Hi all, I was taking 125mcg of Levo for years and then 4 months ago, after a blood test at my surgery, the doctor said that she would be cutting to 100mcg as results show that I was over medicated. I don’t understand the results of blood tests and would really appreciate it if somebody could tell me if the results of tests done last Friday are ok please. Thank you for any help.
Unfortunately you have a GP who, like most, only looks at the TSH test result and adjusts dose by that. This is incorrect but unfortunately it's what they are taught to do.
TSH is useful for diagnosing hypothyroidism but once on thyroid hormone replacement it becomes largely irrelevant and it's the FT4 and FT3 that tell us our thyroid status (more important is the FT3 result) as these are the thyroid hormones, TSH is a pituitary hormone.
Generally speaking, a treated hypo patient on Levo only tends to feel best when TSH is 1 or below with FT4 and FT3 in the upper part of their reference ranges if that is where you feel well.
**
TSH: 0.12 miu/L [0.35 - 4.94]
FT4: 13.5 pmol/L [7.5 - 21.1]
FT3: 4.1 pmol/L [3.8 - 6]
Your FT4 is 44.12% through it's range and your FT3 is 13.64% through range. Your TSH is below range but not suppressed (suppressed is below 0.1). You can see that your FT3 and FT3 are both low in range so if your GP reduced your dose these levels will reduce even further and you will very likely become unwell with hypothyroid symptoms. You do not need a reduction in dose, if anything you need an increase to raise your FT4 and FT3 further up the range.
Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine (the professional publication for doctors):
"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).*"
*He confirmed, during a talk he gave to The Thyroid Trust, that this applies to Free T3 as well as Total T3 and this is when on Levo only. You can hear this at 1 hour 19 mins to 1 hour 21 minutes in this video of that talk youtu.be/HYhYAVyKzhw
You can obtain a copy of this article from ThyroidUK:
tukadmin@thyroiduk.org
print it and highlight Question 6 to show your GP.
Also, this reply from member diogenes (who is Dr John Midgele, scientist, thyroid researcher, publisher of many thyroid articles and advisor to ThyroidUK) explains why TSH is not important:
Thank you so much for your reply and help. I feel tired all the time and I have started gaining weight again but I thought that this could be all in my head. The doctor has said the results are satisfactory and there is no need for any further action. Apparently my heart etc will be working overtime if I continued on the 125mcg and at my age, I’m 73, it could cause problems. You think your doctor knows what they are talking about and you blindly follow. Do you think I should question it?
Thank you SlowDragon. I will tackle my doctor on my medication and also try to get her to authorise vitamin test. The trouble is, the last couple of years especially, getting to see a doctor, unless you have a limb hanging off, is almost impossible. I will phone for an appointment and see how I get in. Thyroid is treated like it is so unimportant to doctors. They have been trying to cut my medication down for quite some time but I kept resisting until the last call when the doctor said it could be harming me. Now I am armed with knowledge from you good folks, I maybe able to hold my own against her. Thank you again.
Thousands upon thousands of U.K. Thyroid patients forced to test privately because either GP won’t allow testing or even if GP requests tests lab refuses
Hi justmaz for some reading material to bolster you confidence before you tackle the GP.. please see my reply to this post : healthunlocked.com/thyroidu... (3rd reply down) it contains a list of links to useful evidence and other helpful discussions on the subject of Low TSH /Risk /Quality of life
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