Feeling annoyed

[Gummybearx]

Hi all, I recently had appt with my endo, who has been very helpful. I asked for some more bloods to be taken as have still not been feeling right. I have been on 125 mcg of Levo and 5 mcg x 2 of Lio. I also take Vit D, K2, Zince, Magnesium, Evening primose, Probiotics, Selenium, recently started with Iron and Gloucosamine. All these are taken well apart from the Levo. I also take inhalers and montelukast.

Tsh 0.02

T4 18

T3 5.3

My gp has seen these and says I am slightly over medicated tho as I was seeing endo it would be sorted. Endo wasn't too worried about Tsh being so low at mo.

Gp has now stopped my 25 mcg of Levo. She has told I am slightly over-medicated.

I am also mildly anaemic haemoglobin 117

Haemotocrit 0.342

Cholesterol is slightly high at 5.9

Serum Iron level 18.3

Vit D is 177

Any advice please? I know I will have to ring them on Monday to find out why she has rejected the prescription.

Many thanks

[SlowDragon Administrator]

Tsh 0.02

Ft4 18 

T3 5.3

Please add ranges on these results (figures in brackets after each result )

Was test done early morning and last dose levothyroxine 24 hours before test

Do you always get same brand levothyroxine at each prescription for both 100mcg and 25mcg tablets

Day before test ALWAYS split T3 as 5mcg doses spread through the day with last 5mcg dose approx 8-12 hours before test

You need ferritin, folate and B12 tested

Taking almost any dose of T3 will reduce TSH

It doesn’t mean you are over medicated

If you feel well …..Refuse to reduce dose

GP should NOT be meddling, you are under care of endocrinologist

Ask for 25mcg dose to be reinstated

If GP says " I have to reduce your dose because the guidelines say i can't let you have a below range TSH" .....

The first paragraph in the NICE (NHS) Thyroid Disease, Assessment and Management guidelines says :

nice.org.uk/guidance/ng145

"Your responsibility

The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian. "

[Gummybearx in reply to SlowDragon]

Thank you SlowDragon.

The ranges are Tsh 0.27 - 4.2

T4 11 - 22

T3 3.1 - 6.8

Have been Lio for 18 months now.

Test was done at 9 at the hospital. Last dose of Levo at 7.15 am day before and Lio at 9 pm. Always the same brand.

Ferritin 89

Folate 16

No B12 done

My test results previously have been

Sept 22

Tsh 0.01

T4 18

T3 4.9

May 22

Tsh 0.11

T4 18.1

T3 5.6

Feb 22

Tsh 0.37

T4 17.4

T3 4.52

All ranges are the same.

Will go and look at the Nice info and have that ready for Monday.

[SlowDragon Administrator in reply to Gummybearx]

what’s the range on Folate

Obviously you need B12 and folate tested together

And vitamin D test

How much vitamin D are you taking

When was level last tested

As I said in previous reply

GP should NOT be changing your levothyroxine

[Gummybearx in reply to SlowDragon]

Folate range 2.4 - 17.5

Vit D doesn't show range tho chart says 17.7 to 212.4 . I take 5000 due to winter months and reduce spring time. Tho on the nhs app it says 75 - 200 is optimal. Last test for Vit D was May 2022 it was 130.

I'll have a look at getting both folate and B12 done privately.

Thank you so much

[serenfach]

Ring up the surgery and ask to speak to the Practice Manager. Sound all confused, and tell them you think a mistake has been made with your prescription as the Endo did not say anything about a reduction. Ask if you should ring the Endo. This will put the fear of God in them as a GP cannot overrule an Endo. They know this, and the Endo may get quite cross with them.

Ask them then to put the prescription back to the Endos recommendations.