Change to medication

[MrsD6]

Hi everyone,

I have been taking 150mg of thyroxine for over 10 years. At the beginning of the year, I spoke to my doctor because my fatigue was increasing, I didn't feel like myself, and I was having heavy periods. I thought I was starting to become perimenopausal. The doctor said I was depressed and prescribed me sertraline. This did not help, I gained 2 stone in weight and my symptoms became worse; I almost fell asleep while driving. I spoke with another doctor, who told me to come off sertraline and did some blood tests, suggesting that hormone replacement therapy (HRT) may be helpful. For 8 years, my thyroid test had come back normal, but now it is borderline, and they want to reduce my thyroxine to 125mg and said HRT is not an option. I am so frustrated and worried that my symptoms will get worse. The doctor has said they will redo my blood test in 4 months!

Any advice?

[Buddy195 Administrator]

Welcome to the forum MrsD6,

So we can offer better advice, can you share blood test results (with ranges in brackets) for:

TSH

FT3

FT4

Plus any antibody and key vitamin tests (ferritin, folate, vitamins D and B12)

If your GP is unable to complete all the above (eg if TSH is within range, some surgeries may not be able to access FT4 and FT3 tests), you could look to do this privately, as many forum members do, for a better picture of your thyroid health:

thyroiduk.org/help-and-supp...

Please be aware when GPs say ‘normal/ within range’, this may not be the same as ‘optimal’. I (like many others here) was offered anti depressants when it was actually my thyroid condition not been optimally treated that was affecting both my physical & mental health!

What reason did the GP give for not prescribing HRT?

Regarding HRT, it may be useful to have a look at Dr Louise Newson’s free Balance App, as I find it really useful for comparing HRT medications & having up to date research articles. There is also an ability to post questions.

healthunlocked.com/redirect...

[MrsD6 in reply to Buddy195]

Hu, he didn't give me the full results and online it just shows at boardline. He said to wait for 4 months to see if my symptoms were because I was taking to much thyroxine, which I have been taking for years

[Buddy195 Administrator in reply to MrsD6]

Do ask for a print out of all results/ ranges, as you are legally entitled to this. Many GPs wrongly look at TSH alone, without considering if FT3/ FT4 are optimal

[SlowDragon Administrator]

strongly recommend you get full iron panel including ferritin, vitamin D, folate and B12 levels tested NOW

ESSENTIAL to test TSH, Ft4 and Ft3 together

Is your hypothyroidism autoimmune?

Always test early morning, ideally before 9am, only drinking water between waking and test and last dose levothyroxine 24 hours before test

Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine

For full Thyroid evaluation you need TSH, FT4 and FT3 tested

Also both TPO and TG thyroid antibodies tested at least once to see if your hypothyroidism is autoimmune

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease

About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high TPO and/or high TG thyroid antibodies

Autoimmune thyroid disease with goitre is Hashimoto’s

Autoimmune thyroid disease without goitre is Ord’s thyroiditis.

Both are autoimmune and generally called Hashimoto’s.

Significant minority of Hashimoto’s patients only have high TG antibodies (thyroglobulin)

20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis

In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

Post all about what time of day to test

healthunlocked.com/thyroidu...

Testing options and includes money off codes for private testing

thyroiduk.org/testing/

Medichecks Thyroid plus BOTH TPO and TG antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes BOTH TPO and TG antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

Only do private testing early Monday or Tuesday morning.

Link about thyroid blood tests

thyroiduk.org/testing/thyro...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

Symptoms of hypothyroidism

thyroiduk.org/signs-and-sym...

Tips on how to do DIY finger prick test

support.medichecks.com/hc/e...

Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee