I had a much more general Medichecks blood test drawn Tuesday, but it does include my TSH, T3 and T4, active B12, D, ferritin iron, cholesterol, HbA14c and other bits. 9am, no food no tablet for 26 hours.
Vits Ferritin 119 ug/L (Range: 30 - 150)
Folate Serum 17.9 nmol/L (Range: 8.83 - 60.8)
Vit B12 - Active 128 pmol/L (Range: 37.5 - 188)
Vitamin D 48 nmol/L (Range: 50 - 250)
Thyroid TSH 2.76 mIU/L (Range: 0.27 - 4.2)
Free T3 3.1 pmol/L (Range: 3.1 - 6.8)
Free Thyroxine 12.2 pmol/L (Range: 12 - 22)
27/09/22 tsh 0.02 (0.34-5.6) test taken while I was dehydrated because I was busy on 26th and forgot to drink anything all day (it’s a stress thingy)
16/12/22 tsh 2.03 (0.34-5.6) GP ignored these results
I am at risk of type 2 diabetes (mum has it) and my cholesterol was high in March which is why I opted for this test. HbA14c mid-range and cholesterol still high, but not as high.
I was on 100mg Levothyroxine until 20th October because I refused to succumb to the migraine a sudden change in medication gives me until after hubby's 60th birthday holiday.
Until Sept 27th I was feeling more myself, not perfect, but I was coping. My math indicates forgot to take levo at least once a week, never had the same two brands in a row and had prescriptions issued every four weeks. No test in 6 months. The GP decreased my meds to 75mg without discussion. I was then unable to get an appointment, I was out of the country 3 times, had covid, and they were too busy. I started keeping levo and vits in daily organiser and water bottles kept on my desk and by my bed.
By December, I was feeling hypo - tinnitus, tired, dry skin, constipation, cold and brain fog. In the meantime, my sister lost her son to renal failure at age of just 35 so extra stress and I needed my energy to support her not fight GP.
I had already decided to up my medication as soon as the blood to this test was drawn. Tuesday I took 1 & 1/4 of 75mg levo, yesterday 75mg, today1 1/4. Next week I will alternate 1 and 1.5 tablets. I hope I don't run out of levothyroxine before I can see the GP to argue my point about increasing my levo back up to 100mg per day.
I feel the risk to my health should be my 'informed' decision to make. What is the point of looking after my heart and bones by reducing my levo if my cholesterol is high and I am too yucky feeling to enjoy my life? The tinnitus is driving me insane.
If I cannot get a GP appointment, is it OK to write this all to the GP, admitting I delayed reducing medication, have increased my levo back up, and demanding an endo appointment about the lump in my throat. I would really like it checked rather than GPs ignoring me telling them about it. Yes, I have told three.
I am worried about how low my T3 and free thyroxine have dropped.
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Perhaps bear this in mind ... the will be very reluctant to agree to an increase back to 100mcg because TSH was 0.02 on that dose previously .
I have a research paper that i used to argue low TSH does not increase risks until it goes lower than 0.04 but that won't help you at all, as it also showed the risks did increase sharply below 0.04 .
But you are correct~ TSH rising from to 2 and the further to 2.7 ,and especially your T4 and T3 scraping along the bottom of the range ( and the cholesterol) are all clear indications that a bit more than 75mcg is needed.
They will find it MUCH easier to agree without any argument to a request for an increase half way between the two ie. 87.5mcg (usually prescribed as 100/ 75mcg alternate days using 50 's and 25's .. or if you prefer to take same each day you can cut a 25 in half)
From personal experience i would usually say 87.5mcg might be worth genuinely trying ( as well as being easier to get them to agree to than 100mcg at the moment). Mind you my fT4 was pretty high, not low like yours so this next bit may not be relevant to you.,, but i'l leave it here anyway.
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125mcg looked to be a tad too much for me 'according to the numbers' even though i felt ok . It was reduced to 112.5 which felt undermedicated for about 4/5 weeks but then began to feel ok again.. However GP still didn't like the numbers, so reduced further to 100mcg .. this was definitely not enough, clear symptoms of undermedication that didn't improve by 6 weeks (totally constipated . brain like zombie , struggling to cross road safely ) .. so at blood test i said i would be putting it back myself regardless of result. GP phoned next morning at 9 am(!), I went back to 112.5mcg with GP's very reluctant agreement as "he didn't want to make me unwell" and he noted i 'understood the risks' on my record .
And over the next 6 months . i ended up feeling better overall than i had on 125mcg . my sleep improved.
Thanks. I will bear this in mind. However, I am very aware of the high levels of stress and massive dehydrated headache I had the day that was taking. It was not taken in optimal circumstances.
Time for a reassessment of the treatment of hypothyroidism
John E. M. Midgley, Anthony D. Toft, Rolf Larisch, Johannes W. Dietrich & Rudolf Hoermann
The above authors are all eminent in the field including TUK advisor diogenes AKA Dr John Midgley....not easy for a GP to argue against them !
Your latest labs on 75mcg levo
Vits Ferritin 119 ug/L (Range: 30 - 150)
Folate Serum 17.9 nmol/L (Range: 8.83 - 60.8)
Vit B12 - Active 128 pmol/L (Range: 37.5 - 188)
Vitamin D 48 nmol/L (Range: 50 - 250)
Thyroid TSH 2.76 mIU/L (Range: 0.27 - 4.2)
Free T3 3.1 pmol/L (Range: 3.1 - 6.8)
Free Thyroxine 12.2 pmol/L (Range: 12 - 22)
Your vit D is abysmally low this will affect thyroid function / T4 to T3 conversion. You need either to speak to GP or self treat ....suggest, from Amazon...
BetterYou Vitamin D3000+K2 Daily Oral Spray | Natural Daily Multivitamin Spray and Immune System Support | Natural Peppermint Flavour | 12ml (30 Daily Doses)
The Vit D Council recommend a level of 100-150nmol/L (40-60ng/ml),
FT4 also abysmally low as is FT3!
75mcg levo is totally inadequate
Personally I would not be concerned about your TSH but about your low Frees....research shows that TSH is not a reliable marker
Your GP is pretty clueless if he considers there labs ok
Your FT4 is too low which in turn is causing your FT3 to be low.....difficult to tell if your T4 to T3 conversion is adequate given the low labs....but tentatively it appears ok
That being the case you definately need to increase your levo dose
FT3 is the most important lab followed by FT4.....most medics don't seem to understand this but science shows it to be the case
T3 is the active thyroid hormone and for good health it must flood most of the cells in the body by way of a constant and adequate dose....
Low cellular T3 = poor health!
Your FT4 is 2% through the ref range
Your FT3 is 0% ditto
Both Frees should roughly be approaching 75% ditto
Little wondering you are struggling
Your TSH is likely on the high side because your pituitary gland is attempting to message the thyroid gland to produce more hormone....but it's not as high as it could be with those low Frees!?
When correctly medicated TSH should be close to 1.....2.76 indicates hypothyroidism/ undermedication
Bottom line... you need more levo ...maybe more thn 100mcg....but you know this!
So, using the info above build your case for an increase ....write down all you want to say/ ask, as an aide memoir. It's very easy to forget things during a stressful consultation with a difficult medic ( been there and this helped!)
Stay on a steady dose for at least 6 weeks before testing again to allow the dose to settle in the body.....post new labs on 100mcg levo....the results will point the way forward.
I am aware my results are not great. I have had enough of GP dictating a treatment that isn't working.
I had run out of my Better You at end of November, I have been relying on the D3 (2000iu) 2 capsules daily since. I have already ordered 3 months of my prefered BetterYou D3&K2 spray . Oral supplements don't seem to work for me. Normally I take the that and B12 spray. My B12 is so much healthier than it was before.
Last January my D was equally low. Locum GP just poopooed it, not worried it was that low on supplements. He did at least up my levothyoxine to 100mg in March.
I will download the info, and collect everything together and write my list and start ringing for an appointment at 8am tomorrow. I'm going to be impatient. If I cannot get an appointment booked by next Friday I will deliver a letter by hand telling them how to treat me, that I am aware of any risks of a suppressed TSH. I already know my GP does not accept Medichecks blood test results. She 'does not recognise the ranges'!
It once took me ringing every day for 6 weeks to get an appointment. Then I only got one because the receptionist pointed me towards the e-consult but has now been disabled. The surgery in my village is dreadful.
I realise you know your results are dire ...just thought a few suggestions might help.
I also appreciate the difficulty in achieving a therapeutic dose....it took me years and I now have to self medicate! My problem is fairly rare so I had to research and do the spadework myself with some direction from experienced members on this forum.
Have you considered submitting a complaint to the practice manager.....not to a receptionist or a GP.
Getting a dose increase shouldn't be like climbing a mountain but with clueless medics it can feel like that......your GP clearly doesn't understand that different labs use diferent ranges!
Med schools don't seem to teach students how to analyse lab results...if a result is in range they deem that " normal" which means diddly squat!
Unfortunately the practice is that bad that I have already moved GPs with the practice, I chose not to make a formal complaint, so I genuinely think moving to practice in the next town is the way to go.
But it would ease my mind if people on here would find a polite, but firm letter is acceptable -if I cannot get in to see the GP (appointments are like gold dust).
May I suggest you "take a breather" before deciding exactly what you'd like to do and say? I find if I react from a place of anger I don't necessarily achieve the best results. I need to process whatever is making me feel angry, calm down and reflect, then consider what is the best way for me to react.
Coming back to you and your situation, I'm not clear what you'd like to happen? I can understand frustration at having my dose reduced without consultation with me.... and I'd need time, as above, to consider which way is likely to help me achieve the dose I feel I need.
If I react with anger and frustration, the response I'm likely to get will reflect that. Usually I find it best to ask for help ..... explain what is happening for me, and asking for help in resolving the problem.
You are correct, like you, I used to get over-emotional and forget things ... now I just forget things. However, I have learned something over the years.
I am a writer, so I will write the letter and create crib notes, before I attend the GP, if I actually manage to get an appointment. That way if I lose my rag, I can simply tell the GP to read the letter and calmly walk away.
I know exactly what I want to happen, I want to change GP surgery. However, I need enough medication to see me through while I change GP. Only having 4 weeks of meds while this happens makes me feel nervous. It's been over 30 years since I have had to change surgeries and experience has shown me they lose your notes. Things may have changes, but I don't want to risk it.
You seem to have misunderstood what I was trying to explain...obviously not well enough, sorry
I don't get over emotional..... but have found it best to deal with any feelings of anger before reacting to any situation. Sometimes the "calming period" takes longer than I'd like, but it is as it is.... and I need to wait until I feel calm. Running the risk of I may "lose my rag" is not where I want to be, and nor is it likely to achieve what I'd like to achieve.
As a writer you have the opportunity to write out your anger and frustration.... and then sit back and consider if your approach is likely to achieve what you feel you need to achieve..... with the chance to reappraise what you've written and perhaps amend with your "end view" in mind?
I am pleasantly surprised. I had to wait for a 25 minutes in the queue system, to be told there are no slots available. I explain what what the issue - that the drop in meds was making me feel unwell. Hhey presto, I have a non existant appointment next Friday.
Sticking to my guns. I want the levo increased, and enough of it to see me through a transition to another practice.
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