advice for next appointment

hi there,

I’ve been on 87.5mcg dose for 1.5 weeks… I had some bloods last week and for some reason they also did my thyroid bloods which are below:

TSH 2.73 (0.27-4.2)

FT4 21.3 (11.0-21.2)

They’ve already been marked as abnormal.

My question is, do these results matter?

Can I argue that we disregard them as I’ve only been on new dose for ten days when test was done?

My TSH is still over 2 which as I understand isn’t optimal.

just steeling myself for an argument when this wasn’t even the test they were supposed to run…

[DippyDame]

Can I argue that we disregard them as I’ve only been on new dose for ten days when test was done?

Absolutely! Refuse any suggested dose change on that basis

The incompetence beggars belief!!

[Hidden in reply to DippyDame]

Thank you for reassuring me!

I hate speaking with GP and seem to have a lot going on health wise atm but feel like I’m slowly stabilising on levo so this has thrown a spanner in the works a bit!!

I’m assuming because my Tsh is still over 2 I’m not over medicated? I certainly don’t feel it!

[Hidden in reply to Hidden]

Your thyroid blood results are meaningless anyway without FT3 🙃

[Hidden in reply to Hidden]

Unfortunately I cannot afford a private test at the moment and this is all the NHS provide…

[Hidden in reply to Hidden]

Not true I’m afraid. I’ve seen NHS endos with quite a good knowledge base. It sounds to me as though this chap could be a diabetes specialist. Endocrinology covers both conditions.

[Hidden in reply to Hidden]

I haven’t seen an endo at all, it’s just my GP managing this unfortunately

[tattybogle in reply to Hidden]

ridiculous isn't it ... they say the reason they can't test fT3 is cos it's "unnecessary" and therefore wastes NHS money ., but the same organisation happily wastes (more) NHS money by unnecessarily running TSH AND fT4 10 days after a dose change ...

[Hidden in reply to tattybogle]

They’re awful. It’s frightening that they’re let loose on patients.

[DippyDame in reply to tattybogle]

It's an absolute travesty...I feel a rant coming on!!

[Hidden in reply to tattybogle]

It certainly makes things very confusing! I’ve really tried to be patient with NHS but have found their management of my thyroid stuff very inefficient and muddled

[DippyDame in reply to Hidden]

I'd push for inclusion of FT3 when FT4 is so close to top of range.....I guess your T4 to T3 conversion may also be impaired

TSH is not an accurate marker....FT3 followed by FT4 are the important results....but try telling that to a medic and most will think you flew in on a broomstick!!

Goodness knows what they teach them about thyroid disease in med school....very little it seems

You know your body better than anyone else so don't be fobbed off by a medic's limited knowledge.

This might help

thyroidpatients.ca/2021/07/...

Suggest you make a list of what you want to say and ask and take it with you...that used to stop me squawking like a demented parrot at appointments!!

Just refuse any change based on those untimely labs!!

[Hidden]

They’ve marked your FT4 as abnormal although it’s less than one point over the top of range. That will have been flagged by the lab. This is inconsistent with the idea that ‘abnormal’ FT4 should trigger an FT3 test.

This doctor wants to have his cake and eat it doesn’t he?

[Hidden in reply to Hidden]

I have a phone appointment tomorrow to discuss my other bloods but I’m sure thyroid will defo come up!! I will certainly ask about the ft3.

[SlowDragon Administrator in reply to Hidden]

They shouldn’t have tested until at least 6-8 weeks after any dose change or brand change in levothyroxine

If you took levothyroxine before test it’s false high Ft4 anyway

Always …..Last dose levothyroxine 24 hours before test

[Hidden in reply to SlowDragon]

I followed protocol and hadn’t had levo for 24 hours before, I just had a feeling they’d add thyroid to the test…even though they weren’t due or supposed to be part of this set.

Does this maybe mean that 87.5mcg is too much?

This has really thrown a spanner in the works and made me a bit stressed about my apt. tomorrow!

[SlowDragon Administrator in reply to Hidden]

No it was just far too soon to test

It takes minimum 6-8 weeks for each dose increase to settle in

[Gingernut44]

Just a little tip - next time you go for a blood test of any sort, ask the phlebotomist what tests have been listed. If they try to throw in thyroid tests and the bloods are for something else, refuse the thyroid ones. It is your right to refuse any blood test you don’t want and they should honour your decision. It happened to me, I actually told the nurse not to include a TSH test as I’d already taken my T4/T3 too close for testing. I had already agreed this with my GP as he leaves my dosage to my Endo. As it was on the system, she ignored me and didn’t remove the TSH test which prompted the usual guff from the Lab that my dose should be reduced. I’m very wary of this particular nurse, she obviously doesn’t know the protocol. If she does it again, there’ll be a strongly worded letter going to the Practice Manager 😁