I have changed the title of your post as when requesting feedback on doctors or recommendations this needs to be by private message only to prevent information being posted publicly.
Its sadly very common for doctors not to listen to symptoms or how we feel and instead rely (badly) on blood results.
Also they tend to only test TSH which is completely inadequate for making a proper assessment of thyroid function. We need TSH, FT4 & FT3.
Even so, your TSH at over 2 is showing you have room for an increase in Levo of 25mcgs. Many hypo people find they have to become their own health advocates and challenge their GPs and be a little pushy in a nice way.
Have a good read around here, get your confidence up, make an appointment with GP and insist on a 'trial' increase which often goes down better. If one GP says no then keep going back and asking different GP's until you are successful.
Your B12 result was very low. Are you vegan or vegetarian?
Do you have a result for ferritin?
Which B complex plus are you taking? Some are betetr than others in dose and type of vitamins.
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.
Do you do tests as per the protocol recommended here?
Recommended blood test protocol: Test at 9am (or as close as possible), fasting, last levo dose 24hrs before the 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.
Hi Jaydee1507,Thank you for your reply, I would still like advice on a private Endocrinologist in Birmingham, as I'm struggling to get an appointment and I have had 2 appointments cancelled within the last 6 months.
I'm not vegetarian or vegan, and again the B12 levels have not been reassessed since my initial blood tests.
I have been taking vit B supplements from Trienics.
I have included othe
I had a fall 2 years ago and broke ankle in 3 places , which required 2 x surgery. At no point was I offered a Decca scan , but I'm concerned that I could be at an impressed risk of it osteoporosis - due to my vit D levels being poor.
My ferritin levels are not known but I've included other results regarding iron .
I always take my thyroxine on an empty stomach 1st thing in a morning, and have no caffeine or food for another hour.
Hopefully you will be able to offer suggestions re a consultation, as I'm exhausted and struggling to have a life / work full time. My GP wasn't prepared to help with my menopausal symptoms until my other issues were under control !!
Thats just a full blood count and not specifically iron related.
Initially you need to focus efforts on raising the low vitamin levels, then you need a Levo dose increase.
Suggest you retest vitamins 3-4 months from starting supplementing. 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.
Ask GP to test ferritin & full iron panel.
Your B12 was low enough that I'd recommend pushing GP for pernicious anaemia investigations.
When taking a vit D supplement its recommended to choose one with vit K as well as this helps the vit D go to your bones.
The trienics supplement is quite high in B6 which is possible to overdose and cause problems with. I have a few suggestions that might replace it.
You might also benefit from the addition of a separate B12 sublingual or spray.
B12 - do you have symptoms of B12 deficiency? The reference range for B12 is very wide and cut off point too low. theb12society.com/signs-and...
If you do then you should discuss this with your doctor for further tests for Pernicious Anaemia.
If not, then start with a methyl B12 sublingual spray or lozenge for a week, then add a good B complex. Once you run out of the separate B12 just continue with the B complex.
I'm not surprised you're feeing terrible with such low B12 & thyroid levels. Its really worth trying to engage with your GP which might take effort which is obviously hard on low energy.
I am not in the Birmingham area so cant offer any suggestions. This would need to be by personal message anyway.
You can email info@thyroiduk.org for a list of Endo's. Pick a couple and make a new post asking for feedback by private message only.
Your TSH level is too high for someone on thyroxine therapy and your T4 is very low.
50 mcg levothyroxine is a starter dose and your GP should have called you in after 6 weeks on that dose and increased your levothyroxine by 25mcg. You probably need further increases as well, but the first step is to get an increase straight away.
The NICE prescribing guidelines state that replacement therapy should be given at 1.6 mcg levothyroxine per kg of weight. So if a person weighs 63 kg, they would need around 100mcg levothyroxine. Here is the guidance you can show your GP:
Many patients feel best when the TSH is around 1 or even below and both the T4 and T3 are between 60-80% through the range. This will mean that your body has enough thyroxine hormones to work with and can perform essential actions, such as metabolising glucose and cholesterol from your diet. If you have not got enough hormones these levels can rise, this is why many patients have elevated cholesterol levels, as their ability to process lipids (fats) is slowed down. However, it is a metabolic issue not a dietary issue.
Your Vitamin D level is very low. You have mentioned that you are taking 4000IU Vitamin D, but do you take Vitamin K2 with it as well? K2-MK7 will help to absorb your dietary calcium and direct it into the bones, which in turn will strengthen them. If you take a good quality magnesium supplement as well, this will help your body absorb the Vit D better.
Your Vitamin D level should be at least 80nmol/L, some people have it even higher. If your Vitamin D level is good, it will help your body utilise the levothyroxine you are taking and assists with the conversion of T4 to T3, which is the active thyroid hormone.
Sadly, many GPs do not understand thyroid treatment and if you are a women of a certain age, you get fobbed off with excuses such as being menopausal. Yes, some symptoms can overlap, but if your metabolism is slowed down due to a lack of hormones, this should take priority before even looking at any other symptoms.
I would show the GP the prescribing guidelines and insist on an increase of 25mcg, as you are very symptomatic. Even a GP cannot argue with NICE guidance.
I would show the GP the prescribing guidelines and insist on an increase of 25mcg, as you are very symptomatic. Even a GP cannot argue with NICE guidance.
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