Hello, around 15 yes ago I was tested for an underactive thyroid and the GP told me I was borderline. Nothing was done and they told me to go back if the symptoms persisted.
Fast forward to recently, where I have lots of the known symptoms and have been having a regular migraine because I'm just so hot. I'm at the age when I could be pre/peri menopausal though so the GP said they would do some bloods.
Last week the surgery called to say some results have some back as outside the normal range:
TSH 7.69
ESR 21
Vit D 18
I had a phonecall appt already booked for 1st April and the GP had asked them to change this to in person.
I've since phoned to ask if the GP can tell me what these mean.
Today they've called to say the GP isn't worried about my bloods, apparently he didn't request the ESR and says it's outdated, and the appointment is more to catch up. He didn't know why he'd since asked to see me face to face.
I appreciate your are not qualified to give medical advice, and I'm seeing the GP anyway, but wondered if in your experience these seem 'normal'?
Im not feeling any better so I was hoping this appointment was going to unearth the cause 🙂
Thanks in advance.
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Murp85
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Your TSH is over range. The Thyroid stimulating hormone is a hormone from the pituitary is rises when thyroid hormones FT4 & FT3 are low. Doctors are taught that unless it’s very over range up to 10 your thyroid can manage.
You need FT4 & FT3 tested. The lab should automatically test if TSH abnormal. It’s likely low in range. Were they tested? Thyroxine & triiodothyronine
You also need antibodies TPO & TG testing this will show if your thyroid is under autoimmune attack.
ESR is an inflammation marker and wouldn’t diagnose a specific condition. What is the lab range for it & vitamin D?
The vitamin D looks extremely low what has dr said about it? Should be 80, 100 if nmol range.
Thank you for replying.I don't have the other results so I'm not sure what else was tested.
I've asked the surgery to send me the full list so I can see, but this might take a while apparently they've lots of staff off due to Covid.
The problem is I had the blood tests 10 days ago and the receptionist called the following day to say some of the tests were outside the normal range, but they're obviously not medical trained and the earliest GP appointment is 1st April.
I'm feeling generally unwell/exhausted/hot etc and after today's call with the receptionist at the surgery I got the impression that the GP didn't think there was anything to worry about and would just be telling me he wasn't concerned with those results. He told the receptionist he didn't know why he'd asked to see me face to face and it could be a phone appt.
I'm a bit cheesed off at the thought of waiting X 3 weeks for an appointment and being no further along 🙄
I've asked the surgery to send me the full list so I can see, but this might take a while apparently they've lots of staff off due to Covid.
See if your practice offers online access as you can then view results as soon as available and also gives access to notes & letters so very helpful to track health.
Be sure to request full access and historical record as initially a basic coded record is given which doesn’t always include notes, letters & test results. Practice has 1 calendar month to set up access from request.
If you are in England practices are contractually mandated to provide online access to your medical record. (Wales & Scotland are different) but if in UK you are legally entitled to copies of your own medical record. Practices can not resume, but are good at distracting & delaying from requests. They also must NOT charge.
First off do not ask doctors for results (as they don’t like patients knowing). Ask via practice reception. Before I had online access I would contact reception and explain I would like a copy of blood test for xx date or from xx date and say I will collect on eg “Wednesday” give them 2 or 3 days or so to print.
Staff might say they need to check if allowed if but if the results have been dealt with “read & filed on system” they can be release to you. Sometime they don’t have time to print there & then, or have staff shortages. So doing it this way with advanced notice means they have no excuses & can not refuse to provide.
Occasionally I would get questioned, eg why I needed them & would I understand them? You don’t have to give a reason but to avoid debate I would say “for my records” & yes I could understand results, just want to keep track of my results.
I also found if my husband phoned and said my wife will be collecting her results, he was always told yes of course - she’s entitled to them & they would always be ready!
Waiting longer for appointments so frustrating, and when your told you need an appointment & then don’t it’s very bewildering.
You have some guidelines to take with you re the vitamin D and retesting thyroid function in 6 weeks time.
Yes…….so you are (just) clinically hypothyroid and should be starting on levothyroxine
Standard starter dose of levothyroxine is 50mcg
Bloods should be retested 6-8 weeks after each dose increase or brand change in levothyroxine
Typically dose levothyroxine is increased slowly upwards in 25mcg steps over coming months until TSH is around one, Ft4 in top third of range and Ft3 at least half way through range
Guidelines on eventual dose levothyroxine by weight is approx 1.6mcg levothyroxine per kilo per day
I spoke to the GP today who told me that my results were borderline and that he'd recommend an annual thyroid check. He said if he spoke to an endocrinologist, they wouldn't suggest an underactive thyroid.
I discussed the info I'd read via the links here and said, with the symptoms I'm experiencing, I strongly think I have hypothyroidism. He said he could see id previously been tested in the last 5-7 years and my results were 8 something and 6 something. I honestly can't remember when I wasn't tired/achy etc.
He told me to buy a vitamin D supplement from the supermarket, said he wasn't concerned as we don't have any sunshine in the UK from Oct-April, despite saying my reading was too low to show up on the test.
Anyway, he has agreed to start me on 50g of levothyroxine and has said I will need to be retested in 3 months.
When I go back in 3 months, I'll ask if there are any GPs who have experience in this area. He told me he'd not long finished his GP training so I'm hoping someone who's seen a bit more action will be a better shout.
Thanks so much for your help, I wouldn't have felt confident to push back without reading beforehand
he has agreed to start me on 50g of levothyroxine and has said I will need to be retested in 3 months.
Well that’s brilliant……at least one achievement is a positive
It’s 50mcg levothyroxine
Unless you suspect you are lactose intolerant, avoid Teva brand levothyroxine
Many people find Levothyroxine brands are not interchangeable.
Many patients do NOT get on well with Teva brand of Levothyroxine.
Teva contains mannitol as a filler, which seems to be possible cause of problems.
Teva is the only brand that makes 75mcg tablet. So if avoiding Teva for 75mcg dose ask for 25mcg to add to 50mcg or just extra 50mcg tablets to cut in half
But for some people (usually if lactose intolerant, Teva is by far the best option)
Teva, or Aristo (100mcg only) are the only lactose free tablets
Most easily available (and often most easily tolerated) are Mercury Pharma or Accord
Mercury Pharma make 25mcg, 50mcg and 100mcg tablets
Accord only make 50mcg and 100mcg tablets
Accord is also boxed as Almus via Boots, and Northstar 50mcg and 100mcg via Lloyds ....but Accord doesn’t make 25mcg tablets
If a patient reports persistent symptoms when switching between different levothyroxine tablet formulations, consider consistently prescribing a specific product known to be well tolerated by the patient. If symptoms or poor control of thyroid function persist (despite adhering to a specific product), consider prescribing levothyroxine in an oral solution formulation.
Physicians should: 1) alert patients that preparations may be switched at the pharmacy; 2) encourage patients to ask to remain on the same preparation at every pharmacy refill; and 3) make sure patients understand the need to have their TSH retested and the potential for dosing readjusted every time their LT4 preparation is switched (18).
Levothyroxine is an extremely fussy hormone and should always be taken on an empty stomach and then nothing apart from water for at least an hour after
Many people take Levothyroxine soon after waking, but it may be more convenient and perhaps more effective taken at bedtime
No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap.
Some like iron, calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away
(Time gap doesn't apply to Vitamin D mouth spray)
If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test
If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal
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