Am I over medicated?

[Susie82b]

Latest test results below. Currently taking 75 MCG levothyroxine. Feel the best I have since diagnosed and starting to slowly lose weight. Waiting for phone call from GP to discuss results. Thanks Serum TSH 0.07 range 0.38 to 5.33

Serum T3 4.3 range 3.8 to 6

Serum T4 13.2 range 7.9 to 14.4

[SlowDragon Administrator]

FT4: 13.2 pmol/l (Range 7.9 - 14.4)

Ft4 81.54% through range

FT3: 4.3 pmol/l (Range 3.8 - 6)

Ft3 only 22.73% through range

Was test done early morning, only drinking water between waking and test and last dose levothyroxine 24 hours before test

Previous post shows you have Hashimoto’s

ESSENTIAL to test vitamin D, folate, ferritin and B12 at least annually

When were these last tested

What vitamin supplements are you taking

For good conversion of Ft4 to Ft3 we need OPTIMAL vitamin levels

Refuse to reduce dose based just on low TSH

[Susie82b in reply to SlowDragon]

Thanks for your prompt reply. Yes, test was taken first thing, just water and before medication.I think vitamin tests were about 9 months ago (medichecks) vitamin D was slightly below range so I took a supplement until summer) and ferritin near bottom of range. Not currently taking any supplements. Should I book a private test to check current levels?

Thanks for link to NICE guidelines.

[SlowDragon Administrator]

If GP says " I have to reduce your dose because the guidelines say i can't let you have a below range TSH" .....

The first paragraph in the NICE (NHS) Thyroid Disease, Assessment and Management guidelines says :

nice.org.uk/guidance/ng145

"Your responsibility

The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian. "

[DelicateInput in reply to SlowDragon]

Thanks, I have copied the article as my GP also wants to change my dose of 100 mcg daily. TSH 0.22 on two occasions and guidelines say should be 0.27 + (I ask you, a 0.25 difference). On both occasions tests were late morning. On the first I had eaten. On the second I had had a cup of tea and taken levo that morning. I could only get appt with end at that time and did not know GP would do TSH blood test. Therefore, I should be within range anyway. No need to reply but very grateful for the reference.

[SlowDragon Administrator in reply to DelicateInput]

refuse to reduce

Test vitamin levels and Work on improving

Then retest thyroid correctly

[RobinRosieDibs123]

I too am told I’m over medicated (should be on 75mcg but taking 100mcg). Feel much better and have now lost weight that I put on before increasing my dose. I have dug my heels in for once, was told that it will go on my medical notes that I am going against medical advice. However, my HBA1c is now normal so I feel that I am treating myself holistically. Weigh up the options and do what feels right for you. Numbers don’t take everything into account.

[Mrst1982]

With secondary hypothyroidism the tsh goes low these are similar to my results and private endo isn’t concerned. There is an article I shared with my Gp on the pituitary foundation website on secondary hypothyroidism.

[Merlio18 in reply to Mrst1982]

How do you know you have secondary hypothyroidism to do with pituitary issues as on the article it only mentions the below I am abit confused, I have hashimotos and since being on NDT my T4 is always low around 10 / 11 but on levo only 50/75 and I was taking multivitamins when I probably felt the wellest years ago it was top end at around 18 ? And when I asked the endo they never had an explanation so how do I know where my T 4 levels should be and whether I am under medicated myself and need more meds ?

Please note that recommendations only apply for patients with a large pituitary mass (macro adenoma) or after pituitary surgery or pituitary radiotherapy:

[Litatamon in reply to Mrst1982]

Synthroid even writes it in their own flippin' pamphlets, that TSH should not be the marker for secondary hypothyroidism.

So even big Pharma tries to talk some sense into them. Insert smile, sigh and laugh.

My TSH is at 35.8 & I got a sermon today about overmedication and heart attack & stroke when deciding to go way up and let me go slowly on my own. I was truly appreciative of my endocrinologist trusting me to go up slowly on my own and not abusing it, but the things they feel they have to say. And he was typing so much as he was 'educating me', so curious what he was writing in my chart. Spellbinding.

[Hidden in reply to Litatamon]

I’m very confused Litatamon.

Are you saying that your doctor considers that you are overdosed with a TSH of 35.8. What is the range for TSH in Canada?

[Susie82b]

Thanks for all the advice. Waiting for a call from the GP.

[Newmummy82]

when I’m having issues with my GP i find writing a letter explaining my points to the GP helps so that I don’t forget to mention something or let them bamboozle me. I include links to articles and studies to support my case

[Hannahhhhhhhh in reply to Newmummy82]

Hello, what links and articles do you include for your GP? Is it possible to post them?

[Bearo in reply to Hannahhhhhhhh]

Tattybogle posted a collection of useful articles/references and I think CharleyFarley pinned them if you look on ‘all pinned posts’. But if you can’t find them you can click on Tattybogle’s avatar and see all her posts.

If I’ve got any of that slightly wrong I hope someone will correct me!