Extraordinary dosage for my friend

[diamondial]

I saw my 77 year old friend yesterday. She has stage 4 bowel cancer. She had a blood test in October and I can't remember the exact results but there didn't seem to be one for T4, her TSH was 5 something, which was over the given range and her FT3 was one point over the lowest limit of the range. On these results she has had her thyroxine reduced from 100mcg daily to 100mcg and 75mcg on alternate days. Am I going mad to be absolutely flummoxed by this?

[tattybogle]

No, you are right, that is illogical.

possibly fT4 was over range ?,

but that is very unlikely with TSH of 5

(mind you i've recently had tsh of 5 .3 with fT4 91% and fT3 13%, so it is theoretically possible)

seems much more likely someone has decided to follow the " 'old people' will have a higher TSH anyway and need less levo " mantra .

but hard to say without asking the GP who reduced the dose to explain their reasoning .

[diamondial in reply to tattybogle]

I don't know - it was frustrating not to be able to see a FT4 result. With that TSH of over 5 and the FT3 being so low - I think it was 3.9 with the range being 3.8-6 or something like that (I know it was only 1 over the bottom of the range) I am completely at a loss to understand. She is absolutely exhausted but we were all assuming it was from the chemo and morphine. She is going to ask the doctor about it so it will be interesting to hear what they say.

[RedApple Administrator in reply to diamondial]

Unusual for FT4 not to be tested when FT3 was tested. I wonder whether GP reduced dose mistakenly (or ignorantly) thinking that high TSH means over-medicated. We have seen this reported here on the odd occasion.

[diamondial in reply to RedApple]

Really? Hahaha you have to laugh or you'd cry!

[helvella Administrator]

Do remember that many chemotherapy agents interact with thyroid hormones and TSH. It gets very complicated very quickly. And I doubt many doctors would actually know enough to make appropriate adjustments.

Nonetheless, what you have posted makes no sense to me. I agree with RedApple

[diamondial in reply to helvella]

I did wonder about that which is why I mentioned the chemo and morphine. Apparently the doctor did say something like "it's only a bit..." raised - something like that. My poor friend isn't really au fait with thyroid treatment although I have tried to explain and no doubt the morphine is making it even harder. When I find out more I will post it here so hopefully the puzzle will be explained.