Successfully negotiated Levo increase but GP ha... - Thyroid UK

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Successfully negotiated Levo increase but GP has scared me 😱

Samd39 profile image
29 Replies

Hi everyone,

Sorry for the long post, I think I might just need some reassurance that I’ve done the right thing. I have been having symptoms for the last few weeks - headaches, increased hunger, put on a bit of weight, mood issues, feeling cold, constipation. So I did a medichecks test which came back well within range (TSH 2.3 (0.27-4.2), T3 had dropped to 4 (3.1-6.8) but T4 looked good at 19.4 (12-22). So I waited because I knew the GP wouldn’t do anything. But I felt really rough last night and thought I’d give it go! He very reluctantly increased from 75 to 100 but wasn’t happy about using medichecks results- very scathing about them despite me reassuring him that I’ve used them with Endocrinologists in the past. But he really laid it on thick about going Hyper and how I wouldn’t be able to tell. ‘I’d just drift into it gradually.’ So I’m a bit scared about taking it now. Is this a familiar story? Should I consider waiting a bit longer? Or is this just him covering himself? Again, sorry for the long one. Thank you

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Samd39
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TiggerMe profile image
TiggerMeAmbassador

Nice and supportive then 🙄 I would alternate 75/100 and see how you feel, your TSH is above 1 which is around where you are aiming for, so you could do with a little increase...

You don't look like you are converting particularly well how are your ferritin, B12, folate and Vit D levels? All needed above mid range to aid conversion 🤗

p.s. you did well to push for the increase and you now have a little wiggle room with how you implement it 👏

You mention an Endo? Have you talked about adding T3?

You can't become hyper just over medicated

TSH 2.3 mIU/L (.027 - 4.2) 54.5%

Free T4 (fT4) 19.4 pmol/L (12 - 22) 74.0%

Free T3 (fT3) 4 pmol/L (3.1 - 6.8) 24.3%

T4:T3 Ratio 4.850 

Samd39 profile image
Samd39 in reply toTiggerMe

Thank you 🙂 I was super proud to have convinced him to increase it- but then the little niggling doubts started 😀 Alternating the doses is a great idea, I’ll try that.

I’ve been supplementing for a couple of years- my ferritin is 134 (30-150), B12 124 (37.5-188), Folate 18.2 (8.83- 60.8) & Vit D 105 (50-250. I was low on folate a little while back as stopped the supplement so I’m making up for lost time but Vit d seems to always be a struggle to absorb- I’ve been taking 4000 IU constantly for 2 years.

I haven’t seen an Endo for a while, I’ve been under the GP but I could see if I can get a consultation. Is it worth waiting to get my folate up a bit first?

Thank you again- I can tell you how much I love this forum

TiggerMe profile image
TiggerMeAmbassador in reply toSamd39

They are funny about handing over the goods and then agree to quite a big increase 🙄12.5mcg is a much better step when you are near the top

They all look pretty good 👏 I have found that the oil based sub lingual Vit D works best

It might be worth getting your DIO2 gene tested as you just aren't making good use of the T4 and only have a little more headroom... I did this, found it was wonky, T4 top of range and requested an Endo referral which got me the T3 😅

It is the most fantastic community isn't it 🤗

Samd39 profile image
Samd39 in reply toTiggerMe

Okay, great! I’ll look into the gene test, it’s good to have all the knowledge you can get. I’ll also try the sublingual Vit d, hopefully it’ll be what’s needed to get me optimal 🤞🏻

Thank you again- I know what I’m doing now 😀

TiggerMe profile image
TiggerMeAmbassador in reply toSamd39

Once you are top of the range with fT4 but still low fT3 the GP needs to hand you on as they can't prescribe T3 and they really don't like above range fT4

I did this one first as it was the cheapest but it's a bit of a faff as they insist on sending it to your GP due to some EU rules or charge you £65 for them to read the report to you ( it's less than half an A4 page).... they won't send it direct to you.... took a few visits and some nagging to get it from the GP but it did get me the referral

regeneruslabs.com/products/...

I've since done this one which they do send the results straight to you, it's a bit more comprehensive as I wanted to get my daughter done too 🤗 (luckily not as wonky as her Mum!)

bluehorizonbloodtests.co.uk...

Samd39 profile image
Samd39 in reply toTiggerMe

That’s great, thank you 🙂 I’ll probably be wonky too 😂

TiggerMe profile image
TiggerMeAmbassador in reply toSamd39

All the very best people are 😁… I really ought to sign off as wonky donkey 🙃

Gingernut44 profile image
Gingernut44 in reply toTiggerMe

Have you seen Wonky Donkey Grandma on YouTube - it’s a must watch

TiggerMe profile image
TiggerMeAmbassador in reply toGingernut44

I shall check it out.... I didn't know wonky donkey was such a big thing 😆 Go donkey!!

Gingernut44 profile image
Gingernut44 in reply toTiggerMe

Oh yes, second only to Eeyore 😁

TiggerMe profile image
TiggerMeAmbassador in reply toSamd39

Of course it goes without saying that you will probably need to do the full thyroid test privately in 6-8 weeks time to see where your at especially fT3 as the GP will no doubt refuse to test properly even though he's so concerned for your health 😩

Samd39 profile image
Samd39 in reply toTiggerMe

He did say he’d like me to do bloods in 3 months but I doubt it’ll include fT3, it doesn’t usually.

tattybogle profile image
tattybogle in reply toTiggerMe

Exactly .

Samd..... if you were a GP and you feared increasing dose was really dangerous for an insistant patient , and if you really knew what you were talking about when it comes to adjusting thyroid hormone doses....

..... would you dole out a 25mcg , just because that is the size most tablets come in ?

or would you advise a more cautious approach and offer to prescribe 12.5mcg tablets ? ( they do exist)

They can't have it both ways, either there's a dangerous risk of overmedicating your patient and "you're gonna die without even realising it's happening" if they allow you to take a little too much .

or........They are just repeating the rather groundless fears that they have been indoctrinated with, and it's not actually a problem, and they can whack doses up and down by 25mcg at a time because that's what size most tablets happen to come in because they haven't the imagination or maths skills to figure out how to prescribe 87.5mcg .

Worry not ..

try 87.5mcg for 6 weeks and see how you go .

Samd39 profile image
Samd39 in reply totattybogle

Thank you. You make total sense and I feel much more confident now. It never helps that when you have to speak to a GP, you’re never at your best so don’t deal with it in the way you would usually. So I very much appreciate this amazing community of knowledgable people.

tattybogle profile image
tattybogle in reply toSamd39

last time i saw a GP face to face about thyroid , we both lost our cool a bit , he told me "but you'll die !" if i didn't reduce my dose to 100mcg (my fT4 had gone very over range for some reason and hadn't come down even though he'd already reduced dose to 112.5mcg )

eventually, a few wks later , i got scared by what he'd said and reduced further to 100mcg .

it made me very unwell (i'd been feeling well before he started reducing dose)

he later agreed to put the dose back up to 112.5mcg despite the fT4 still being way over range "because he didn't want to make me unwell"

~ he's an experience senior GP partner.

~ he now prescribes the same dose the that he'd said would kill me. (and i'm not dead)

~ my fT4 level later came down by itself .

in contrast , a few yrs before this , when i WAS actually overmedicated (and yes, it does 'creep up on you') ...i felt very unwell indeed .... but none of the 2 GP's i saw considered if my symptoms might suggest i had become overmedicated , they sent me off for for ultrasound (looking for kidney stones) endoscopy , colonoscopy ( looking for cancer).. oh.... and a CT scan with contrast. (also looking for cancer)

in the middle of this bunch of tests while still feeling like i was dying , i happened to see a semi retired GP to chase one of the appointments up , who took time to do a proper physical exam and asked proper questions , including "why has no one ordered any thyroid bloods yet ?" ..... she told me to hold my hands out ~ she saw a fine tremor ~ a classic sign of overmedication .. she identified the problem and fixed it by reducing dose by 25mcg and i felt much improved within a few weeks.

What most GP's say to patients about thyroid medication is based on a lack of personal experience about how to adjust medication by looking at patients symptoms .. they are ruled by numbers nowadays .... they haven't been taught how to identify symptoms, and so they are consumed by panic because they are out of their depth ....... 'the number' often don't make sense , and they are fed on a diet of scare mongering BS both during their training and in the guidelines endocrinologists write for them .

So they pass that fearmongering on to us , and feel they have done their job well and kept us safe , and covered their backs.

Rapunzel profile image
Rapunzel in reply totattybogle

The bl**dy Rimmer experience strikes again x

Samd39 profile image
Samd39 in reply totattybogle

God, what a nightmare for you. I think I also spoke to a senior partner- he seemed very old school. Maybe we can hope for the younger doctors to have had a more up to date education. I have three daughters so I’d like to think they won’t have to deal with ignorant doctors but that might be a bit too optimistic 😬

tattybogle profile image
tattybogle in reply toSamd39

Hate to disillusion you ~ the current younger lot have been / are being fed a much worse diet of BS.. and the ones writing the BS are very influential., and not that old.

Some aspects are slowly improving ,, but a lot of ego's will have to get out of the way first. . and they don't want to go ., or to admit they have been wrong .

TiggerMe profile image
TiggerMeAmbassador in reply totattybogle

Scarecrows are far more eloquent than donkeys! 🤗

birkie profile image
birkie in reply totattybogle

Hi tattybogle ❤️

I love reading your comments, it fills me with pride that most on here know way more about thyroid conditions than the people who train, go to university to be a specialist or a gp.

When I eventually got diagnosed with hyperthyroidism (later diagnosed with graves) i was put on the 2 wonder drugs carbizole (don't think I've spelt that correctly) but you know it, then the beta blockers.

Unfortunately for me I couldn't stomach the anti thyroid drug both carbiz and PTU.. I eventually vomited them back.. So on both anti thyroid drugs I told my gp constantly.. "doctor if I'm vomiting these drugs back surely they won't be working, in that they won't be lowering my already high T4, T3 and TSH of 0.01

But....he insisted form sep 19th 2018 (initial diagnosis of hyperthyroidism) I must take the drug🤦‍♀️(I AM, BUT VOMITING IT BACK 😠)

In Nov 2018 he changed it to PTU with the same symptoms vomiting it back, I was constantly calling him and relaying my fears this drug cannot be working if its not getting into my system.

Again he insisted I persist with it, at no time from sep 2018 till January 2019 when I was rushed into hospital in thyroid storm did my gp do ANY thyroid blood tests on me.

They did in hospital.. My T4 was 100..my T3 was 36.9..my TSH was suppressed, I'd no doubt been that way for some time... Very HYPER..

Got thyroid removed in the may 2019, and since going HYPO all the flipping gp is NOW bothered about, is me over medicating myself with to much T3😂... He wasn't bothered about my health when I couldn't stomach the anti thyroid drugs making me go into thyroid storm🤦‍♀️

This is a little story I'd love to print out not just for my incompetent gp.. But for all gps.. You can't change your mind to suit yourself doctor... But it appears they do😠

Rapunzel profile image
Rapunzel

Ah, another Dr Buffoon. They are legion, but so are we. Take no notice of this tw*t and his nonsense, although if you wish you could get further TFT done via Royal Devon and Exeter NHS Foundation Trust laboratory, and Dr Buffoon will have to zip his ignorant lip, then, won't he? thyroiduk.org/help-and-supp...

Samd39 profile image
Samd39 in reply toRapunzel

That’s really interesting, I’ll take a look, thank you 🙂 I would love to be the one to educate him 😀

Rapunzel profile image
Rapunzel

I would love to be the one to educate him 😀

youtube.com/watch?v=r-ZiI3i...

You could always send him this. Dear Buffoon: please watch this video, swapping out Rimmer for yourself. This is an exact and scientific parody of our consultations

Samd39 profile image
Samd39 in reply toRapunzel

That’s hilarious. I bet it would go right over his head 😂😂

birkie profile image
birkie in reply toRapunzel

Omg.... Just seen this.... Rimmer... I've been a dwarfer since the first episode THE END, I love this song😂 very appropriate rapunzel.... Smeging fantastic.... I'm now going to think of my gp as a smeghead.. 😂😂😂😂😂😂

greygoose profile image
greygoose

It's just him demonstrating his overwhelming ignorance! Stupid man.

You're hypo, you cannot 'drift into hyper'. The thyroid doesn't work like that - in fact, yours probably doesn't work at all. You could be over-medicated but with a TSH that high, it's hardly likely, is it. And, even if you did become a bit over-medicated, it's nothing to be scared of. You're not going to drop dead on the spot! It would show up on the next tests and you'd just drop the dose again. It's just that doctors hate increasing doses and are scared rigid themselves of any kind of hormone, because they just don't have the education to understand them.

Take your increase, with joy that you got it, and I hope it helpss. x :)

humanbean profile image
humanbean

You might find this link of interest :

healthunlocked.com/thyroidu...

Samd39 profile image
Samd39 in reply tohumanbean

That is helpful, thank you

humanbean profile image
humanbean in reply toSamd39

You're welcome. :)

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