Advice re latest blood tests

[Cat_bluenote]

Hi all, please can I ask for advice on my latest Medichecks test results?

- 14/2/24 - 6 weeks after increasing Levo to 50 mcg daily

TSH - 4.74 (0.27-4.2)

T4 - 16.5. (12-22)

T3 - 5.1 (3.1-6.8)

Ferritin - 66.9 was 38

Vit D - 110. was 87

Folate - 45.4 (7- 46.8)

B12 active - 102 (37.5 - 188)

Previous 3/1/24

TSH - 6.87 ( 0.34 - 5.44)

T4. - 14.1 (11.5 - 22.7 )

I still have symptoms. I have already increased to 400 mcg weekly, instead of 350!

I'd like to increase to 50 /75 alternate days as I'm impatient (and hopeful )to start feeling better after feeling rough for most of last year. I'm 50 kg, so I'm thinking I should eventually be on around 65-80 mcg

However, I've booked to see a private endo in 8 weeks. I don't know what they'll think of me increasing Levo without GP permission? I will have to tell them, and don't want to get on the wrong side of them at first appointment! Would it be more sensible to stay on same dose for the next 8 weeks?

Ps there's no point asking GP for increase, it's like talking to a brick wall. That's why I'm trying Endo.

Thanks

[Bearo]

With TSH that high you definitely need an increase in Levo to 75mcg. So alternate day dosing should be fine. After that you may have to proceed more cautiously as you will be closer to your ideal dose just going by your weight.

Your frees are in not too bad a place for only being on 50mcg. And you seem to be converting ok.

Are you buying your own Levo? It shouldn’t be too difficult to get an increase on the NHS. There are guidelines for increasing levo, guidelines stating your TSH shouldn’t be above 2 once on Levo, and, as you know, there’s a rough guideline for weight to Levo ratio.

Vit d is in a good place.

Ferritin could do with a slight improvement which will have to come from diet unless you have tests showing low iron.

I can’t comment on the high folate.

At this stage in your thyroid journey I would be relying on the advice from this forum. You may be fine, symptoms wise, after another increase in Levo. But if seeing an endo seems right for you then I hope you find a helpful one!

[Cat_bluenote in reply to Bearo]

Thanks for all the advice. I wouldn't be bothered with a private endo if my GP would increase my Levo, but I've asked different ones mentioned NICE guidelines etc, and been refused. (Apparently, everyone is fine once their TSH is in range, or your symptoms are nothing to do with your thyroid). It's quite clear it's about risk management for them - It really isn't right, but I'm not up to having a battle with them. The only times I've been allowed an increase in meds, is when my TSH has gone above the range!

I booked the Endo appointment before I knew my latest test results. GP said not to come back til mid March anyway - even if they did agree I'd have to wait, and I'm sick to death of waiting!

Would prefer not to go it alone completely and be buying my own levo , but if it fails with the Endo then I'll have to. So grateful for all the advice from this forum. I have some spare levo 25s to supplement with., and I'll continue to take iron, as I'm vegetarian. Thanks again.

[greygoose]

I don't know what they'll think of me increasing Levo without GP permission?

Hang on a minute. You're not a naughty schoolgirl. You don't need your GP's permission! You are an intelligent adult who knows their own body. And if your GP is ignorant enough to keep you on a dose that is too low for you, and making you ill, what on earth are you supposed to do? Stay ill to bolster his ego? I don't think so! Just hold your head up high and say 'my GP refused to increase my levo, although I know it was too low, so I increased it myself'. If he jumps up and down then you'll know that he's just as ignorant as your GP and you need to find another endo. But for goodness sake don't let him intimidate or brow-beat you. He's only a human being, not a god.

[Cat_bluenote in reply to greygoose]

Thank you. You're quite right 😆 . I have this idea that if you question your GPs opinion, that they don't like it, and then don't want to help you. I don't actually want to see my GP at all, but unfortunately with this health condition it seems like I will have to for rest of my life 😣.

[greygoose in reply to Cat_bluenote]

Why? I have Hashi's/hypo and I haven't see a doctor since 2014. I started to self-treat for exactly the reasons you're finding out: I refused to be dictated to by someone who knew less about my disease than I did. I buy my T3 (T3 mono-therapy) on-line and dose by symptoms. I know my body well enough to know what I need - I know it far better than any doctor ever will! So, why should I listen to them?

[Cat_bluenote in reply to greygoose]

I agree entirely. You're right, we do know our own bodies better than doctors do. I'm only at the start of my journey with this and whilst I've learnt a lot already, I am a bit hesitant about self-treating. I've got to the point where I know they're wrong, and I don't want to remain under medicated and develop other health conditions. If getting to correct dose of T4 doesn't help, then T4/T3 may be the next step. I really would like to get help from someone who has more understanding of hypothyroidism than my GP ( shouldn't be difficult!) Life would certainly be easier if you could trust that your GP was actually interested, and able to look after your health competently.

[greygoose in reply to Cat_bluenote]

But they're not in the least interested, are they! They just don't care. And they certainly are competent to look after the health of hypos. And, you'll have a hard job finding anyone that is! Even endos know nothing about it.

OK, so you're still learning right now, but there will come a day when you will feel confident about striking out and treating yourself. When that day comes, you'll find all the help and advice you need on here.

[Cat_bluenote in reply to greygoose]

Thanks