/...

1.3.6

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.

Also here

cks.nice.org.uk/topics/hypo...

gp-update.co.uk/Latest-Upda...

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.

BMJ also clear on dose required

bmj.com/content/368/bmj.m41

[SeasideSusie Remembering]

Certainly say that you have spoken to ThyroidUK which is the thyroid charity recommended by the NHS for information about thyroid conditions, but I wouldn't say anything about the forum, just say ThyroidUK.