hello my Gp wants me to reduce my dose of thyroxine to 75mcg. I am currently on 100mcg. I don’t want to reduce but he says based on the lab results my dose is too high
T4 16.3 range 11.0-24.3
T3 4.2 range 3.5 - 6.5
TSH- 0.06 range 0.10 - 4.00
I have Hashimoto’s and just had a flare up but trying to get them to understand this is like banging your head against a brick wall.
Thank you in advance 🙏
welcome to the forum
This seems to be your first post
Was test done as recommended 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
Free T4 (fT4) 16.3 pmol/L (11 - 24.3) 39.8%
Free T3 (fT3) 4.2 pmol/L (3.5 - 6.5) 23.3%
Speak to GP and say with such low results you are definitely not reducing dose
Request new test in 6-8 weeks via GP
Or test privately
These current results show you more likely need dose increase soon
What vitamin supplements are you taking
When were vitamin D, folate, ferritin and B12 last tested?
are you on gluten free diet and/or dairy free diet
Thank you so much for the reply. I’m gluten free. I take Accord (which suits me) The test was done at 8.30 am and I forgot to stop my b vits beforehand. My GP is lovely but has zero knowledge about thyroid. My cholesterol has shot up and I think it’s due to low t3 - he says not and tried to give me statins!!!
I probably need to get vits tested but I’m going to test privately. Going to the GP is pointless.
Thank you SD your help is invaluable. 🙏
Did you take your Levo dose before or after the blood draw? A patient to patient tip is to delay Levo dose until after the draw.
Hello buddy I took my dose after the blood draw 🙏
This post by tattybogle has links re low TSH that may be helpful
healthunlocked.com/thyroidu...
Thank you Buddy.
Silvermoon ~These two will be more relevant when TSH is below range as yours is ,( the one Buddy195 linked to is for keeping TSH towards the lower end of range) :
healthunlocked.com/thyroidu... /useful-evidence-that-tsh-between-0.04-0.4-has-no-increased-risk-to-patients-on-levothyroxine-updated-new-study-does-show-small-risk
healthunlocked.com/thyroidu.... tsh-is-just-the-opinion-of-your-pituitary-about-your-dose-but-your-pituitarys-opinion-is-a-bit-warped-once-you-take-thyroid-hormone.
Thanks tatty!
Thank you Tatty. 🙏
If you took your thyroxine before your blood draw, this will have influenced your results. When we take levothyroxine, or body starts to digest the tablet and the highest concentration of your medication in the blood can be reached after 3 hours.
So if you took your medication at 7am and had the blood draw at 10am, you would have measured your results when the medication you just took was highest. To get a more accurate reading of where your levels are, you need to have taken your last levothyroxine around 24h before the blood draw.
In any case, even with you taking your meds before taking blood, it shows that you are under-medicated. Instead of lowering your medication, you would actually need an increase. GPs only go by TSH, which is not a reliable measure, especially when taking levothyroxine, and the TSH-T4 feedback does sometimes not work as it does in a person without thyroid disease (as it could go lower than it should be). Hence, your free T4 and T3 should guide treatment - and these indicate that you need more, not less thyroxine. I would refuse to reduce the dose.
Thank you Tina-Maria I took my Levo the day before the blood draw at 7am in the morning. I took my morning dose the next day after blood was taken at around 8.45am. I’m just going to carry on with 100mcg and wait for this horrible dip to pass. My cholesterol has gone up and I’m sure it’s due to low t3. It’s utterly pointless trying to explain to my Gp although he is very nice , just clueless. I’m dreading asking for an increase.
Ah sorry, my bad, I thought that you have taken your meds before the blood draw. Well, in any case the numbers clearly show that you are under-medicated, so I would also continue with your 100mcg dose (you may actually need an increase!). Yes your T3 is low and this will give you symptoms and is also the reason your cholesterol is high, as there is a direct link. Even the NHS acknowledges that:
nhs.uk/conditions/underacti...
And you should also not be given statins for your cholesterol, before your thyroid has been treated properly, as the high cholesterol will resolve itself, once you have sufficient amounts of thyroid hormones:
nhs.uk/conditions/statins/c...
Thank you so much Tina- Maria that’s brilliant. 🙏
I agree with SlowDragon your doctor has no idea about hypothyroidism the TSH is a pituitary hormone not a thyroid hormone it’s the T4 and T3 that counts but a lot of GPs don’t know this
Your GP looked at your TSH and nothing else matters - this is how he was trained. You may find this interesting, print it out and send it to the surgery:-
thyroidpatients.ca/2019/03/...
The you tube video of Dr Midgeley is great! This should be compulsory study and played in medical school when students learn about the thyroid!!
The GPs definitely needs to be educated on this. Just had a consult with the GP and he recommended to reduce my T4 dosage down to some months when I was feeling unwell, just because my TSH was suppressed due to me taking T3 as well. They are taking the TSH biomarker too seriously...
The battles I’ve had over the years with GPS. I changed my Doctors two years ago and this one is just as bad as the previous one. When I ask for an increase I just get told they have to adhere to the NICE guidelines and that my TSH is below range. It mostly always is. I dread going for blood tests as I know what’s coming. So fed up these Doctors not knowing their jobs.
I get you. The GP is so hyperfocused on that one marker, they are simply ignoring other sources of information. When the mind is already made up, it's very difficult to have a constructive discussion. Furthermore, we are limited by only 10 minutes for the entire appointment....
I'm just reviewing my last test results using the NHS app. Under the thyroid function test, I discovered this laboratory comment: Target for T4 treatment is TSH within reference range.
And that's why if the TSH is fine within range, the doctors don't look further than that even if there are reported symptoms, unfortunately.
Back in October, I had fatigue, brain fog, aching and cold intolerance. Funnily my thyroid function test result returned within the normal range for both TSH and FT4. But I also took my dosage just before I took my blood test so I seriously doubt the accuracy. FT3 was not measured but because the results returned normal, we did even more tests while I got more fatigue over the next two weeks. That was the first time I cautiously increased my dosage and I felt much better after. And later on I discovered this forum and started on the journey of T3 when I realized my conversion was low.
What I realized is, it's important to be prepared when having conversations with the GP and also demonstrate you are responsibly monitoring your own health and dosage and that there is evidence backing up your requests.
Well I certainly am going to be prepared when I next go to see Gp. I’m fed up with them and they should be made to keep up to date with changing treatments instead of just looking at numbers! I’m very glad you are feeling well and hope you stay that way. 🙏
100% agree they shouldn't be looking at only numbers, or in this case only ranges. 😅Thank you! Hope your next appointment goes well! 🙏
oh my lord thank you! I’m going to print it out and send it to them. 🙏
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