Neice Diagnosed hypothyroid and aneamic .why the low dose ?

[poppppy]

Hi my niece has been diagnosed hypothyroid and aneamic . So she was given 25 mg thyroxine and told to have bloods done again in 6 weeks . And also given ferrous fumarate for low hb .

I have asked her to get her results off doc to see . Despite the results though I feel 25 is too low a starter dose . Pharmacist told her because she is on iron as well then 25 is the right dose ??!

Neice feels dizzy weak and gets paraesthesia in arms and legs .

Is this correct advice . Sorry no results to show but my tsh wasn't too high on diagnosis and they gave me 25 . Spoke to pharmacist who said 25 was rubbish and I went back immediately and got a higher dose. I went on to find atrophied thryoid on scan and antibodies sky high .

[SeasideSusie Remembering]

Pharmacist told her because she is on iron as well then 25 is the right dose ??!

First time I've heard that. 25mcg is a starter dose for children, the elderly or those with a heart condition. Otherwise starter dose can be 50mcg.

She should take her iron tablets with some Vit C to aid absorption and help prevent constipation. Iron should be taken 4 hours away from thyroid meds and 2 hours away from any other medication and supplements.

[poppppy in reply to SeasideSusie]

Thank you so much for this swift and very helpful answer . I will pass this on . Hope she will listen to me . So she avoids all the pitfalls I went through . Thanks to all your dedication to thai site and others like you I now am off thyroxine as it didn't increase my t3 to normal range . So thank you only this site alerted me to the fact that this can happen . I am on liothyronine only . Your help is amazing . All of you . Thank you

[shaws in reply to poppppy]

I'm glad you're on liothyronine and I am also. Some of us who take levothyroxine cannot recover our health at all.

[poppppy in reply to shaws]

That was tsh 10.49 sorry and free t4 11.2

[shaws in reply to poppppy]

My TSH was 100 and GP phoned to tell me I had no problems as blood tests were fine!

[poppppy in reply to SeasideSusie]

Update if you don't mind . Don't worry if you are too busy . I am going to go for an appointment with my neice . She is being all independent so has not allowed me. But now she will as she is having worse symptoms. She couldn't feel her legs properly the other day . Pains in chest . But is not central chest pain etc . So does not sound cardiac . More like anxiety but who knows for sure . She will not attend "a and e " despite my advice . Doctor told her they won't up the dose when she went again . She did give her her tsh result and free t4 Tsh 10. 6

Free t4 10 . 4

These are worse than my first results and I was put on 25 but after a pharmacist advise me it was too low . I went back and argued for a higher starting dose. And was upped to 50 or 75. I cant remember now.

I have looked at nhs site and took screen shot of starting dose for her is 50 to 100 with blood checks every few weeks till on right dose . I will be taking this with me.

She has a baby too. And is scared now of dropping her , etc.

It may be anxiety . But brought on now by her health worries . She was not given a print out of her iron levels . Which is low . So How low I dont know. But she has low iron symptoms . She is crying a lot now over this. I am fuming . But ofcourse when I go I will give them time to explain any mitigating circumstances why she is getting this treatment plan . Something I don't know about . Thank you so much for your advice as always

[shaws in reply to poppppy]

I'm sorry about your niece and she should have been prescribed thyroid hormone replacements. Some women become hypo after childbirth.

hopkinsmedicine.org/health/...

Looking after a baby when Mum doesn't feel well can be even more stressful. She must be worried herself if she has a baby.

[poppppy in reply to shaws]

You have hit the nail on the head . Regarding new baby. She is scared of dropping her whne her legs go weak. She did end up on floor but tnot when holding baby . I mean duuuh . Why didn't doc request a blood test rather than prescribe anti anxiety tablets. Same cost surely. This would have helped with her anxiety and prevented potential complications induced from new anxiety tablets. And/ or prevented potential harm to her baby . My sister ,her mum , is now staying with her . But she has arthritis so its not ideal . Doc does not know this though. I have posted as new post also now. Mostly repeats what I said to you . Thank you so much for your concern and advice

[SeasideSusie Remembering in reply to poppppy]

Poppppy

She was not given a print out of her iron levels .

We have to ask for them, they aren't offered to us. Get your niece to ring and ask the receptionist (not the doctor) for a print out and say she will pick it up later, or you can pick it up on her behalf as long as your niece has told them you will.

Doctor told her they won't up the dose when she went again . She did give her her tsh result and free t4 Tsh 10. 6

Free t4 10 . 4

That's ridiculous. TSH is way out of range and the guidelines say to bring TSH into range.

Tests for follow-up and monitoring of primary hypothyroidism

1.4.1 Aim to maintain TSH levels within the reference range when treating primary hypothyroidism with levothyroxine. If symptoms persist, consider adjusting the dose of levothyroxine further to achieve optimal wellbeing, but avoid using doses that cause TSH suppression or thyrotoxicosis.

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

[poppppy in reply to SeasideSusie]

Thank you so much for this link to nice guidelines. This is why I love you lot. You are amazing with your knowledge, support, commitment to us all . Thank you . Regarding the print out she did ask sorry for her print outs and was given one result only . Tsh and free t4 . I know ridiculous. But thank you I will push the receptionist tomorrow . I think I will ring for the appointment too . She rings and today .as in 10th February. She was told here were no appointments left . I will push . Thank you . I am awful at having the guts to push for me but great when its others. My mates are the same. Think it may be a common thing . Do you find that . I think its because you are the one that is ill. Or you feel it may jeopardise your treatment chances in the future . As they hold the power . If you get me . Don't get me wrong I am in awe of the work of nhs doctors. Seeing them on their knees crying for years as a nurse . Working 60 hours a week and paid for only 40 of them . Sucking sweets on the go . And feeding them my sandwiches and tea because they haven't eaten for 12hours . Only to see them get bleeped to go to another ward leaving tea and sandwich hardly touched.

[SlowDragon Administrator]

Your niece is legally entitled to copies of her test results and ranges

She needs to know exactly what has been tested

If her iron /ferritin levels are low issue prescribed iron supplements 2 or 3 times a day

Levothyroxine needs to be minimum 4 hours away from any iron supplements (also 4 hours away from pill, vitamin D and magnesium or calcium rich foods)

Levothyroxine at bedtime can be more convenient, might be more effective

Essential to have vitamin D, folate and B12 tested too

[poppppy in reply to SlowDragon]

Thankyou so much . I forgot I had not replied sorry .