surpressed and dose reduced

[Welshscot]

hi yesterday I met with the Doctor to talk about my recent blood tests. I have an under active thyroid, I’ve had it for years, I’m 63 - anyway she said my tsh (?) was surpressed and wanted to drop me from 125 to 100. She also said my cholesterol was higher than previously. My question is is there a connection between my surpressed results and higher cholesterol. I have been feeling very tired a lot lately but I did have covid about 10 weeks ago so not sure if that’s why I feel so knackered or if it was my thyroid. I must admit I had thought that she might increase my thyroxine not reduce it. Any advice gratefully received 😊

[Star13]

“was surpressed and wanted to drop me from 125 to 100.”

Did you agree to drop or did you tell them what you have told us?

what was your latest blood test result with reference range? What time of day was the blood test taken? Are you taking any vitamins like B12, folate, ferritin or Vit D and if so what was the last blood test results for those?

[Welshscot in reply to Star13]

hi, I told her I wasn’t very happy about reducing, that I was very tired etc. I did tell her that I didn’t believe that the range was all there was to it, that it didn’t always reflect how I feel but that I would try the reduced dose to see how that went. I’ve not had any other tests re:vitamins etc and I don’t take any of those you mention….I used to take B12 but after a while my skin got very itchy so I stopped it. I’m going to try to get through to them and ask for copies of blood tests. She wanted to put me on statins but I said no! Thanks

[Welshscot in reply to Star13]

meant to say test was taken around 5pm and I usually take my tablets around 10.30 pm. Thx

[SlowDragon Administrator in reply to Welshscot]

NEVER agree to dose reduction based just on TSH

ALWAYS Test thyroid levels early morning, ideally just before 9am and last dose levothyroxine 24 hours before test

TSH would be substantially lower if tested at 5pm than if tested at 9am

Most important results are always Ft3 followed by Ft4

Aiming for Ft3 at least 50% through range

Low Ft3 is likely cause of increased cholesterol levels

For good conversion of Ft4 (levothyroxine) to Ft3 (active hormone) it’s essential to have good vitamin tests

As you have recently had Covid and test was done in afternoon

1) Request GP test vitamin D, folate, ferritin and B12 NOW

Once you have results

Work on improving low levels (if necessary)

Optimal vitamin levels are

Vitamin D at least over 80nmol

Serum B12 at least over 500

Folate and ferritin at least half way through range

2) request retest of full thyroid tests….TSH, Ft4 and Ft3…..at least 6-8 weeks after getting all four vitamins improved to OPTIMAL levels

Book early morning test and last dose levothyroxine 24 hours before test

Do you always get same brand levothyroxine at each prescription

Always take levothyroxine on empty stomach and then nothing apart from water for at least an hour after

No other medication or vitamins within 2 hours minimum of levothyroxine

Exactly what vitamin supplements are you currently taking

[Star13 in reply to Welshscot]

It’s possible the GP only tested your TSH and as your test was at 5pm yours would be at its lowest. We recommend you do the test early in the morning no later than 9am.

The reason I replied to you was because you sounded very similar to me in how I felt after having Covid with fatigue weeks after. I also found it made my FT4 drop slightly. More importantly though after testing B12, Folate and Ferritin I found I was low in Folate, in fact deficient. Now after supplementing with a good BComplex not only do I feel better but my FT4 has jumped up to a more acceptable level.

It’s up to you if you decide to drop your levo dose or not but if I were in your shoes I’d test B12. Folate, ferritin and Vit D first before you do anything and if the GP has not tested your hormones also test FT3 and 4. Then you will have a better picture on what best to do next.

[SlowDragon Administrator in reply to Welshscot]

If GP won’t test vitamin levels now

Remember to stop taking any vitamin supplements that contain biotin (eg vitamin B complex) 5-7 days before any blood test

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...

Only do private testing early Monday or Tuesday morning. 

[PurpleNails Administrator]

The TSH is what the pituitary is signalling the thyroid to produce. But the TSH doesn’t cause symptoms & can be unreliable.  

It is the FT4 & FT3 you need to know.  If both are high you’d be over replaced but they might actually be low.  

Were they tested or is GP going by TSH alone? 

Low thyroid levels can contribute to increase in cholesterol.  

[Welshscot]

I’ve emailed the GP asking for my results and also the previous one - thank you

[Anthea55 in reply to Welshscot]

Best place to get your results is online. Ring your surgery and ask to be set up for online use. They should give you a user name and link. Then you can see previous results and often you can set up appointments as well. I think there is an app as well.

[SlowDragon Administrator]

You are legally entitled to printed copies of your 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 your medical record and blood test results

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

Link re access

patients-association.org.uk...

healthunlocked.com/thyroidu...

In reality some GP surgeries still 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.

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 for autoimmune thyroid disease

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

[Welshscot]

thanks, I’ve requested results and they’ve sent me a form to fill in. I’ve never had b12 etc tested! Will see how I get on thx again 🙂

[Bearo]

NICE guidelines actually say if cholesterol is high treat the thyroid first because then the cholesterol will probably reduce on its own (mine did).

The guidelines also state that statins are not recommended for those being treated for thyroid disorders.

Sorry I don’t have the link, but it’s often quoted on this site.

[Suvi8901 in reply to Bearo]

”The guidelines also state that statins are not recommended for those being treated for thyroid disorders...”🧐

—————-

Are you sure about this?👆🧐

I have been prescribed 10mg Rosuvastatin to be taken at night and 100mcg Levothyroxine to be taken in the morning by a consultant NHS endocrinologist doctor whom I have great faith in.

I have primary hypothyroidism, lupus, DLE, SLE, type 1 diabetes and high cholesterol with good blood test results.

Do you actually mean to state the drugs should not be taken at the same time or co-administered during the day?

Regards

[tattybogle in reply to Suvi8901]

nhs.uk/conditions/statins/c...

"If you have an underactive thyroid (hypothyroidism), treatment may be delayed until this problem is treated. This is because having an underactive thyroid can lead to an increased cholesterol level, and treating hypothyroidism may cause your cholesterol level to decrease, without the need for statins. Statins are also more likely to cause muscle damage in people with an underactive thyroid."

[Suvi8901 in reply to tattybogle]

THANK YOU!✅

I’m wondering now whether I should stop taking that rosuvastatin as I’m getting left lower leg pain in my calf muscle for over a week now?🧐👆🥹

Hopefully the muscle damage is reversible?

I have cataracts as well and statins are implicated in that eye condition ie subcapsular cataracts.

[tattybogle in reply to Suvi8901]

i know there is lots of info on statins/ risks/ experiences on here somewhere .. but i don;t have a quick link to any of it ... perhaps it's worth you putting up a new post asking about your statin use / muscle pain , then those with better info wil be more likely to see it and offer info /opinion .

[tattybogle in reply to Suvi8901]

p.s Suvi, when you do, include you latest TSH / fT4 / fT3 result on your increased dose of 100mcg .. on previous dose of 75mcg your TSH was very high ( 18 ish )..... so your hypothyroidism treatment should really have been sorted out before anyone suggested statins.

[Bearo in reply to tattybogle]

thanks for the link, tattybogle