Had a call this afternoon from GP surgery telling me “doctor has some concerns about your blood results and needs to see you”. First thing is panic mode then I realise that I've seen most of them with the exception of thyroid function.My TSH has come back at 0.09 (0.49-5.23) but T4 is only at 18.5 (11.5-22.7) = 62.5%
Receptionist said that everything had come back “normal” except for TSH and cholesterol and doctor needs to discuss. Yep, doctor can discuss as much as he likes but there is no way on god's green earth that I am agreeing to a reduction in Levo again. I refuse to play TSH hokey-cokey.
Appointment is for beginning of August so I'm just starting to work on my game plan and would appreciate any help and input.
1. Get full thyroid panel done by Monitor My Health - NHS lab so he should take results into account
2. Read up on thyroid/cholesterol links - reasons for adequate treatment of hypothyroidism before cholesterol is addressed.
3. Remind GP that statins are not a good idea for hypo patients.
4. Ask why my abysmal level of ferritin isn't a concern - I think I already know the answer to that (your result is marked as normal)
If anyone can point me in the direction of easy to understand websites or papers on the hypothyroid/cholesterol thing then it would be very useful.
Not sure if I should mention my recent discovery that fruits don't really agree with me or not. I have enough on my plate at the moment without going down a rabbit hole of gastroenterology.
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Jingley
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Unfortunately you may have a fight on your hands, as you know GP's are very blinkered regarding thyroid issues.His "concerns" will only be about the TSH and I doubt very much he will even mention T4(which at 62% still has plenty of scope for increase)Defo get your T3 tested again, if I read correctly it was just 35% in May? Others on here will be better educated about cholesterol but I know it being high is a symptom of hypothyroidism.
Serum ferritin level is the biochemical test, which most reliably correlates with relative total body iron stores. In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency.
Never supplement iron without doing full iron panel test for anaemia first and retest 3-4 times a year if self supplementing.
It’s possible to have low ferritin but high iron
Test early morning, only water to drink between waking and test. Avoid high iron rich dinner night before test
Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption
This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.
Thank you for your incredible patience while you have been awaiting the outcome of our ferritin reference range review. We conducted this with Inuvi lab, which has now changed the reference ranges to the following:
Females 18 ≤ age < 40. 30 to 180
Females 40 ≤ age < 50. 30 to 207
Females 50 ≤ age < 60. 30 to 264l
Females Age ≥ 60. 30 to 332
Males 18 ≤ age < 40 30 to 442
Males Age ≥ 40 30 to 518
The lower limits of 30 are by the NICE threshold of <30 for iron deficiency. Our review of Medichecks data has determined the upper limits. This retrospective study used a large dataset of blood test results from 25,425 healthy participants aged 18 to 97 over seven years. This is the most extensive study on ferritin reference ranges, and we hope to achieve journal publication so that these ranges can be applied more widely.
Be prepared for your doctor to offer you statins. My surgery have been pushing them so much that doctors have actually rung me. I've said NO and explained why.
Here is a link to the NHS website about statins and hypothyroidism
If you have an underactive thyroid (hypothyroidism), treatment may be delayed until this problem is treated. This is because having an underactive thyroid can lead to an increased cholesterol level, and treating hypothyroidism may cause your cholesterol level to decrease, without the need for statins. Statins are also more likely to cause muscle damage in people with an underactive thyroid.
I've emailed my surgery and got it put on my record that under no circumstances am I taking statins. Just in case any eager GP wants to increase their quotas, they're not doing it at my expense.
Jingley good plan of action. My Nana was hypothyroid and in her day it was diagnosed by raised cholesterol levels. When I had my first TFT the doc only focused on my raised cholesterol and gave me statins. They made me very ill. I went back to see my usual GP who said I needed levothyroxine.
The next 5 years were a roller coaster of levo up and down. Then I found this website and began to learn. Good luck.
Thanks crimple . When I was first diagnosed hypo my cholesterol was approaching 9.0. It's been decreasing ever since apart from an increase in 2021 (post lockdowns so I think everyone's health took a bit of a battering during that time)
If you split your levothyroxine dose half morning half later in the day. This could reduce spikes leading to suppression of the TSH. You’d still be on same dose per day and levels same but your TSH just might rise and be just about in range. I’d seriously give it a go and when you speak with your GP I’d definitely go down this avenue and a three month trail of doing that. When you take a full dose it can make levels spike for a short time and if you’re doing that daily your TSH will pick that up and reflect it as suppressed.
I always split my levothyroxine dose twice a day and my T3 twice a day. My TSH is never suppressed nor levels over range. It really is worth a try.
What is your cholesterol level? What is too high for your gp? Cut out fatty and sugary foods and go on brisk walks. Also cut down on alcohol as that increases cholesterol significantly. You don’t need statins. Also request a 3 month trail of this before statins.
Cholesterol currently 6.2 As per my reply to crimple, was approaching 9.0 when diagnosed but seems to be stuck on just over 6
Managed to get it down to 5.89 at one point but that was on a very restricted and difficult diet with virtually no fat. Even then it didn't drop that much really.
Jingley my cholesterol was only just over 6 when they gave me statins! They don't even bother testing my cholesterol now as they know if I dont want to do something/take something I am very stubborn! It's they only way to survive this pesky disease.
Hi McPammy, I'm not sure that I agree with you about TSH spiking.
As I understand it TSH has a circadian rhythm with a 24 hour cycle. It is at it's highest between 2 and 4 in the morning and then decreases to a low point between 4 and 8 in the evening. Neither of these times are convenient for regular blood draw at your surgery! We recommend drawing blood for testing about 9am having fasted except for water - breakfast and meds after the blood draw. If your surgery can't get it tested until the afternoon your will get a lower TSH. If you want to be diagnosed your need the higher TSH and your diagnosis could be missed if the test is in the afternoon.
You should not be taking any thyroid meds on the day of testing until after the blood draw as this will give a false result.
If you are taking liothyronine (T3) your TSH will be suppressed. The range used is wrong and most doctors don't know that. Mine has been suppressed for years.
If you google for something like 'TSH daily variation' you will get various links about this.
Tell GP this - "research has shown that the T4 needs to be in the upper range to decrease the levels of cholesterol, so I would like to try that before statins, as statins are not recommended for females with hypothyroidism, as you know Doctor"
No, I have not come across any papers that say that, but it is generally accepted that this is true. By dosing by TSH he is showing he is not keeping up with research, and is ignorant of how this works. They get paid to push statins.
The brain is the most cholesterol-rich organ in the body and contains almost 25% of the total amount. The majority (70–80%) of this cholesterol is present in myelin, where it fulfils a critical insulating role. "I would rather have my brain in working order, Doctor"
Stupid stupid doctors. If you're not converting T4 to T3. Your T4 will go up and up your T3 will go down and down and SO will your TSH. If you're not converting you need T3 medication Liothyronine sodium. And NOT more T4 levothyroxine that you can't convert
Love your 'TSH Hokey-cokey' You seem to have a good handle on this. Insist they test T3 before even considering any reduction. And as you imply there is a link to low T3/T2 to chlorestral and you are fully aware of ferrin. Sounds like you can easily baffle this GP with science. Just had a similar conversation with my GP about T2, he hadn't a clue, pharmacist was better. Understand increasing B Niacin has beneficial affects on chlorestral, give that a try, job for the GP to look up the research, I also set him to find out about T2 suppliments. Enjoy.
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