I received a phone call this morning from my GP regarding my TSH levels being 7.83.
She said this was normal and that they didn’t need to worry about medication yet. I told them I’d been on 50mg for a number of years and she said first of all that it wasn’t on my records. She then said I’d cancelled it earlier this month!!!!
I get my medication every month from the pharmacy!
I then told her how I had been feeling over recent months, very fatigued, muscle aches, weight issues despite me going to the gym 4 times a week and walking out dog and she said ok we will increase it.
I have gone from being told no medication was needed, to it’s not on my records, to I’ve cancelled it and then it’s being increased.
I don’t understand what is a normal level and whether my current dose needs in reading now. Any advice you can offer would be appreciated
Thank you
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Sheepy001
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A TSH lab range is usually something like (0.35 - 4.94) they vary between labs - most without a thyroid issue have results in this range.
I think you have one of those doctors that think you don’t need treatment unless TSH is over 10 and assume that as long at it’s under 10 you are ok.
If so, they are very out of date and most do not feel well until TSH is nearer 1. FT4 usually needs to be top 3rd of range & FT3 at least half way. TSH isn’t always reliable but when it’s above range when already on Levo replacement - it’s clear you need a higher replacement dose.
You don’t have a test for FT4 & FT3, so you could test privately or you could argue you have hypothyroid symptoms & your 50mcg starter dose isn’t not adequate.
As they didn’t seem aware you had a diagnosis and that you were currently left of a starter dose for 10 years. I think you need to phone them, say you have hypothyroid symptoms and think you’re well overdue a dose increase.
Have antibodies ever been tested? In your last post you mentioned they planned to repeat TSH & test TPO antibodies and this would be the next step if it was a new diagnosis of raised / (sub clinical) TSH. Labs often automatically test FT4 if TSH abnormal, but doctors go by TSH. But might be worth arranging online access to results of asking for printouts of your results.
Reread your previous post as you have articles supporting this advice.
Click on name & icon to go to your profile & see prior posts.
Request immediate increase in levothyroxine to 75mcg daily
Which brand of levothyroxine are you currently taking
Do you always get same brand levothyroxine at each prescription
How long have you been left on just 50mcg levothyroxine (which is only the standard STARTER dose levothyroxine)
If only been on 50mcg a long time ….initially increase slowly to 50mcg and 75mcg alternate days for 3-4 weeks before increasing to 75mcg daily
Retest thyroid levels 6-8 weeks after getting to 75mcg everyday
ALWAYS Test thyroid levels early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test
Likely to need further increase in levothyroxine after this
Approx how much do you weigh in kilo
Even if we frequently start on only 50mcg, most people need to increase levothyroxine dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until eventually on, or near full replacement dose
Consider starting levothyroxine at a dosage of 1.6 micrograms per kilogram of body weight per day (rounded to the nearest 25 micrograms) for adults under 65 with primary hypothyroidism and no history of cardiovascular disease.
In the majority of patients 50-100 μg thyroxine can be used as the starting dose. Alterations in dose are achieved by using 25-50 μg increments and adequacy of the new dose can be confirmed by repeat measurement of TSH after 2-3 months.
The majority of patients will be clinically euthyroid with a ‘normal’ TSH and having thyroxine replacement in the range 75-150 μg/day (1.6ug/Kg on average).
The recommended approach is to titrate thyroxine therapy against the TSH concentration whilst assessing clinical well-being. The target is a serum TSH within the reference range.
……The primary target of thyroxine replacement therapy is to make the patient feel well and to achieve a serum TSH that is within the reference range. The corresponding FT4 will be within or slightly above its reference range.
The minimum period to achieve stable concentrations after a change in dose of thyroxine is two months and thyroid function tests should not normally be requested before this period has elapsed.
I have gone from being told no medication was needed, to it’s not on my records, to I’ve cancelled it and then it’s being increased.
Personally I would go on the "offensive" regarding this UNFIT for purpose GP. Write to the Practice Manager with bullet point FACTS - use only facts nothing else e.g. Your records are inaccurate. Ask WHY they are inaccurate and how long has that situation been going on.
(In fairness it may not be that particular GPs fault as such - he/she/they or them (!) might be new for example - or possibly there is a patient with the same name as you so the wrong details were looked at on screen).
See what they say.
Also insist on the other tests that have been recommended.
(Just for your own credibility really), remember that all T4 and T3 thyroid hormone replacement pills are measured in mcg (micro grams) - your 50mg would = 50,000 mcg!
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