advice please: I was diagnosed with... - Thyroid UK

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advice please

Distressedthyroid profile image

I was diagnosed with hypothyroidism two years ago and my dose of Levothyroxine was increased to 100 micrograms per day in January. I had bloods taken yesterday morning at my local surgery and have just looked at results on the NHS app.

TSH 0.02 mlU/L. Lab comment - Normal fT4 with suppressed TSH: su clinical hyperthyroidism

Serum free T3 level

I assume my GP will recommend a reduction in the dose of Levo.

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Distressedthyroid
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5 Replies
RedApple profile image
RedAppleAdministrator

Are there any numbers for FT4 and FT3?

Distressedthyroid profile image
Distressedthyroid in reply to RedApple

Just the following comment:-

Normal fT4 with suppressed TSH: sub clinical hyperthyroidism.

If on T4 consider review of dose and compliance. If not may reflect non-thyroid illness or early hyperthyroidism so repeat TFTs with ft3.

RedApple profile image
RedAppleAdministrator in reply to Distressedthyroid

In which case, yes your GP will almost certainly reduce your levothyroxine. Typically it will be dropped by 25mcg daily, so down from 100mcg to 75mcg.

If you feel well on your current dose, you could ask your GP if you can drop to 75mcg on alternate days only i.e. 75mcg one day and 100mcg the next. That would give an effective daily dose of 88mcg, which may work for you.

SlowDragon profile image
SlowDragonAdministrator

Assuming you feel well and not over treated….I would refuse to reduce dose until had FULL thyroid testing including Ft3 and vitamin D, folate, B12 and ferritin

Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

do you always get same brand levothyroxine at each prescription

When were vitamin levels last tested

What vitamin supplements are you taking

If GP won’t test

Testing options and includes money off codes for private testing

thyroiduk.org/testing/

Medichecks Thyroid plus BOTH TPO and TG antibodies and vitamins

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

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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

Monitor My Health also now offer thyroid and vitamin testing, plus cholesterol and HBA1C for £65

(Doesn’t include thyroid antibodies)

monitormyhealth.org.uk/full...

10% off code here

thyroiduk.org/testing/priva...

SlowDragon profile image
SlowDragonAdministrator

If GP says " I have to reduce your dose because the guidelines say i can't let you have a below range TSH" .....

The first paragraph in the NICE (NHS) Thyroid Disease, Assessment and Management guidelines says :

nice.org.uk/guidance/ng145

"Your responsibility

The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian. "

Just testing TSH is totally inadequate

INSIST on testing Ft4, Ft3 and all four vitamins before considering reducing dose

If Ft3 is over range….then a small dose reduction eg 12.5mcg 4 days per week…..retest in 10 weeks

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