Should I lower dose

[2122anne]

Hi everyone I had my bloods done last Mon the receptionist rang on Wednesday and told me the doctor wants me to lower my dose to 100 should I ask my consultants advice 1st

[pennyannie]

Hello 2122anne :

Do you know the reason why ?

Can you share the blood test results and ranges on which this decision has been made as then we can advise you better :

If just based on a TSH reading - decline the advice and ask for a full thyroid blood panel to include at least a TSH, Free T3 and Free T4 reading and range - ideally to also include, antibodies, inflammation and ferritin, folate, B12 and vitamin D.

Did you take your T4 after the blood draw and do you always take the T4 on an empty stomach with a full glass of water and wait an hour before eating or drinking anything other than water.

[2122anne in reply to pennyannie]

I take my levo thyroxine in the morning and wait at least 30 mins b4 I have a coffee it's always on an empty stomach

[pennyannie in reply to 2122anne]

Ok good -

and when you have a blood test - is that always an early morning appointment

and you remember to take your daily T4 dose -

AFTER you have had your blood drawn for the tests ?

[2122anne in reply to pennyannie]

I only take levo thyroxine I'm getting my blood results today from my gp

[pennyannie in reply to 2122anne]

Yes - but just asking about your routine on the day the blood test -

Do you wait until after the blood has been taken and then take your daily dose of T4 -

or do you take your daily dose of T4 as usual and then have a blood test later on in the morning ?

[2122anne in reply to pennyannie]

I take my medication 1st they didn't ask me to fast

[pennyannie in reply to 2122anne]

Ok - well that is likely why you are getting the dose reduction as the blood test will be a false high and measuring the dose you have just taken :

Maybe ask for a rerun of the blood tests and follow the protocol as detailed to everyone on this forum and explained in full below by     Jaydee1507

Your doctor may say it doesn't matter if you are following the same routine all the time - the results reflect accurately - but it certainly does matter - and considering you haven't a thyroid this will impact you more than someone who has some residual own daily thyroid hormone production.

T4 is a storage hormone - so do not worry - you will be fine until after the blood test - I was - and so will you be.

More important than the TSH or the Free T4 result is the Free T3 reading and range and these need to be read in conjunction with each other to be accurately dosed and monitored.

If your metabolism has been slowed down too much ( likely ) you body will have struggled to extract key nutrients through your food and we need optimal levels of ferritin, folate B12 and vitamin D for T4 - Levothyroxine to work well within our bodies and convert to the active T3 hormone that runs all the body's requirements, from the physical, mental, emotional, psychological and spiritual to our inner central heating system and our metabolism.

[Jaydee1507 Administrator]

Your dose has been reduced alot. You were taking over 150mcgs a few years ago.

I would be asking on what basis your GP is wanting to reduce your dose.

Refuse if he is basing this on TSH only and get private blood tests done.

How do you feel?

Have you seen the blood results and can you share them with us here? You are legally entitled to a printed copy of your results, ask at GP reception. In England you can get the NHS app and ask for permission to see your blood results on that by asking at GP’s reception.

When hypo we get low stomach acid which means we cannot absorb vitamins well from our food, regardless of a great diet. For thyroid hormone to work well we need OPTIMAL levels of vitamins. Have you recently or could you ask your GP to test levels of ferritin, folate, B12 & D3? Private tests are available, see link for companies offering private blood tests & discount codes, some offer a blood draw service at an extra cost. thyroiduk.org/help-and-supp...

There is also a new company offering walk in & mail order blood tests in Crawley, Hove and Reigate areas. No charge for blood draw in clinic. Check to see if there is a blood test company near you. onedaytests.com/products/ul...

Only do private postal testing early Monday or Tuesday morning.

Recommended blood test protocol: Test at 9am (or as close as possible), fasting, last levo dose 24hrs before the blood draw, last T3 dose 8-12 hours before blood draw & no biotin containing supplements for 3-7 days (Biotin can interfere with thyroid blood results as it is used in the testing process)? Testing like this gives consistency in your results and will show stable blood levels of hormone and highest TSH which varies throughout the day. Taking Levo/T3 just prior to blood draw can show a falsly elevated result and your GP/Endo might change your dose incorrectly as a result.

[2122anne in reply to Jaydee1507]

I'm in Belfast I don't think we have that service this is the 2nd reduction in dose I was reduced a few months ago fro 150 to 125 and now 100

[Jaydee1507 Administrator in reply to 2122anne]

We do need to know your blood results that the GP is working from as do you. Can you get a print out of the results.

Most of the private blood test companies also use mail order.

[SeasideSusie Remembering]

2122anne

If you are under a consultant then surely the consultant is the one who decides your dose? Are you due to see the consultant or has he passed your care on to your GP?

[2122anne in reply to SeasideSusie]

No I still have telephone consults with both endo and oncology every 6 months I have been trying to get through to my consultans secretary to leave a message for him will keep trying also will get a print out of my results thank you

[SlowDragon Administrator]

Assuming you don’t have hyper thyroid symptoms and if Ft3 is not over range you’re unlikely over medicated

Never agree to dose reduction without getting Ft4 and Ft3 tested

A) you are legally entitled to your actual results and ranges

B) always test correctly….early morning and last dose levothyroxine 24 hours before test

C) if taking T3, split dose day before test into 2 or 3 smaller doses spread through the day with last dose Approx 8-12 hours before test

Taking almost any dose T3 will significantly lower or suppress TSH

D) get vitamin D, folate, ferritin and B12 tested at least annually.

Essential to maintain GOOD vitamin levels for conversion of Ft4 (levothyroxine) to Ft3 (active hormone)

what vitamin supplements are you taking

When were vitamin levels last tested

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...

Monitor My Health also now offer thyroid and vitamin testing, plus cholesterol and HBA1C for £65 

(Doesn’t include thyroid antibodies) 

monitormyhealth.org.uk/full...

10% off code here 

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

Test vitamin D twice year

NHS easy postal kit vitamin D test £31 via

vitamindtest.org.uk

Only do private testing early Monday or Tuesday morning. 

Link about thyroid blood tests

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

Symptoms of hypothyroidism 

thyroiduk.org/wp-content/up...

Tips on how to do DIY finger prick test 

healthunlocked.com/thyroidu...

[SlowDragon Administrator]

previous post 4 years ago

healthunlocked.com/thyroidu...

First step is ALWAYS to get FULL thyroid and vitamin testing done…..ideally via GP

But thousands of U.K. patients forced to test privately

healthunlocked.com/search/p...

Blue horizon results

healthunlocked.com/search/p...

Both offer private blood draw at clinic near you for extra fee ….if you don’t want to do DIY finger prick test