When I was first diagnosed my TSH was 14 ( 2 years ago)
With Levo the TSH has improved and this has gradually increased increased to 100mcg daily for a year now. Recently my TSH has increased to 3.3. My usual TSH range over the last 12 months has been 0.5 - 1.83.
This recent test that was done, alongside others incl. Vit D, Iron, B12 etc was because I felt my old symptoms returning - tiredness, fatigue, feeling low. I did not know what was causing this. All results have come back within their normal range. My TSH is 3.3, which although my GP keeps saying is in the normal reference range of 0.5 - 4.8, I still feel that it needs to be below 2 for me to feel ok.
I don't know how to get this across to the GP who was dismissive about it today. I know my body and I feel a generic normal range does not necessarily mean it is optimum for me. When it was below 2 previous 12 months i have felt fine.
I would welcome any advice. What should I do? Why can't the GP raise the dosage, even 25mcg and monitor me for a few weeks? I don't understand why it is such a big problem.
Written by
nimble
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Of course you are right, and your GP is wrong. I'm sure someone will be along with some quotes from NICE to show a GP but can you try a different GP within the same practice.
To feel well your TSH should be around, probably under 1.
GPs are the last person to rely upon as they seem to have had no training (due to my personal experience) as I was told I had no problems and my TSH was 100 at that time!
I am extremely happy now as I have no clinical symptoms as I was switched from levothyroxine (T4) to liothyronine (T3). I have been symptom-free for a number of years now.
Levothyroxine is T4 and is an inactive hormone, should convert to T3.
Liothyronine (T3) is the active hormone and we have millions of T3 cells in our bodies and brain and heart have the most.
I joined Thyroid Uk which has been set up by Lyn Mynott due to her personal experience.
This forum then permits many members to get advice/help from other members who've recovered their health and are now symptom-free.
We also have to ensure that our vitamins/minerals are optimum i.e. B12, Vit D, iron, ferritin and folate. If your B12 was low ask the GP to check that you do not have pernicious anaemia (I have this and so did my mother) as you'd need regular B12 injections. I used to get a quarterly injection but now I get a monthly one.
I have listened to nonsense by a GP and I told him he was wrong.
We are not engines but we need thyroid hormones to enable our body to function from head to toe.
I think the majority of GPs don't have much knowledge about how best to treat a patient who has hypothyroidism - from my own personal experience.
It was only by finding Thyroiduk which was set up by Lyn Mynott that I slowly began to understand how best to recover my health. We do need help/advice.
I have listened to nonsense by a few GPs and told them they were wrong.
The first was one who phoned to tell me that my blood test showed I had no problems. The pity is that he had no understanding of what a TSH of 100 indicated. I was feeling quite unwell - to say the least. I only found out it was 100 when I got a print-out of my results!
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.
Comprehensive list of references for needing LOW TSH on levothyroxine
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