Do I try levothyroxine only?

[Guineapiggy]

I have been hypothyroid since 2007 and felt well taking levothyroxine until around 2016 when I started to experience hypo symptoms again.

My private doctor tried me on Erfa NDT and I stayed on it as it helped and then switched to Metavive.

Before I started NDT I never actually found out if I could have felt just as well by simply increasing my levo dose. I wish that I had done that first so that I could find out if I was able to convert T4 to T3 without paying for private medication.

I would like still to find out. I know the saying "if it ain't broke, don't fix it" probably applies but l feel I need to know.

My GP won't prescribe a small dose of levo for me to introduce gradually whilst decreasing my Metavive as my TSH is suppressed. She will only do it if my TSH is raised so that I am no longer "hyperthyroid" (her words), so, she will only do it if I go cold turkey and stop all self-medicating, which I am not prepared to do in case I feel unwell.

When I was taking 100 mg Metavive my free T3 was 3.6 (2.6 - 5.7) and free T4 11.6 (9 -19). I know these values seem low but I felt OK.

If I can get a private prescription for 25 mcg levo from my private doctor, I was proposing to introduce 25 or 12.5 mcg alongside the Metavive and test in 2 months to see what effect it had on my T3 and T4.

If the results show an increase in both then I can reduce the Metavive by a small amount then retest and repeat this procedure over a longish period of time.

The aim is to see if I can stop the Metavive and use levo only provided, and only if, I continue to feel well. At least I can then find out if my conversion is good or not.

I assume that all the time I take Metavive it will possibly continue to cause some TSH suppression. It will be interesting to see what the TSH does.

Does all this sound a reasonable suggestion?

[Jaydee1507 Administrator]

I'm not sure what to make of this. With numbers like that and feeling OK then probably any treatment would work for you. I do wonder what other health conditions you might have that could possibly be resolved with better treatment for your thyroid.

Maybe I am ignorant but I thought Metavive was a glandular and often used by people that can't get a diagnosis, not by genuine hypo patients. I'm sure someone will correct me!

If you really want to test out your conversion and give Levo a shot then why not. So long as it's done slowly and gradually.

It might be an idea to check your vitamin levels too though. Either by your GP or use one of the private companies on the Thyroid UK website. To get best conversion your levels of ferritin, folate, B12 and D3 need to be optimal.

[Guineapiggy in reply to Jaydee1507]

Thanks. Please see my private message.

[jrbarnes]

With your current levels, if you are not a cardiac or elder patients, you should be able to start on a higher dose like 50mcg for 4-6 weeks and keep increasing every 4-6 weeks until you're on a dose that's suitable for your body weight. Dosing starts at 1.6 mcg per kg of body weight. There's no need to stay on a dose that's too low for your body weight for an extended period of time. That's why people usually complain about how they feel on Levothyroxine is because they're left on a low dose for too long. Currently, I take 112mcg T4 and 10mcg T3.

[Guineapiggy in reply to jrbarnes]

Thanks. Please see my private message.