Good morning all. During my pre op assessment a few days ago they took bloods and the above readings are what they found. The nurse rang me last night to say she would have to check with the anesthetist to make sure the operation can go ahead. I explained the Endo will not give me T3 until my TSH reaches 10 and my GP is saying those readings are borderline? I need the operation as a kidney stone is effecting my kidney. Is the GP right? Am I borderline? I am menopausal and I read that can effect your TSH. I can not get a GP to phone me let alone see me. They text me now as I think they think I am a nuisance. My main symptoms atm are perfuse sweating for hours on end, bone pain and limping left foot. Body pain, feeling stiff like the tin man and fatigue totally burnt out late afternoon. Joint pain but it flashes on and off like a light switch. Last couple of days slight constipation and feeling cold. I was on T4 since 2013 and have had two breaks off it as it makes me feel ill. I just want to get to the bottom of what is going on. I cant affored any more private bloods atm ang cant speak to GP. Thanks everyone
New Bloods before operation raise questions TSH... - Thyroid UK
New Bloods before operation raise questions TSH 5.6 range 0.27 to 4.20 and T4 10.66 rage 12 to 22
Hi maplewood. Are you taking any thyroid hormones? Levothyroxine is prescribed first. If you’re on levo, your test results suggest under treatment - raised TSH and T4 below the reference range. I’m not a doctor but I share your frustration at accessing one!
They took me off the T4 as I feel ill on it and am having to wait before the Endo will trial me on T3. Thanks
ah, sorry, didn’t check your previous posts. I wonder if hospital can apply some pressure to endo? Have you told endo that hospital have raised concerns? Nasty situation for you to be in. I thought waiting for TSH to raise to 10 was only suggested if asymptomatic? Can you challenge endo? Good luck
are you still not taking any levothyroxine
Your clearly hypothyroid
Medichecks results from 15 days ago
TSH 8.29 (0.27 to 4.2)
Free T3 4.7 (3.1 to 6.8)
Free Thyroxine 9.6 (12 to 22)
How much levothyroxine were you taking before endocrinologist took levothyroxine away ….looking at previous results it doesn’t look like you were on high enough dose
On levothyroxine dose should be increased slowly upwards in 25mcg steps until TSH is always below 2. Most people when adequately treated will have TSH around or under one
Most important results are always Ft3 followed by Ft4.
Looking for Ft3 at least 50-60% through range and Ft4 at least 60-70% through range
ESSENTIAL to test both thyroid antibodies privately
Request GP test Vitamin D, folate, ferritin and B12
Levels likely extremely low
Poor kidney function is reversible when thyroid is correctly treated
tandfonline.com/doi/full/10...
Hypothyroidism is an underappreciated cause of renal impairment. The classical clinical signs and symptoms may be subtle or absent, even in severe hypothyroidism. We suggest that patients with renal impairment of unknown cause have thyroid function tests undertaken as part of routine investigation. Thyroid function should be assessed in patients with deteriorating renal function, including those with known renal impairment in whom the deterioration is unexpected. It is worthwhile to examine the thyroid function in known CKD patients and institute appropriate THRT to correct the reversible hypothyroidism-induced renal impairment.
pubmed.ncbi.nlm.nih.gov/243...
Which brand of levothyroxine have you tried
You need urgently starting back on levothyroxine
Dose levothyroxine should be slowly increased over coming months until on full replacement dose
All four vitamins need testing and supplementing to improve to optimal levels if they are too low or deficient
Approx how much do you weigh in kilo
pathlabs.rlbuht.nhs.uk/tft_...
Guiding Treatment with Thyroxine:
In the majority of patients 50-100 μg thyroxine can be used as the starting dose. Alterations in dose are achieved by using 25-50 μg increments and adequacy of the new dose can be confirmed by repeat measurement of TSH after 2-3 months.
The majority of patients will be clinically euthyroid with a ‘normal’ TSH and having thyroxine replacement in the range 75-150 μg/day (1.6ug/Kg on average).
The recommended approach is to titrate thyroxine therapy against the TSH concentration whilst assessing clinical well-being. The target is a serum TSH within the reference range.
……The primary target of thyroxine replacement therapy is to make the patient feel well and to achieve a serum TSH that is within the reference range. The corresponding FT4 will be within or slightly above its reference range.
The minimum period to achieve stable concentrations after a change in dose of thyroxine is two months and thyroid function tests should not normally be requested before this period has elapsed.
Hi, I have tried lots of brands T4 and liquid. All made me feel like i was loosing the plot and really ill. Panic attacks etc which I do not suffer with normally and proven only while taking the T4. In fact the higher the dose I took the worse I felt. I had no option but to stop taking. Of course I felt better initially and now as time goes on I am beginning to feel rubbish again. Different rubbish to what I feel like taking the T4 though. My endo insists he will not give T3 only until my TSH gets to 10. I am dreading to think how I am going to feel if I have not popped my clogs already at that point because I know how bad I feel now. I am going to vamp up all my vit's and have put a request in for my GP to ring but you know what its like at the moment not enough of them. I am aware the T3 is more expensive so I am not sure if that is the issue but since I was diagnosed in 2013 as hypo with a TSH of 12 and I am wondering what he has to prove. My antibodies were all negative. Thank you
Extremely difficult to start on just T3….because as soon as you take T3 TSH will drop to zero shutting your own thyroid output off
Getting all four vitamins tested and optimal levels
Vitamin D at least over 80nmol
Folate and ferritin at least half way through range
Serum B12 at least over 500
Active B12 at least over 70
Get ultrasound scan of thyroid done too
20% of Hashimoto's patients never have raised antibodies
healthunlocked.com/thyroidu...
Paul Robson on atrophied thyroid - especially if no TPO antibodies
paulrobinsonthyroid.com/cou...
Highly unlikely anaesthetist will agree to an operation when hypothyroid
Is this a kidney operation?
Did you say you have kidney stones
Presumably you have had vitamin D, calcium and parathyroid hormone levels tested TOGETHER?
To check for hyperparathyroid
parathyroid.com/kidney-ston...
No tests at all in fact last time i asked for vit d the hospital refused to do the test as they said i had no symptoms. I have a feeling my b12 may not have been as higb as those levels but will have to pull out some old paperwork. I think my gp owes me those texts at least before and if ? T3 is started. Im so worried about a this i just seem to go round in circles x
Thousands of U.K. patients forced to test privately to make progress
Medichecks results
healthunlocked.com/search/p...
Blue horizon results
so what dose levothyroxine did you start at
What were results 6-8 weeks after starter dose
What were results 6-8 weeks after each dose increase
Exactly which brands of levothyroxine did you try
Did you try splitting your dose as 2 or 3 smaller doses spread through the day
All four vitamins need to be optimal to tolerate levothyroxine
Approx how much do you weigh in kilo
I think it is fair to say the levo did its job it brought the TSH down. It was how I felt at that point which was worse with all manner of problems, palps, sob, panic attacks, blurred vision, felt faint plus others. I have tried teva, liquid and cant remember the others. I started at 25 up to 100 last time. Years ago I went up to 150 because i read i should be aiming for TSH under 2. I went hyper and did not sleep for 3 months and was so short of breath i sat up watching TV all night to distract from the shortness of breath and it took 3 months with reducing meds to even notice a difference. I will never be able to get my TSH below 2 because of that as I cant take the amount of levo it would need for me to get to under 2. I am far too heavy at 16 stone but i was 9 stone when all this started. I think I am probably short on the vitamin side of things and will be taking that up with the GP. So the medication works it just causes me problems that are intolerable.
you need vitamins at good levels for levothyroxine, T3 or NDT
Come back with new post once you get vitamin results
hi, brilliant that the hospital have picked this up, your GP needs shaking, you have all the hypo symptoms. Take Slowdragons info with you, BE the squeaky wheel, be a nuisance, I got myself really worked up and anxious about appearing like a hypochondriac but I should have gotten assertive , I am now, I send the GP my results via their online consultation forms with instructions and links to my next appropriate treatment and the last call was under 2 minutes with the GP saying ‘your request sounds reasonable’ before this instead I was weepy and exhausted, thinking I’d have to give up work, begging the GP secretary for help, saying out loud I can go on like this. I had very similar symptoms (right ankle is now chronic for me) and slow increases of Levo with supplements and diet changes (follow slowdragons advice to the letter) things are improving, it’s taken over 12 months. Good luck and be firm, your GP is not up to date when it comes to your condition 🦋💚🦋
Goodness what a mess. There are a few reasons that levo (T4) makes us feel unwell. Sometimes its the fillers in the tablet like lactose or mannitol. Solution - try a different brand or the liquid levo. Sometimes it's due to being on a low starting dose and once the body get's a little hormone the symptoms become more apparent.
It is completely mad that the Endo won't give you T3 until your TSH is 10. That said you may not even need that if you can tweak your treatment, also vitamin levels.
I've had issues with low vitamin levels for years unbeknownst to me. Just beginning to get on top of it myself. Get your GP to test for ferritin, folate, B12 and D3 levels. If he won't then you can get tested by several companies privately.
Thank you for your advice and support.
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