I've just had my most recently blood test results taken (I don't have the full details yet but have requested). They are:
TSH is 0.06 [normal range 0.35-4.94], Free T4 is 10.6 [normal range 9-19.1], T3 is 4.2 [normal range 2.4-6]
The GP has recommended I stop taking T3 completely and move back to Thyroxin. She has sighted this article and also referred me to the NHS Endocrinology team: sps.nhs.uk/articles/review-...
A quick run down of my Hashimoto's journey to date:
From 2010 to Feb 2019: 150mg Thyroxin [had various fatigue issues and caught every virus going)
Feb 2019: 90mg T3 [private consultant prescription]
Jan 2020: 25mg Thyroxin and 90mg T3 [after discussion with NHS GP]
Mar 2021: 25mg Thyroxin and 60mg T3 [consultant suggested but felt exhausted again]
Dec 2023: 25mg Thyroxin and 90mg T3
Jan 2024: 12.5mg Thyroxin and 90mg T3 which is my current dose. I've been suffering with long covid since Feb 2023 and only just recovering, so don't really want to change anything. I'm also taking HRT which I started last year so have had a pretty rough few months. The GP is adamant! Has anyone else been told this? Should I consider it?
I've been tracking TSH, T4 and T3 since 2010 so have full records. At times my TSH is very low, even when I was on Thyroxin so I'm confused how moving back would stop this?
Thanks x
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spaneast
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If GPs are not allowed to initiate prescribing of T3, which surely must be because they do not have sufficient experience and understanding of endocrinological issues to do so, on what basis does ANY GP think they have sufficient experience and understanding of endocrinological issues to stop T3, or recommend that you do so?
(Of course, the restriction on prescribing T3 couldn't possibly be for reasons of cost, or other issues than the patient's welfare, could it?)
And why do they refer to an article which is expressly about Avoid prescribing desiccated (natural) thyroid extract?
however they are also told in that advice that it should not be stopped abruptly , and that prescriptions should continue until NHS consultant endocrinologist review has taken place .
This article seems to suggest that the NHS might prescribe it, which would be a dream! I'm not sure how a review would stop me getting my private prescription though? Does the NHS have the right to block a private recommendation?
is your T3 prescribed by NHS , or do you buy it privately with private endo prescription ?
It's not that they have any logical reason to think you will feel better without T3 , they just want to get most people off it if they possibly can, cos its expensive , and because low / supressed TSH worries them ~ if you buy it yourself you can just ignore them , but they may decide to stop prescribing you any levo if you do .
so go to endo review , keep taking it until then then ....... when you see endo IF you can make a good case for taking it ,, and IF you happen to get referred to an endo who is not totally against prescribing T3 to anyone ... and IF the moon is in the third quarter and there is a b in the month.... then you just might manage to get an NHS prescription for it from NHS endo ..
but obviously as this is the opposite if what they are trying to achieve ,,, you'll have to be very lucky / persistent .
and the down side is that the endo would almost certainly attempt to mess about with your dose , and even try you back on levo only for a while to prove you do need T3 (ie , to try and prove you don't ) ,,,, which of course means you allowing them to make you unwell for a few months......and i've no idea how to avoid that little bear trap .
IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 5-7 days before ALL BLOOD TESTS , as biotin can falsely affect test results
In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg)
I have whichever brand the chemist has of levothyroxine. It seems to be different every time. Apologies for any confusion, I take Erfa and a small amount of levo. The GP says I should stick to the recommended approach of Thyroxin only.
Many patients do NOT get on well with Teva brand of Levothyroxine.
Teva is lactose free, but contains mannitol as a filler instead of lactose, which seems to be possible cause of problems. Mannitol seems to upset many people, it changes gut biome
If a patient reports persistent symptoms when switching between different levothyroxine tablet formulations, consider consistently prescribing a specific product known to be well tolerated by the patient.
Physicians should: 1) alert patients that preparations may be switched at the pharmacy; 2) encourage patients to ask to remain on the same preparation at every pharmacy refill; and 3) make sure patients understand the need to have their TSH retested and the potential for dosing readjusted every time their LT4 preparation is switched (18).
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