Advice Required

[Leopolde]

hi , hoping someone can help offer me advice. I was diagnosed with hashimotos in 2010 at a pregnancy screening. I developed a goiter and its been managed since through my endo and surgeon who is monitoring. I was initially started on 50mcg and was on that dose for 7 years then i got bloods done showing a TSH of 4 and my endo up’d my dosage to 75mcg and its worked well. My frustrations begin this year when i started really Jan time having increased exhaustion, thyroid swelling again and went to GP. They done Thyroid Tsh it was 1.8 and iron foliac acid etc all ok. Told me to stress less and it would be ok. Symptoms didnt go away and stress did start to play a part , i developed anxiety and panic attacks through other life stressors but i did feel it was linked. Then i had some vision issues floaters etc in eyes, i was waking up in the morning with swollen face and tongue. Got back onto GP bloods done again, ecg also it was ok aside a fast heart rate. TSH now 2.39 and when asked for endo referral said id have to wait 2 months! GP also didnt do my T3 T4 or antobodies despite pleaing with him !

So,

Now waiting on call from endo and the one i deal with is quite poor on follow up. I did in desperation contact a private GP as only option- As Need a letter from GP to get private referral for endo, which he wont give until my current endo comes back!

The private GP listened to my symptoms and said i recommend you increase levo to 100mcg and take this twice a week until your endo comes back and gave me prescription . But , Im terrified of going hyper just if i do increase dosage in interim, but would appreciate any steer from the community on next steps. Just on side note, ive chased and chased GP for clearer blood panels , even asked for another GP with no success and its nearly as frustrating! Any good endo’s in Northern Ireland would be helpful and if anyone could offer advice appreciated.

[greygoose]

The private GP listened to my symptoms and said i recommend you increase levo to 100mcg and take this twice a week until your endo comes back and gave me prescription .

What does he mean 'twice a week'? 100 mcg on two days and 75 mcg on the other five days? If so, that's not likely to help you at all. It's not enough. It should be 100 mcg every day. 75 mcg is only a small dose.

But , Im terrified of going hyper just if i do increase dosage in interim

Well, that's a physical impossibility because you're hypo. Your thyroid is under-producing thyroid hormone. It cannot suddenly start producing too much hormone. You could be over-medicated, but that's hardly likely on 100 mcg levo a day. And, even if you did become over-medicated, it's not the end of the world. You just reduce your dose, that's all.

[Leopolde in reply to greygoose]

Thanks for your response. I think they are concerned around over medicating me as my TSH is still within range at 2.39. It would just be nice if an endo came back to me and done a proper blood panel to i understand fully my bloodwork

[greygoose in reply to Leopolde]

Yes, that would be nice. But your TSH is much too high. The TSH of a person with no thyroid problems - euthyroid - is around 1, never over 2. And when it reaches 3 you are technically hypo.

But, the TSH is the least important test. The FT3 is the most important, but doctors know absolutely nothing about it. Failing that, your doctor should at least be testing the FT4. He should not be dosing by the TSH - especially as he doesn't appear to know what it is!

Your TSH can be zero, and that would be ok as long as your FT3 is still in-range, or just slightly over. So, there's absolutely no danger of over-medicating you with 100 mcg a day. In fact, you would probably still be under-medicated on that.

[Leopolde]

Thank you grey goose, for advice i will pick up prescription. Can i ask would low thyroid affect heart rate , my GP did mention that as my ECG picked up it was fast. Im quite a fit person and the last few months havent done much exercise cause just feel so exhausted when i do. But i’m think all this is linked!