advice please: I was on 100mcg for years and... - Thyroid UK

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advice please

Goinginsane1 profile image
8 Replies

I was on 100mcg for years and years and was reduced to 75mg this time last year after having a baby. It was increased again in July this year but GP has reduced it back down to 75mg a couple of weeks ago due to blood test showing over medication. Since the change in medication my anxiety has hit the roof again. Is this common?

I genuinely believe I have a hormone imbalance due to other symptoms I have been experiencing for the last year and more. Can I get tested for this on NHS in Wales as well as thyroid testing?

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Goinginsane1
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SlowDragon profile image
SlowDragonAdministrator

GP should not be adjusting dose levothyroxine by TSH

Perhaps you are anaemic or vitamin deficient

ESSENTIAL to test vitamin D, folate, ferritin and B12

Request GP test these 4

If ferritin is under 50, request full iron panel test for anaemia

all thyroid blood tests early morning, ideally just before 9am and last dose levothyroxine 24 hours before test 

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

List of private testing options and money off codes

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off down to £26.10 if go on thyroid uk for code

thyroiduk.org/getting-a-dia...

monitormyhealth.org.uk/

NHS easy postal kit vitamin D test £29 via

vitamindtest.org.uk

Only do private testing early Monday or Tuesday morning. Watch out for postal strikes, probably want to pay for guaranteed 24 hours delivery 

Link about thyroid blood tests

thyroiduk.org/getting-a-dia...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

Symptoms of hypothyroidism 

thyroiduk.org/wp-content/up...

Goinginsane1 profile image
Goinginsane1 in reply toSlowDragon

thank you. I think I may have to pay private for proper tests as GPs don’t seem to want to do them. So frustrating!

SeasideSusie profile image
SeasideSusieRemembering

Goinginsane1

It was increased again in July this year but GP has reduced it back down to 75mg a couple of weeks ago due to blood test showing over medication.

What is your GP basing the dose changes on? Is s/he looking just at TSH or taking FT4 level into considerations. Is FT3 tested? Are you asked about any symptoms?

Are you doing your thyroid tests under the exact same circumstances each time, ie

* No later than 9am. This is because TSH is highest early morning and lowers throughout the day.

In fact, 9am is the perfect time, see first graph here, it shows TSH is highest around midnight - 4am (when we can't get a blood draw), then lowers, next high is at 9am then lowers before it starts it's climb again about 9pm:

healthunlocked.com/thyroidu...

If we are looking for a diagnosis of hypothyroidism, or looking for an increase in dose or to avoid a reduction then we need TSH to be as high as possible.

* Nothing to eat or drink except water before the test - have your evening meal/supper as normal the night before but delay breakfast on the day of the test and drink water only until after the blood draw. Certain foods may lower TSH, caffeine containing drinks affect TSH.

* If taking thyroid hormone replacement, last dose of Levo should be 24 hours before blood draw, if taking NDT or T3 then last dose should be 8-12 hours before blood draw. Adjust timing the day before if necessary. This avoids measuring hormone levels at their peak after ingestion of hormone replacement. Take your thyroid meds after the blood draw. Taking your dose too close to the blood draw will give false high results, leaving any longer gap will give false low results.

* If you take Biotin or a B Complex containing Biotin (B7), leave this off for 7 days before any blood test. This is because if Biotin is used in the testing procedure it can give false results (most labs use biotin).

These are patient to patient tips which we don't discuss with phlebotomists or doctors.

I genuinely believe I have a hormone imbalance due to other symptoms I have been experiencing for the last year and more. Can I get tested for this on NHS in Wales as well as thyroid testing?

I see no reason why you shouldn't ask for hormone testing, ask your GP. You've recently had a baby so hormones may still be settling.

Goinginsane1 profile image
Goinginsane1 in reply toSeasideSusie

thank you so much

SlowDragon profile image
SlowDragonAdministrator in reply toGoinginsane1

Also request GP do full iron panel test for anaemia including ferritin, vitamin D, folate and B12

Do you have autoimmune thyroid disease also called Hashimoto’s. Hashimoto’s frequently goes a bit bonkers after pregnancy

Goinginsane1 profile image
Goinginsane1 in reply toSlowDragon

I asked for this to be clarified a few months ago but they didn’t really give me a definite answer. I don’t think it’s hashimotos as far as I am aware.

Do you know if dropping from 100 to 75 is too much of a drop? Should I request to take 1 x100 and 1 x 75 on alternate days?

Last time the lowered it (this time last year) I had swollen lymph nodes under my arms for months and it appears that they are doing the same things now. Going mad!

DippyDame profile image
DippyDame in reply toGoinginsane1

You're not going mad....but your medics are seriously short of thyroid knowledge. That, possibly because med school did not give them a good grounding!

due to blood test showing over medication.

That would be a TSH test! Well, research proves that is not a reliable marker for dosing!

This should help explain

thyroidpatients.ca/2021/07/...

Unless your FT3 is over range you will not be overmedicated

T3 is the active thyroid hormone and for good health should saturate almost every cell in the body with a constant and adequate supply.....usually from within the body ( the thyroid), by conversion of T4 to T3 and in some cases it has to be taken in tablet form

it sounds very much as if you are suffering symptoms of undermedication....but your GP is wrongly relying on a TSH test without considering your symptoms....or worst still without a full thyroid test.

Many of us test privately for this reason as has already been detailed by SlowDragon who has provided links to those tests.

The parlous state of current thyroid treatment beggars belief otherwise this forum would not reflect the level of suffering experienced by it's members!

Suggest you test, at minimum, TSH, FT4 and FT3 but ideally, TSH, FT4, FT3, vit D, vit B12, folate ferritin and antibodies TPO and Tg.

With the latter group we can thoroughly evaluate your thyroid function and point a way forward!

Speak to your GP about hormone testing if they cannot help you now have info to help you test privately!

Hang on in there....with correct treatment things should improve

Post any lab results you can obtain and members will help

SlowDragon profile image
SlowDragonAdministrator in reply toGoinginsane1

First step is to get hold off all recent test results

Far too often only TSH is tested, which is completely useless

NEVER agree to dose reduction without FULL thyroid and vitamin testing

Your only over medicated if Ft3 is over range

If vitamins are low, which is extremely common after dose levothyroxine inappropriately reduced….then results in poor conversion of Ft4 to Ft3. This results in high Ft4, low Ft3 and even lower vitamin levels.

Low vitamin levels tend to lower TSH

You are legally entitled to printed copies of your blood test results and ranges.

The best way to get access to current and historic blood test results is to register for online access to your medical record and blood test results

UK GP practices are supposed to offer everyone online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.

Link re access

healthunlocked.com/thyroidu...

In reality many GP surgeries do not have blood test results online yet

Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up.

Important to see exactly what has been tested and equally important what hasn’t been tested yet

Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine

 

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested.

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

come back with new post once you get old GP results/full thyroid and vitamin test results

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