On all my blood test results for years my TSH has been suppressed. Usually around 0.007 or thereabouts. I saw a new doctor for an unrelated issue & she told me to reduce my levothyroxine because Iām apparently overmedicated. I felt perfectly fine. Now I donāt. I reduced from 125mcg to 112.5mcg nearly two weeks ago. On and off since then Iāve had headaches, a slightly sore throat but worst of all I have ear ache. Iām taking pain killers for it but Iām wondering if this is related to the dose change or not? Iāve never suffered with my ears before š.
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Sarahlouise1980
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It's very wrong to change your dose on the basis of TSH alone - you are ONLY over-medicated when free T3 is over-range - not if free T4 is too high or TSH is suppressed.
I'd suggest you get full testing - that means TSH, free T4, free T3 and key nutrients - ferritin, folate, vit D and B12. I've had some success with my GP by saying that these are the tests recommended by Thyroid UK. Get the actual results and related lab ranges (which vary from lab to lab) - and we can help you to understand what's what. Sounds as if something isn't quite right
Don't forget to have as early a blood test as you can get, when TSH is highest - certainly before 9am, and leave 24 hours from your previous dose of levo x
The first 2/3/4 weeks after a dose change are often full of all sort of odd changes in how you feel.. ... even if the new dose change does turn out to be OK in the end. So 'two weeks' is a bit too soon to assume you will continue to have these symptoms on 112.5mcg. Things often settle down over time. (and it's possible they may be unrelated to dose reduction)The 5/6/7 week point is where you know for sure what new dose will be like.But having said that ... if you were feeling good before, and if you are sure the unrelated issue was definitely unrelated to high thyroid hormone levels ,then it might be that she's meddled with your Levo dose just because the low TSH has worried her.
If TSH is over 0.04 then there is evidence you can use to prove to GP that it isn't associated with any increased risk for heart /bone problems .. but anything below that (like 0.007 ) and it is harder to find an argument that works .
It's easier to argue the case if your fT4 is 'in range'.
So get hold of the actual results the GP used to decide you were overmedicated . an see how they compare to you previous results on 125mcg.
ie. Did she have an fT4 result too ,or was she just going off the low TSH ?
Unfortunately ,now you 've 'agreed' to the reduction and already done 2 weeks, you might as well continue until the 6 week point and then get blood tested again.
Because your TSH is so low the GP will be very unlikely to agree to put dose back up just yet. But if, after you've given it time to settle down and had a new test on 112.5mcg you still have the headache / ear / throat problems ..then post the new blood results and lab ranges here and people can help you with the best argument to persuade GP to put dose back to 125mcg.
I realise waiting another 4 weeks is a major pain in the butt, but having evidence of what actually happens to your symptoms during 6 week trial of a 112.5mcg dose will be very useful for future arguments (when the next GP through the door decides they don't like your TSH being that low and decide they want to mess with your dose too)
And also .... there's a (small ) chance you might be pleasantly surprised..... i had a dose reduction from 125 to112.5 and really didn't like it or or want it at first .. but 3 months later i realised i was actually sleeping much better than i had for years , and my painful intermittent back problem had curiously vanished and hasn't come back since.
Thank you so much for your informative reply! I think i have an ear infection - its really painful and there is discharge from my ear. I just found it strange that started within days of reducing my dosage and has just got worse. My results that prompted the reduction were TSH 0.007 (0.34 - 5.6), Free T4 13.1 (7.7- 15.1) and Free T3 5.00 (4.3-6.8).
GPs are ignorant (in the main). Not stupid (well not all) but definitely ignorant. They are not taught much about thyroid and most are incapable of understanding test results- they just read off the lab sheets like a receptionist would- no added value and then ignore the most valuable diagnostic tool- your symptoms, or lack there of.
My analogy may explain š¤£
Patient āPing pongā
It is important to distinguish between ānormalā or āin rangeā and optimal. The term ānormalā (note my use of the inverted commas) it is a misused term that you should be wary of. What should be aimed for is OPTIMAL - whatās makes you feel well and that is an individual thing.
Only two little words but they mean very different things. In fact one could say ānormalā is meaningless. GPs who donāt know what they are doing generally tell you that you are ānormalā if you are in range.
Also, the majority of GPs donāt understand what the range is there for - itās a guide only! Sadly most think the range is a ācupā and that the patient is a āping-pong ballā and if they get the ping-pong ball in the cup they win a prize. š
They simply do not understand that you can be on completely different doses at either end of the range and be hypo (at the lower end) and be optimal and well (at the upper end) OR, heaven forbid, because of other confounding factors you may sit outside of the range before you feel well OR (panic stations) the range might not apply at all! š±š
Symptoms should be the most important diagnostic tool, but it sits at the bottom of the list as an annoyance. Nothing annoys a doctor more than having a lovely set of blood results, all ānormalā and the damned patient goes and spoils it all by having symptoms! š
Ever been told by a GP āYour symptoms should have cleared up by nowā or something similar and made to feel the failure for not having responded to their rubbish treatment??
Vitamins need to be higher than just in the bottom of the range SlowDragon and SeasideSuzie have loads of info on this. GPs in the main have no idea on this either - refer back to cup/ping-ping ball scenario.
Get PRINTED results, donāt rely on Patient Access- my Patient Access is patchy and things have been altered/disappeared (yes really). My Patient Access has been more ādoctoredā than I have š¤£
I have screenshots to prove it. I also have my complete set of tests- get copies of everything keep records šš.
My TSH is suppressed, FT3 and FT4 still in range, but higher in it, Iām 15 stone (š¤oops) and on 150 Āµg of levothyroxine. I feel great! I was in range at every dose increase and fought to get to full therapeutic dose.
If I had not had knowledge and advice from this forum, I would not be here now.
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