Doctor wanted to reduce 100 mg levothyroxine to 75mg 3days a week and 100mg the other 4 days , we discussed this over the phone , when I explained that I’d had a bad reaction to Teva 25mg in the past and was reluctant to change my dose he told me to take it up with the pharmacist and I was at risk of heart problems and stroke on current dosage . Two days ago I tried to order my repeat prescription online and it’s been changed to 25 mg and 75mg of levothyroxine instead of my usual 100mg (Almus/Actavis brand) . Rang the surgery, explained again why I want to remain on named brand they said Doc would be in touch, waited in all day, no phone all. Today I received a letter by email stating I am at risk of seventeen different ailments if I don’t reduce my dosage, and that 100mg of levothyroxine is better than none but I would have to sign a disclaimer before the medication would be approved. I’ve just rang the surgery again and asked to speak to a different Doctor , can’t get to speak to anyone unless I phone in at 8am tomorrow . I am gobsmacked to be treated like this ,he has obviously taken offence because I questioned if T4 or T3 had been tested ( they had not ) , also questioned dose change on TSH test only , was told it’s the body thermostat and the test result meant a dose reduction , questioned fluctuation in TSH , the more I questioned him the more annoyed he seemed to get.He wasn’t interested in the fact that it’s taken a long time to find a brand of Levothyroxine that I can tolerate , he was just treating a number. I AM NOT A NUMBER. Will be changing doctor tomorrow. Sorry rant over .
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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.
Just testing TSH is completely inadequate
The first paragraph in the NICE (NHS) Thyroid Disease, Assessment and Management guidelines says :
nice.org.uk/guidance/ng145
"Your responsibility
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with themand their families and carers or guardian. "
You can say you will be getting FULL thyroid testing including Ft4 and Ft3 via NHS private testing service
£29 (via NHS private service ) and 10% off down to £26.10 if go on thyroid uk for code
If you want a copy of the article then email tukadmin@thyroidUK.org
and ask for a copy of the Dr Toft article in Pulse magazine. The quote is in answer to question 6.
Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine:
"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)."
You're allowed to rant ha ha, particularly as I have had a similar conversation about reducing my dose from 100 to 75, which I was concerned about. I was told 75mcg was a decent dose (?) I reminded him of the specialist advice when I was first diagnosed last year with a TSH of 161 and severe symptoms, which was to go to 100mcg even if not needed from a results point of view, but he wasn't listening. I asked if I could go half way between 75 and 100 instead, by splitting a 25 tablet as I don't like alternating doses. The Dr spouted nonsense about splitting tablets not accurate, won't get exact split ( so, I'll get the other bit next day!!) etc etc. It was laughable. Wouldn't hear of it and I felt browbeaten. Useless appointment. Considering my next move now. My new lower dose has me whacked. I'd forgotten what this fatigue feels like but I'm fit for nothing by lunchtime. Hope you get sorted.
Conclusions: The serum biochemical markers of thyroid function in patients on LT4 following total thyroidectomy suggest that the patients with mildly suppressed TSH levels were closest to euthyroid, whereas those with normal TSH levels were mildly hypothyroid and those with strongly suppressed TSH levels were mildly hyperthyroid.
How weak was his pill splitting argument? And what are the 17 different ailments? I may have asked if he was trying to gaslight you? Because you’re a woman? Because you think it’s all in my head? Because you’re having a bad day or simply because you’re a massive egotistical controlling prick?
Gone are the days that I bow down to the utter sh*t they spout. I’m sorry but when I read things like this I am just so glad that I self medicate now.
I do believe I jumped on your rant there! Sorry! Lol.
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