Help with getting medication

[Superduperloopylea]

Hi so this was my blood results a month ago. GP told me I’m sub clinical and even though I have symptoms because they’d just prescribed me HRT because of aching, anxiety, tiredness, hot flushes in bed they said I had to try that first to see if it worked. Anyway the hot flushes have eased but nothing else so I got a blood test done through medichecks which has two of my results in red and says to speak to GP. I’m worried though because looking at their results my levels are a bit better (range is different for free T4 I think. I’ll post pic for other test separate. Any advice speaking to my GP or interpreting the new results would be really appreciated. Below was a month ago

[Superduperloopylea]

second results received today

Thyroid results

[Jaydee1507 Administrator]

You posted 5 years ago with a TSH above range. I think you should see a different GP thats more helpful and understanding. You need to be a little pushy in a nice way and stand your ground. Become your own health advocate.

Guidelines in the UK are to begin treatment after 2 consecutive TSH results above range or one above 10. You surely must have fulfilled the criteria for hypothyroidism already.

What time of day were these tests taken? Highest TSH is at 9am. Do blood test fasting from night before.

Have you ever had thyroid antibody tests?

HRT often increases the need for thyroid hormone.

[Superduperloopylea in reply to Jaydee1507]

Hi Jaydee

Thanks for the reply. The Drs wouldn’t medicate me 5 years ago because they said it was sub clinical. I have had to redo my test for antibodies but I’ve previously had tests done and I am positive for antibodies. I did the test about 9.30am. I just don’t know how I can convince them to give me medication. Any advice on what to say would be appreciated.

[Jaydee1507 Administrator]

Which antibodies were positive? What was the result?

There is usually at least one GP at any surgery thats a bit more amenable than some of the others so find them and approach them. They should at a minimum be monitoring your thyroid levels every 3-4 months and really should be treating you by now, not palming you off with HRT. Do not give up, be persistent. Take someone with you if you think it might help.

This is a quote from the NICE guidelines that you can show to your GP.

Treating subclinical hypothyroidism

1.5.2 When discussing whether or not to start treatment for subclinical hypothyroidism, take into account features that might suggest underlying thyroid disease, such as symptoms of hypothyroidism, previous radioactive iodine treatment or thyroid surgery, or raised levels of thyroid autoantibodies.

Adults

1.5.3 Consider levothyroxine for adults with subclinical hypothyroidism who have a TSH of 10 mlU/litre or higher on 2 separate occasions 3 months apart. Follow the recommendations in section 1.4 on follow-up and monitoring of hypothyroidism.

1.5.4 Consider a 6-month trial of levothyroxine for adults under 65 with subclinical hypothyroidism who have: a TSH above the reference range but lower than 10 mlU/litre on 2 separate occasions 3 months apart, and symptoms of hypothyroidism.

1.3.6 Consider starting levothyroxine at a dosage of 1.6 micrograms per kilogram of body weight per day (rounded to the nearest 25 micrograms) for adults under 65 with primary hypothyroidism and no history of cardiovascular disease.

1.3.7 Consider starting levothyroxine at a dosage of 25 to 50 micrograms per day with titration for adults aged 65 and over and adults with a history of cardiovascular disease.

[Superduperloopylea]

This test was done back in 2020. I had one before this but can’t find it. I appreciate the information. I will try the Drs again armed with this info. Thank you

Thyroid antibody results

[Jaydee1507 Administrator in reply to Superduperloopylea]

Get them to look back on your old thyroid results and remind them how long you have been unwell with high TSH results. Understand that you can question your GP and put forward your case for treatment. Get a bit of confidence up.

Also point out the positive TPO antibodies. This means that you have Hashimoto's disease, an autoimmune thyroid condition where your thyroid is slowly destroyed.

Can recommend trying a gluten free diet which helps many Hashi people. Dairy can be an issue for some others too.

Did you test vitamin levels with Medichecks? Hypo people get low vitamin levels due to low stomach acid. This means they cannot absorb vitamins well from food. If necessary ask GP to test ferritin, folate, B12 & D3. If you have results pls post them.

[Superduperloopylea]

I mentioned about my antibodies at my last discussion. The Dr said it doesn’t always result in hypothyroidism. My TSH has only been above range these last 2 tests and one borderline. I need to do some retests with medicheck. They couldn’t do some of my vitamins and antibodies. I have taken pics of all my previous tests and can see TSH has tripled in 5 years. Whether this is of any note?

I will definitely consider looking at gluten free. Thank you

[ICE187 in reply to Superduperloopylea]

I would find a different doctor. Here is a helpful link.drhedberg.com/optimal-tsh-l....

[serenfach]

Your GP is waiting for you to hit the magic number of TSH of 10. In the USA it is 5. You are not sub-clinical, you have hashi's. Your GP is wrong. Send her the info that Jaydee1507 gave and ask her the simple question of why you have to get sicker before she starts treatment, as it will take longer to recover. Sending a hug.

[Superduperloopylea]

thank you ICE187 and serenfach for your advice. I am ringing first thing in the morning gonna get my confidence up as recommended by Jaydee1507 😄. Will update once I’ve spoken to them

[Superduperloopylea]

I just thought I’d post an update. Got to see a locum at my Drs surgery and I’ve been prescribed 50mcg of thyroxine. So relieved to finally be getting some help! As soon as I mentioned NICE guidelines he was straight on checking and agreed to see if it helps. I don’t know if it’s the sunnier weather, placebo effect or what but I actually woke up this morning and felt more refreshed after only 3 days of taking. Thank you again for the great advice 😁

[Superduperloopylea]

Hi me again - I’ve had all my bloods back now as first test needed to be redone - some of my vitamins are low. Should I tell the GP or just try and treat with diet. I’m going to take 2 vitamin D tablets as they are only 10ug and eat more greens does this sound reasonable to get my levels back up? Thank you

Test results

[Superduperloopylea in reply to Superduperloopylea]

folate and vit d low

Test results

[Superduperloopylea]

thyroid again showing issues but now on thyroxine so hopefully will help

Test results

[Superduperloopylea]

Jaydee1507 hi sorry to be a pest not sure if anybody has seen my recent posts regarding the rest of my blood results. Would you be able to take a look? Thanks

[Jaydee1507 Administrator in reply to Superduperloopylea]

Good job you pinged me as I never would have seen your new results! Posts get buried very quickly this forum is so busy.

....now on thyroxine so hopefully will help

This is great news after so long. Keep coming back here and updating us so we can steer you along the right path.

Antibodies.

Yours are positive for Thyroglobulin which the NHS doesn't recognise. This really doesn't matter though as it doesn't change the treatment. It does mean that you have autoimmune thyroid disease, otherwise known as Hashimoto's. Many people with Hashi's benefit from a strictly gluten free diet. A smaller percentage also benefit from removing dairy from their diet. Worth trying.

We really do have to supplement to get our levels to OPTIMAL. Diet just doesn't work as we have low stomach acid and cannot absorb vitamins well from our food.

Your folate is deficient. Show this result to your GP, they may want to do their own tests and should prescribe 5mg folic acid.

B12 is not great. Suggest you buy a good quality B complex which will keep all your B vitamins in balance. This one is about the cheapest with all the right things in it, 90 days supply. amazon.co.uk/Liposomal-Soft...

Vit D you should be aiming for a level of 100. Buy a D3 +K2 that helps it go towards the bones. What you have may well not be enough. Use this calculator to work out how much you need to take to get you to that level. grassrootshealth.net/projec...

Was there a ferritin result too?

[Superduperloopylea]

Ah thank you so much I thought that might be the case 😀. I have already cut right back on gluten, but will see about cutting out completely. Thanks for the advice on the vitamins, will speak to docs about folate and having ferritin done. What reason would I need the ferritin doing? Just so I can go armed with the right information. I am definitely starting to feel better already. My hands are warm for the first time in so long! Boils I had on my face that would not go are disappearing. Im feeling happier and have more energy! A massive thank you to this group for giving me the information I needed to finally get treatment 😁.