Worried about GP decreasing levo dose (low TSH, high FT3)

[AtemiM]

Hi Everyone

Hoping for some advice before I speak to my GP following recent bloods.

Background is in bio but in a nutshell – Hashis/Hypothyroid diagnosis (as well as Coeliac diagnosis) in April/May 2022 after 2 years of symptoms. Slowly been increasing my levo dosage since then.

My last dosage uplift was in February (to 125mcg). For reference I weighted 81KG at that time so that was appropriate dose for my weight based on the NICE guidelines.

I cannot tell you how much better I have felt since this dose increase. Symptoms are all but eradicated (I couple of tired days and a couple of joint pain days but possible they were due to accidental glutination, not thyroid). I’ve been able to go back to the gym, started training with my martial arts club one day a week again. I have energy, no brain fog, and I’ve managed to lose 9lbs (with a reasonable calorie deficit and the exercise). I had honestly forgotten what it feels like to feel like a regular (non-chronically ill) human. It’s amazing!

Now – 3-month bloods checks from the GP on the new dose have shown low (out of range) TSH, in range FT4 and above range FT3 (table in photo with a comparison of previous results (the blue ones at the bottom are the new ones, out of range marked in red)). I'm waiting on medichecks results (advance thyroid (TSH, FT4, FT3, ferritin, folate, Vit D and B12) - as the GP doesn't normally check FT4/FT3 (done this time because TSH is out of range) and I want to check if my supplementation has improved by vitamin levels).

I will be scheduling an appointment with the GP for the next few days and I’m worried he’s going to say he’s going to reduce my levo dose. I REALLY don’t want to do that (given how well I’ve been feeling). I don’t have any hyperthyroid symptoms.

Can you arm me with some arguments for maintaining my current dose despite these results?

I suspect he’s going to raise potential cardiac issues? (my heart has been checked, scanned, and tested up the whazoo the last 2 year due to some intermittent chest pains (there are no concerns identified)).

Are there any other things he might bring up?

Any input greatly appreciated as always!

Thanks

Mx

[AtemiM]

Also, just stupidly realised I did not stop taking my B complex the week before my blood tests (what was I saying about no brain fog??). Grrrr.

What impact is that likely to have had?

Feel like such a numbskulk 🤦‍♀️

[Jaydee1507 Administrator]

For reference I weighted 81KG at that time so that was appropriate dose for my weight based on the NICE guidelines.

We do try and stress that this is a guide and not at all precise. There will be a number of factors that mean that you cannot rely on this. On levo alone I was always on less Levo than the calc suggested.

I'll comment on your current results but have read your update saying that you took biotin up until the test time. We cannot really say for sure the effect on your results but if you have another test with Medichecks then do make a note in your calendar to stop 5 days before. You could always repeat the thyroid tests for certainty.

The below range TSH is not as much of an issue as your over range FT3. I personally would not want that for myself. We are usually guided more by the FT4 & FT3 and they really should be within the range.

I do understand that you've only just began to feel better, but these things cannot be rushed, and more time at a slightly lower dose is what I would recommend. Many people do alternate day dosing to achieve 12.5mcg increments so you could negotiate a 12.5mcg decrease with your GP possibly.