Good morning. I have an appointment next week for the GP to check current levels, and I'm just trying to correlate all the amazing info I have read on here in order to go into battle! Which is exactly what it feels like I'm having to do.
I've read several times about NICE guidelines on optimal ranges for TSH levels, but can't find a link to it,or when I tried googling it. Does anyone have it handy?
My last TSH level through GP testing was 4.81 (0.27-4.20) and she stated then that I did not need to be on levothyroxine. I recently self-tested to find out my TS3 levels and the TSH came back as 3.21 (0.27-4.20) so it has come down and I'm fully expecting her to say I'm at an optimal level now,but have read on here it should be under 2.
I know I am going to have to point this out to her so just wanted a link to the guidelines I can read to her, if it's possible.
Thank you in advance
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Holiday74
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Thanks RedApple , that's the one I've looked at, either I'm being enveloped in brain fog or I just can't see it! First is highly likely! It just keeps mentioning the "reference range" without actually stating what that is 🤔
i.e:
1.4.1Aim to maintain TSH levels within the reference range when treating primary hypothyroidism with levothyroxine. If symptoms persist, consider adjusting the dose of levothyroxine further to achieve optimal wellbeing, but avoid using doses that cause TSH suppression or thyrotoxicosis.
There isn't one reference range. It's dependent on the lab the test is done by. You need to look at your own test results, which shows your personal level within the range of that lab. For example, my last private test results show the TSH range for that lab to be 0.27- 4.2. But at another lab with a different piece of equipment, it might be a different range.
It's where you are within the range that matters, not what the range is.
Follow the guidance given by SeasideSusie for blood testing.
Sorry, I don't have a link to hand that will help you persuade your GP that TSH should be lower when on thyroid hormone replacement. Hopefully SeasideSusie or SlowDragon can help with that.
Sorry RedApple I see my mistake! I've written down quotes from my other posts of advice given, I just want to know how/where to cite it on the NICE guidelines. i.e. In different posts people have said TSH should be under 1, or under 2, I get that it changes depending on the ranges, but when I speak to the Dr I want to be able to say where that info has come from and if I can't find it I can't really use it.
I'm still only on 50mg of levo SlowDragon - this is the first time I've spoken to my GP since I began taking them, as she was reluctant to put me on them in the first place I doubt she will be willing to increase them, hence me wanting to get my facts straight before I speak to her.
This is from GP notebook - a site expressly for GPs!
aim of levothyroxine treatment is to make the patient feel better, and the dose should be adjusted to maintain the level of thyroid stimulating hormone within the lower half of the reference range, around 0.4 to 2.5 mU/l. If the patient feels perfectly well with a level in the upper half of the reference range, then adjustment is unnecessary
Hi it's unfortunate that GPs and nurses can all point to those nice guidelines if they feel like it that say the whole reference range is in range. I really think if that extra info in GP notebook helvella links to here was in there it would save a lot of us a headache. I do hope they accept it, as it's the info I'm try to use as my first option.
This post contains my list of references recommending GP's keep TSH lower than about 2 ish (some are taken from GP's own magazine's, so should be acceptable to them)
Unfortunately NICE don't mention a figure for TSH, it's GPOnline, GP Notebook, and Dr Toft that mention an actual figure for TSH. Check out Tattybogle's link below, she has put them all in the post she links to.
At moment it’s almost more important to get low vitamin levels improved….but push for next 25mcg dose increase in levothyroxine ……even if you initially only increase by 12.5mcg ….retest in 6-8 weeks
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