GP appointment today - help!

[HotelHurricaine]

Hello lovely people,

I have a GP appointment today and I wanted to ask for advice.

I'm on 125mg Levothyroxine. Feel well except for inability to lose weight, Have lost about 3 stone over past 4 yrs but need to lose 2-3 more I'd say (don't use scales).

I have pretty much optimised all necessary vitamins & minerals and ferritin has just moved up to 86 (October) from 42 (May). T3 is low but has increased slightly since Feb (3.2). Am trying to improve through lifestyle before engaging with T3 and will wait until ferritin has been optimal (90/100 I believe from this forum) for a few months before trying T3.

(I tested just iron panel this week and haven't tested thyroid profile since July - trying to save pennies.)

Am intermittent fasting, gone gluten free since April, eat low carb high fat, dealing with gut biome, doing yin yoga, meditating, strength training, couch 2 5k, I don't drink alcohol, have reduced sugar but allowed on a Friday (!), eat all home cooked food, nothing processed etc.

A previous poster suggested I might be under-medicated as my FT4 is low in range.

My TSH in July was 0.47 (0.27 - 4.2) - I wondered what is the lowest TSH can go? Is there nay chance GP can be persuaded to put my levo up? Would others agree that would be a good idea?

Thank you in advance 🙏

[TiggerMe Ambassador]

Great job you are doing all the right things 👏

Your free's are quite low but if you feel well then this might be your happy place?

I wouldn't mention weight loss as a reason to request a 'trial' dose increase to try and put your free's up a little... perhaps say still fatigued, cold etc and would like to try a small increase?

It rather depends on the stance of your GP as most would view these results as perfect no need to meddle 🙄

If it comes back as a no I would orchestrate your own trial if you can work that into your prescription timings... even just adding an extra 50 -100mcg per week might just be the icing on the cake 🤗

[HotelHurricaine in reply to TiggerMe]

ooh really this is interesting! 50 - 100mcg / week could make a difference?

I confess to having been doing a little trial this week of extra 25mcg for 3 nights and already have noticed a difference. I will try just 50-100 mcg across a week and see what happens.

Thank you so much 🙏

[HotelHurricaine in reply to HotelHurricaine]

And thank you re the tip not to mention weight loss but stick to fatigue 😉

[TiggerMe Ambassador in reply to HotelHurricaine]

Once you are getting near to your sweet spot you need to sneak up on it with small increases and give it the full 6 weeks to see how it settles... bit like snakes and ladders if you go too high you end up back at the beginning

Perhaps stick with your extra 25mcg on alternate nights?... an extra 12.5mcg daily is a good sneaking up tack tic 🤗 alternate nights of 25mcg is good too if you have a good system of remembering where you are 😵‍💫

Edit... Does your GP accept your results or insist on doing their own? Be careful if they spring another test on you whilst experimenting 😳

[HotelHurricaine in reply to TiggerMe]

I love this idea. I am on it. About to order pill cutter!

[TiggerMe Ambassador in reply to HotelHurricaine]

I had an after thought and added the bit about GP testing...

[HotelHurricaine in reply to TiggerMe]

Good point. GP accepts private results but wont change prescription (just spoken to her). But she has agreed to refer to endo at local hospital - which will I expect take months if not years, so I think I can continue with my little experiment for a few months and see what happens.

I will re-test thyroid panel in December.

Thank you again.

[TiggerMe Ambassador in reply to HotelHurricaine]

Excellent! I wouldn't hold your breath about seeing an Endo, with those results they won't see you as you aren't wonky enough 😁

[HotelHurricaine]

Yes I suspect your right. Will go private if necessary and I have the list ready!

[greygoose]

eat low carb high fat

Make sure your carbs aren't too low, because we do need carbs to convert. And your conversion isn't brilliant.

[HotelHurricaine in reply to greygoose]

Conversion is pretty rubbish! I didn't know carbs were needed for conversion, thank you.

I do eat some carbs, just not bread, pasta, rice, potatoes, but lots from vegetables does that count?

[greygoose in reply to HotelHurricaine]

As far as I'm concerned, carbs are carbs, doesn't matter where you get them. But I'm willing to bet somone will disagree with me! 🤣

[SlowDragon Administrator]

Do you always get same brand levothyroxine at each prescription

Which brand?

Try extra 12.5mcg daily Levo

Get weekly pill dispenser to keep the other half of 25mcg in for next day

Have you considered trialing dairy free

Easier these days will all the non dairy alternatives. Oat milk is great (avoid ones with added iodine

[HotelHurricaine in reply to SlowDragon]

Thank you, I don't always get same brand but this time I have Mercury Pharma 100 mcg and Wockhardt 25 mcg. Is there any brand I should be asking for? or just consistency is key. I know one brand has lactose in but I don't think I have an issue there, although who knows.

I will try 12.5mg extra levo and use my holiday weekly pill dispenser - great idea - for the other half.

I am aware of dairy free being helpful for some and am just trying to avoid ( love yoghurt, cheese, milk and don't like most of the substitutes as they are full of fillers) but maybe that will be my next step if getting ferritin optimal and raising by 12.5 mcg don't help raise T3.

Thank you so much 🙏

[HotelHurricaine in reply to SlowDragon]

May I ask, what happens if the extra 12.5mcg makes a difference ( I will test after 6 weeks) - an extra 14 tablets each month might get noticed by my GP eventually. The computer seems to tell them when I'm not using my asthma inhalers as much as they've prescribed..

Would the next step be a private endo and hope they will recommend raise of levo?

[SlowDragon Administrator in reply to HotelHurricaine]

Which brand is 25mcg

Get bloods retested 6-8 weeks after increasing

See what results show

Assuming you find it better

Then tell GP you increased and feeling better etc

Please increase my prescription to 137.5mcg daily

If GP won’t endo is likely to do so

Meanwhile…if necessary

You can “loose” a prescription or box of levothyroxine (eg left behind at holiday hotel etc) and request to get new prescription early

[HotelHurricaine in reply to SlowDragon]

The 25mcg is Wockhardt.

Yes losing a box is of course very possible, thank you.

Thank you again!

[wavedancers in reply to HotelHurricaine]

With us, 'brain fog' is definitely a defense! 😂