Updated labs, new doctor, but still a no on adjusting meds

[spookyscaryskeletons]

I posted my labs back in December and contacted my doctor asking for an increase in levothyroxine to 100 instead of my current 75. I've talked with them twice about this, but they seem to think that since my TSH is in range that any med adjustments may make me have some heart issues.

I recently changed my PCP and she mentioned to me that she also has Hashimotos on my last visit. I gave it a shot and went to her about these specific issues. I shared my last results with her, and she too said the endo probably didn't want to adjust my ranges because it could throw something else out of bounds. She said she wanted to do her own labs, including checking other hormones because it could be something else that is making me feel less than good.

She did prescribe me b12 shots, so I guess that is a plus. I told her I have a lack of energy or motivation, weight gain, lost libido, etc. She hinted that maybe my testosterone was out of range. I have my new lab results and a virtual appointment with her in a few days. What do you think?

If changing meds does have a negative impact, can you just stop taking them and symptoms will stop or does it cause semi-permanent issues that are hard to recover from? It doesn't seem to matter what I say, they will not adjust my meds. I try not to sound like a know-it-all but still advocate for myself. It is a fine line and I haven't been successful.

New Lab Results: Fasting before 9 am. No levo that day and only half a dose of my t3 the day before.

B12 Current 715 Previous 421 Range: 232-1245

Folate, Serum Current 12.2 Previous 12.7 Range: >3ng

Testosterone Current: 10 Range: 8.60

Free Testosterone Current: .9 Range: 0.0-4.2

Free T4 Current: 1.55 Previous: 1.02 Range: 0.82-1.77

DHEA Sulfate Current: 139 Range: 57.3-279.2

TSH Current: 0.806 Previous: 0.599 Range: 0.450-4.5

Reverse T3 Current: 15.2 Range: 9.2-24.1

Vitamin D Current: 26.2 Previous: 20.8 Range 30-100

T4 Current: 8 Range: 4.5-12

Thyrogloblin Antibody: Current and Previous both <1 Range: 0.0-0.9

TPO Current: 100 Previous: 130 Range: 0-34

Free T3 Current: 2.7, Previous: 2.8 Range: 2-4.4

[TiggerMe]

Free T4 (fT4) 8 pmol/L (4.5 - 12) 46.7%

Free T3 (fT3) 2.7 pmol/L (2 - 4.4) 29.2%

T4:T3 Ratio 2.963 

Vitamin D 26.2  (30 - 100) -5.4%

So your thyroid levels are both low which you need to point out to them if they are just looking at your TSH and your Vit D is deficient

[SlowDragon Administrator]

no ferritin result?

You need dose increase in levothyroxine

[spookyscaryskeletons in reply to SlowDragon]

How do I get them to do this though? I've been trying for a few months.

[Espeegee in reply to spookyscaryskeletons]

Maybe consider buying your own? Waiting around for the GP to awaken might be longer than you can afford to wait. At least having some prescribed is better than having to buy it all.

[spookyscaryskeletons in reply to Espeegee]

I think it is only available by prescription in the US, but I could be wrong.

[Espeegee in reply to spookyscaryskeletons]

It is only on prescription in the UK too but there are other sources, if you like I can pm you with one.

[NanaV54]

Your D is also low and D has been shown to be directly related to T4 to T3 conversion. Deficiencies also cause similar symptoms... Depression, fatigue, etc. You might want to consider adding Vit K2 with D3. It helps to regulate calcium, directing it to your bones and teeth and, potentially, away from your arteries. It might actually improve your FT3 levels and help your symptoms.

[Dryski]

I'm in the same boat but older. My doctor wont increase either. Their fear as explained to me as increase could cause atrial fibrillation which may not be reversible by backing off. You could then be on beta blockers for high heart rate and blood thinners to prevent clotting for the rest of your life. I feel your pain. My case is central hypothyroidism and I feel like a zombie but trying to deal.

[spookyscaryskeletons in reply to Dryski]

I'm sorry you're experiencing the same. It's so frustrating.

[Dryski in reply to spookyscaryskeletons]

Didn't mean to add tour frustration but I was told each dose increase has a fifty fifty chance of your heart not handling it. I personally got ripped a new one for asking because another one of his patients did not listen, went to another provider and now has problems.

[spookyscaryskeletons in reply to Dryski]

Oh no you didn't add to the frustration but provided some clarification. Thank you for that!

[FancyPants54 in reply to Dryski]

50/50 chance of heart not handling a dose increase!? I'd like to see which lucky dip bag he drew that one out of! The man's a fool. A lot of people experience some side effects at the time of a dose increase but they settle down. Or you back off and half in the increase and try again. I have to do that. 25mcg a shot seems too much in one go. 12.5 (by breaking tablet in half) is much easier to handle for a couple of weeks and then I add the rest.

Low FT3 is just as likely to give you AF as over range FT3. But they never tell us that. I don't think they even realise it. My permanent AF started long before I added T3 to my meds.

[Sparklingsunshine in reply to Dryski]

AF is also a side effect of undertreated hypothyroidism. At one point, until I introduced some T3 I was taking 200mcg of Levo. I'm 54 and dont have AF. I think the whole heart problem mantra is very overblown and is just a scare tactic used by rather ignorant doctors. Who conveniently ignore the health implications of having long term poorly medicated UAT.

[redhead41 in reply to Sparklingsunshine]

We do have to remember that atrial fibrillation occurs with increasing age and is seen in the general population without thyroid disease so you may have gone into af with or without thyroxine.

[Sparklingsunshine in reply to redhead41]

I dont have AF.

[Dryski in reply to redhead41]

I agree with you on that. My doctor just said that with doses above 100 on levothyroxine your odds of atrial fibrillation become higher and if your in range they don't like to push it. I'm on 125 and have a low normal again but he doesn't want to raise it. Also depends on your other meds and other problems. Everyone has a different situation.

[FancyPants54 in reply to Dryski]

It largely depends on how ignorant they are of proper thyroid treatment. And if yours is trying to fob you off with "over 100 increases risk" and "but what about" your other meds, then he's ignorant and will keep you sick.

[FancyPants54 in reply to redhead41]

Exactly. And for some of us it's hereditary. Mine started in my 40's, thank Dad!

[Espeegee in reply to Dryski]

I'm not medicated for thyroid as my results are "within range" despite T4 and folate at the very bottom but I have paroxysmal Afib. I don't take blood thinners or beta blockers mostly because although suggested no one has actually got as far as prescribing them. I read up on Afib and the chances of it killing you are very slim. I wouldn't be accepting that as an excuse for not prescribing an increase. I wonder how many thyroid patients in a practice it would take for the GPs to have a lightbulb moment that they're getting it all wrong.

How did you get a diagnosis of Central Hypothyroidism? It's been suggested on here that that's what I have but the Endos I've seen clearly haven't heard of it?

[Dryski in reply to Espeegee]

About twenty years ago my tsh and free t4 both went low. I was scanned and told I had a microadenoma and that my pituitary was the problem not telling the thyroid to produce t4. I was put on levothyroxine for life. Further scans showed the microadenoma had disappeared since but I'm still in the medication. My thyroid itself was never really the problem. It's also called secondary hypothyroidism.

[Espeegee in reply to Dryski]

In order to rule out my pituitary as the problem I paid for an MRI, it showed no signs of a tumour. I managed to get a referral for, I think, a TFH test, that might be wrong, go to the hospital only to be told they don’t do them anymore so they did a cortisol test instead which was deemed normal.