Thyroid meds reduced

[Mitzimoomin]

Following on from bloods ( last test Sept 2022) and call from Dr today,my meds have been refuced from 75mcg a day to 50mcg a day..as my TSH was something (hard to hear properly as I was at work) Dr said cholesterol levels slightly raised...my concern is lowering the dose as I was on 50mcg early 2022 (still suffering symptoms) and was increased to 75mcg a day from mid 2022..I have no problems related to thyroid on this dose...any advice please.

[SeasideSusie Remembering]

Mitzimoomin

Following on from bloods ( last test Sept 2022) and call from Dr today,my meds have been refuced from 75mcg a day to 50mcg a day..

Are you saying that your doctor has today reduced your Levo based on test results from 8 months ago? If so that is ridiculous. Refuse to reduce your dose and insist on a new full thyroid panel (TSH, FT4 and FT3) before agreeing to any dose change. Things are not static and could very well be very different from 8 months ago.

as my TSH was something (hard to hear properly as I was at work)

Ask the receptionist at your surgery to arrange for you to have a print out of your results (don't ask the doctor, they don't like us having them and understanding them but in the UK we are entitled by law to have our results so they can't refuse), get a print out (never hand written or verbal results as mistakes are often made), pick them up from the surgery and post the results here. Make sure you also have the reference ranges, your TSH result should look something like (I've made up this result/range):

TSH: 2.5 (0.27-4.20)

You could also check to see if your surgery offers online access to test results, if so register for this and you will then be able to see the results/ranges yourself.

Dose should never be adjusted on TSH result alone, TSH is not a thyroid hormone, it's a pituitary hormone. The thyroid hormones are FT4 and FT3 and these results tell us if we are overmedicated - FT3 being the most important one, if that's over range we are over medicated. We can have a low TSH with FT4 and FT3 well within the range, it does not mean we are over medicated and need a dose reduction.

Dr said cholesterol levels slightly raised...

Raised cholesterol is one of the signs/symptoms of hypothyroidism/under medication. This is why you also need FT4 and FT3 tested, these could be low in range despite a low TSH, and if FT4/FT3 are low then you are undermedicated. The aim of a treated hypo patient on Levo only, generally, is for TSH to be 1 or below with FT4 and FT3 in the upper part of their reference ranges if that is where you feel well.

[Mitzimoomin in reply to SeasideSusie]

Thank you for your advice..sorry my test was from 2 weeks ago and call was today from the Dr..I will ask for the test results as you suggest..Dr has asked for more bloods mid Aug..last year the bloods were rather sporadic and I had to call to arrange the test!..but from Sept to now has been difficult for me to keep ontop of my own health as my Mother passed away suddenly so everything has been put on hold..I've explained to my (new Dr) that my cholesterol was raised slightly last year (and meds increased from 50 to 75 )and it's a by product of thyroid conditions meds being correctly regulated (her response was 'I'm sure you are an expert on your thyroid!)..not really impressed with her.

[SlowDragon Administrator]

Refuse to reduce dose until had FULL thyroid and vitamin testing

Just testing TSH is completely inadequate

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

 

For full Thyroid evaluation you need 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

About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high thyroid antibodies 

Autoimmune thyroid disease with goitre is Hashimoto’s

Autoimmune thyroid disease without goitre is Ord’s thyroiditis. 

Both are autoimmune and generally called Hashimoto’s.

as per your post 3 years ago

healthunlocked.com/thyroidu...

ESSENTIAL to get thyroid antibodies tested

Have you done full thyroid and vitamin testing at any point in last 3 years?

Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease

Recommended that all thyroid blood tests early morning, ideally just before 9am and last dose levothyroxine 24 hours before test 

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

List of private testing options and money off codes

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

If you can get GP to test vitamins then cheapest option for just TSH, FT4 and FT3 and includes BOTH TPO and TG antibodies -£29 

randoxhealth.com/at-home/Th...

Only do private testing early Monday or Tuesday morning. 

Link about thyroid blood tests

thyroiduk.org/getting-a-dia...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

[Mitzimoomin in reply to SlowDragon]

Thank you..I really do need to be more insistent regarding this..have asked in the past for full screening of everything you have shown me today (I requested with Dr back in 2021 ) but my Dr seems to be reluctant to do a full test..I feel my only option is private..I'll look into the links you've posted.

[SlowDragon Administrator in reply to Mitzimoomin]

Thousands upon thousands of members forced to test privately (as I explained in reply 3 years ago)

A) testing vitamins regularly and self supplementing to maintain OPTIMAL vitamin levels essential

B) important to test TSH, Ft4 and Ft3 together

Always test early morning, last dose levothyroxine 24 hours before test

If Ft4 is low you need dose increase in levothyroxine

If Ft4 is high and Ft3 is low then you have poor conversion…..common with low vitamin levels and/or autoimmune thyroid disease (hashimoto’s)

Examples of private test results

Medichecks usually cheapest and therefore most popular

healthunlocked.com/search/p...

Blue horizon results

healthunlocked.com/search/p...

Both Medichecks and Blue Horizon offer private blood draw if you don’t want to do DIY finger prick test