Hi I contacted my gp regarding my thyroid level last month and asked for them to be checked as I have been a lot more tired. I have also been confirmed to have a vitamin d deficiency which I taking a 6 week 50,000 ice course for.
My tsh has come back at 5.8 which they are saying is normal depsite In 2022 the last time my levels went wrong they were 5.9 they upped my thyroxine dose to 100mg . I have questioned why this has not upped again this time as my tsh was 1.8 in August I am fed up of feeling awful should my levels be upped? And if so how do I get them to listen.
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Kezzaaa
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If your TSH was that high you shoudl definitely be given an increase.
Some doctors are ultra conservative and actually don't really seme to know what they're doing. Even a TSH of 1.8 is too high. Most people feel well when their TSH is at or just below 1.
So it looks like you're going to have to push your GP/s for an increase. This is a lot more common than you think and it might help you to know that you are not alone.
If you ask one GP and they refuse then go right back and try a different doctor at the same practice.
Show them the NICE guidelines where it says people can start on an estimate final dose based on a calculation 1.6 x weight in kilos.
Have you also had your vitamin levels checked? This is essential as low vitamin levels are very common in hypothyroidism, caused by low stomach acid and not being able to absorb vitamins well from food.
Have you recently or could you ask your GP to test levels of ferritin, folate, B12 & D3? Private tests are available, see link for companies offering private blood tests & discount codes, some offer a blood draw service at an extra cost. thyroiduk.org/testing/priva...
There is also a new company offering walk in& mail order blood tests in London, Kent, Sussex & Surrey areas. Check to see if there is a blood test company near you. onedaytests.com/products/ul...
Only do private tests on a Monday or Tuesday to avoid postal delays.
It's ideal if you can always get the same brand of levo at every prescription. You can do this by getting GP to write the brand you prefer in the first line of the prescription. Many people find that different brands are not interchangeable.
Always take Levo on an empty stomach an hour away from food or caffeine containing drinks & other meds. Many people find taking it at bedtime works well for them.
Recommended blood test protocol: Test at 9am (or as close as possible), fasting, last levo dose 24hrs before the blood draw, last T3 dose 8-12 hours before blood draw & no biotin containing supplements for 3-7 days (Biotin can interfere with thyroid blood results as it is used in the testing process).
Testing like this gives consistency in your results and will show stable blood levels of hormone and highest TSH which varies throughout the day. Taking Levo/T3 just prior to blood draw can show a falsely elevated result and your GP/Endo might change your dose incorrectly as a result.
this one has lots of references to show GP ~ all recommend they keep TSH below 2/ 2.5 ish in all patients on levo ... so use these to get a dose increase if they say 'you don't need one because your TSH is in range' healthunlocked.com/thyroidu.... my-list-of-references-recommending-gps-keep-tsh-lower-in-range
This one is a simple explanation of why TSH 'in range' is not the same as 'optimal for the individual' these may come in useful : healthunlocked.com/thyroidu... the-shoe-size-analogy.-
If symptoms of hypothyroidism persist despite normalisation of TSH, the dose of levothyroxine can be titrated further to place the TSH in the lower part of the reference range or even slightly below (i.e., TSH: 0.1–2.0 mU/L), but avoiding TSH < 0.1 mU/L. Use of alternate day dosing of different levothyroxine strengths may be needed to achieve this (e.g., 100 mcg for 4 days; 125 mcg for 3 days weekly).
Request “trial “ increase in Levo to 125mcg
Which brand of Levo do you take for 100mcg
Approximately how much do you weigh in kilo
Guidelines on eventual daily dose levothyroxine is approximately 1.6mcg per kilo per day
request B12, folate, and ferritin need testing too
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