To be clear, the only difference between the 2 test results was I started taking a Berberine capsule once a day (750mg). Could this be the reason for the massive shift?
I received a message from the GP Today," Your recent Thyroid tests are showing over replacement. Continue with current does of thyroxine and organise a repeat test in 6 to 8 week"
My plan was to stop this supplement and repeat the blood test. Any thoughts please?
Thanks in advance.
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craigdaddy
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Well, the 'massive shift' as you call it, is only in the TSH. And, frankly, that doesn't count. Your FT4 rose slightly, but so it should when you have an increase in dose.
Your doctor is only looking at the TSH, because he's ignorant. But, actually, your FT4 is saying you need and increase in dose because you're under-medicated.
Do did you have the blood draw at the same time of day for both these tests?
Well, if I were you, I would refuse any attempt to lower your dose. your FT4 is too low for someone on thyroid hormone replacement. Most hypos need it up around 75% through the range. Yours is only just over 50%. The TSH is the least important number, and should never, ever, be used to dose by. The most important number is the FT3 and they don't even test that! Don't know what it is. But, with your FT4 it's pretty certain that the FT3 is too low.
Sorry for the butt in here 😬 but this is so annoying, when are gps and endocrinologists going to stop using the TSH as there gold standard to Diagnose patients and to decrease thyroid medication. 😠I'm so sick of my gp doing this😠 I'm also so sick of trying to explain.. I "HAVE NO THYROID" so my TSH should be 1 or below, everytime it goes below 1 as last time it was 0.05 he immediately tries to get me of my T3 medication 🤦♂️ we have a bit of a back and forth, then he says.. "well lf you want your symptoms to get better you must decrease your meds" , bull💩 I'm not over medicated my T3 was well within range 🤷♀️ but he just referes back to the TSH, and when I say that's just a signal not a hormone he gives up... But then another gp sees the next results and it starts all over again 🤦♂️, I'm due to have my bloods done in about 2 weeks I've increased from 20g to 25mg if its took my TSH down to under 1 I'll be having the same conversation with a gp again.. 🤦♂️ 🙄🙄🙄
It's really tricky trying to navigate this journey as they just treat us like numbers but each case is unique. I too have no thyroid and it's difficult to constantly challenge "the experts" that we actually rely on to guide us.
But they're not experts. And they know they aren't! As much as they might bluster about being in med school for x number of years blah blah blah, deep down they know they are out of their depth. So, we mustn't rely on them to guide us. We have to learn as much as we can about our disease and guide ourselves - with they help of other patients who have already been there, and done that...
But that's what they learn in med school. And, what they learn in med school is sacred and not to be questioned. They don't use their brains, or any logic, they're just robots. I can't see it changing any time soon, unless things change in med school. And, that would involve admitting they'd be wrong for all these years, and doctors are not good at admitting they're wrong!
Very true greygoose, unfortunately 🤷♀️.. I recently saw an endocrinologist in Liverpool about my parathyroid, she actually surprised me by saying she and the parathyroid surgeon I saw are trying to change the diagnosis around endocrine illness, in that symptoms should always be the first thing we look at then bloods.. But it's not all about the levels every patient is different 👍 she was a breath of fresh air❤️
Thanks for replying, I have been following your guidelines since my very first post.
I make sure I have not taken any medication 24 hours before my blood test. I make sure the blood test is early morning. I have completely stopped all my supplements that I used to take apart from 1 capsule of Berberine with my food (not sure if that affects anything!)
I'll ask to change to Accord as my 100mcg is by them.
I was taking my Vit C (1000mg), Vit D(2000IU), Centrum Advanced Multivitamins daily but I had run out approx 1 week before my blood test. Additionally I would always take them 5 hours after taking my Levothyroxine.
Many people find Levothyroxine brands are not interchangeable.
Most easily available (and often most easily tolerated) are Mercury Pharma or Accord
Accord only make 50mcg and 100mcg tablets. Accord is also boxed as Almus via Boots,
Mercury Pharma make 25mcg, 50mcg and 100mcg tablets
Mercury Pharma also boxed as Eltroxin.
Both often listed by company name on pharmacy database - Advanz
Wockhardt is very well tolerated, but only available in 25mcg tablets. Some people remain on Wockhardt, taking their daily dose as a number of tablets
Lactose free brands - currently Teva or Vencamil only
Teva makes 25mcg, 50mcg, 75mcg and 100mcg
Many patients do NOT get on well with Teva brand of Levothyroxine.
Teva is lactose free.But Teva contains mannitol as a filler instead of lactose, which seems to be possible cause of problems. Mannitol seems to upset many people, it changes gut biome
Teva is the only brand that makes 75mcg tablet.
So if avoiding Teva for 75mcg dose ask for 25mcg to add to 50mcg or just extra 50mcg tablets to cut in half
But for some people (usually if lactose intolerant, Teva is by far the best option)
Aristo (currently 100mcg only) is lactose free and mannitol free.
If a patient reports persistent symptoms when switching between different levothyroxine tablet formulations, consider consistently prescribing a specific product known to be well tolerated by the patient.
Physicians should: 1) alert patients that preparations may be switched at the pharmacy; 2) encourage patients to ask to remain on the same preparation at every pharmacy refill; and 3) make sure patients understand the need to have their TSH retested and the potential for dosing readjusted every time their LT4 preparation is switched (18).
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