Advice for my 76yr old Hypothyroid mum

[JUUJOO]

Advice for my mum please if that's OK. My mum is hypo - she takes 75mcg of levothyroxine. For years she has struggled with sleep, being cold and brain fog. She has just accepted this as being old age and when she has asked her gp - they just say her results are in range and that's the end of that.

I now take levothyroxine (graves/Rai) and I am struggling and fighting my Endo to help make me feel better, so I can fully appreciate how she is feeling and have explained to her that it might not be old age as her symptoms are the same as mine, so she needs to stand up for herself when she talks to her gp.

I have made her another gp appt and have asked her to try and get copies of her last blood tests from last month so I can post on here.

What else can I suggest to her to help her feel better? I am taking lots of supplements, omega 3's magnesium, B complex, vit D etc etc. For her being hypo are these supplements still important? I am wondering if I should try to convince her to get blood tests done at medichecks? She takes tablets for high blood pressure and statins for slightly high cholesterol. She is generally well.

Can anyone can suggest how we tackle this with her gp? Thanks.

[helvella]

Very much a personal experience comment: My sleep improved considerably when I started taking levothyroxine. And I take mine at bed-time. This does NOT suit everyone.

I suspect she is under-dosed.

I assume you know about timing of blood tests and not taking levothyroxine in the hours before a blood draw?

[JUUJOO in reply to helvella]

Yes I've mentioned to her about taking it at bed time like I do, but her gp has always told her to take in the morning so she is weary of changing.Yes I know about the blood test timings - thanks.

[GlowCoach Administrator]

How successful you are in helping Mum is going to depend a lot on how on board she is with this. It's very difficult with the elderly who have a different set of values to younger people. They can have very fixed ideas about getting information from their GP as opposed to a group like this. I'm speaking from my own experience with difficulties trying to help my hypo father which was nigh on impossible.

Supplements are very important for hypo sufferers. A medichecks full thyroid profile + vitamins would be really useful.

[JUUJOO in reply to GlowCoach]

Yes I agree - although she is coming around to my way of thinking, she really feels the gp's are useless, so that's helpful and good start, haha!

[GlowCoach Administrator in reply to JUUJOO]

Probably a gentle, gradual approach with persuasion might work. My Dad was so entrenched in his 'doctors know best' attitude, despite his terrible health that I was on a hiding to nothing.

Vitamins, especially in the elderly are vital.

[SlowDragon Administrator]

Your Mum is legally entitled to printed copies of her 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 her medical record and blood test results

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

Link re access

patients-association.org.uk...

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

Far too often GP only tests TSH …..obviously completely inadequate

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

 

For full Thyroid evaluation she needs TSH, FT4 and FT3 tested 

Also both TPO and TG thyroid antibodies tested at least once 

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

Approximately how much does she weigh in kilo

Unless she’s extremely petite, likely under medicated

75mcg is only one step up from starter dose

[JUUJOO in reply to SlowDragon]

Oh that's great idea thankyou, I'll get her signed up for the online access. Probably easier all round.

She weighs around 78kg at the moment. Is that too little levothyroxine for her weight then?

[SlowDragon Administrator in reply to JUUJOO]

78kg x 1.6mcg = 124.8mcg as guidelines dose

As she’s elderly, she might not need quite as much, but unlikely to need less than 100mcg

Does she know to ALWAYS test thyroid early morning, ideally just before 9am and last dose levothyroxine 24 hours before test

Which brand of levothyroxine does she take

Teva is only brand that makes 75mcg tablet, so if it’s a single tablet it will be Teva

pathlabs.rlbuht.nhs.uk/tft_...

Guiding Treatment with Thyroxine: 

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.

[JUUJOO]

She normally tests around 9am but always takes her tablet at 730am regardless. I'll educate her on that.

She takes Teva now and thinks symptoms got worse when she swapped to that brand.

[elwins]

I had Teva brand for a while and it was the filler which upset me, it has mannitol in. I switched back to my old brand and felt much better.

[McPammy]

Your mum sounds under medicated with classic symptoms. As previous members have suggested, get her results either through Patient Access or printed copies. We are all entitled to these. It was explained to me that any TSH above 2.5 even though the range is normally 0.35-5.50 you will have hypo symptoms. My private endocrinologist explained that the NHS ranges are too wide. So TSH needs to be around 1-2 to feel well normally. As that’s where a healthy persons TSH normally lays. Her GP really needs to check T4 and T3 levels as well as TSH on the same morning to ensure both are at least midway in their ranges. T3 is extremely important to get right for good health. Not too high, not too low. Next step… get those results off her NHS record and post again on here for valuable feedback. Then maybe a dose reevaluation. Please also remember that GP’s generally don’t know enough about thyroid hormones or treatment. They just look to see if you’re in range. But the TSH needs to be 1-2 and T4 and T3 midway at least.

[JUUJOO in reply to McPammy]

Thankyou, she's had a blood test. Awaiting the results.