Can I get a trial of Levothyroxine?

[RhubarbWR]

A few weeks ago I was refused a trial of Levo or any other tests or investigations I asked for although I’m very symptomatic and showed him last years medicheck full panel results, suggesting central hypothyroidism. He insisted I was over thinking and anxious. I replied that I was not anxious just a bit angry at being ignored. He prescribed Sertraline!

I’ve just had another private thyroid test and the results suprised me a bit.

I'm sure I have a pituitary/hypothalamus issue causing my many problems.

Should/could I be able to get a trial of Levo on these results?

( I’m not sure if I can post 2 photos so I’ll post this then follow with the other photo of last years thyroid results)

[greygoose]

Doubtful your GP has ever even heard of Central Hypo. They don't teach about it in med school. What they teach is that TSH tells them 'everything they need to know', which is so obviously wrong, but as a result doctors tend to only look at the TSH and have no idea what T3 even is!

What you need to do is seek out a CH-savvy endo. They do exist. They must do because there are quite a few people on here that have been diagnosed with CH. Try changing the title of your post so that those that know can respond. Your title at the moment is a bit vague.

You can post other photos in the comments section,, by clicking on the landscape icon.

[RhubarbWR in reply to greygoose]

Thanks I’ve managed to do that.👍

[RhubarbWR in reply to greygoose]

yes, that’s exactly what he said. Your TSH is fine! Can I ask if anyone in my area has used a particular Endo on here?

[greygoose in reply to RhubarbWR]

You'd be better off writing a new post for that.

[jimh111]

These numbers suggest primary hypothyroidism if anything. It could be due to selenium deficiency although it is quite rare. If you have a concurrent illness it could be causing your low fT3 and high TSH.

[greygoose in reply to jimh111]

She doesn't have high TSH, that's the whole point.

TSH 2.49 (0.27-4.2)

FT4: 12.7 pmol/l (Range 12 - 22) 7.00%

FT3: 3.1 pmol/l (Range 3.1 - 6.8) 0.00%

That doesn't look like primary hypo to me.

[RhubarbWR in reply to greygoose]

jimh111 is answering my current results.

TSH 4.93 (0.4-4.5)

T4 15.2 (11.9-21.6)

T3 2.92 (4.1-6.8)

You are seeing my last year results, which looks like pituitary problem.

Sorry, I’m finding this site difficult to use. I couldn’t seem to add 2 photos to the post to explain.

[greygoose in reply to RhubarbWR]

Yes, I know they were last years results. But if you have a pituitary problem, it doesn't just go away. And those results were a better example of a pituitary problem than this years. And I totally disagree with jim. Your TSH now is not much higher, but your FT3 is lower! The lower FT3 has caused the TSH to rise but not by enough. The FT3 and the TSH just do not correspond. The TSH should be much higher with that low FT3. And your FT4 is also much too low at about 32% through the range. Should be at least 50%. If that's not Central Hypo I'll eat my hat!

[RhubarbWR in reply to greygoose]

Aha. I was confused. I’m glad you think it’s pituitary too as my symptoms are pointing that way (from my research). I'm hoping for a more favourable result at the next doctors visit. My pituitary symptoms are worse now, including high cortisol, high BP, high glucose, permamant headache, sweating.

I’m expecting to be up against it to get a pituitary investigation. I saw an Endo last year who called me in to hospital at 7.30 on a Saturday morning and told me I definitely had a pheochromochroma. He dropped me like a hot potato when metanephrines results came back normal. No follow up just a very brief and inaccurate letter to my GP.

So it seems my GPs are sticking to ‘no endocrine problem’.

[greygoose in reply to RhubarbWR]

I'm not sure what you mean by the symptoms point that way. What symptoms are they?

[jimh111 in reply to RhubarbWR]

Yes I was going by these figures. Looking at both it suggests your pituitary may be a little underperforming but I doubt anything would show up in tests. Do you have any concurrent illnesses or are dieting or depressed? All these can cause "low T3 syndrome" which presents with lower TSH and fT3.

A further complication, always overlooked, is that TSH is not a single molecule, it is a group of molecules of varying size and potency. If your TSH has reduced bioactivity it will not stimulate the thyroid sufficiently. Endocrinologists never consider this let alone seek to diagnose or treat it.

[greygoose in reply to jimh111]

I very much doubt if they even know about it.

[SlowDragon Administrator]

How old are you approx

Male or female

Vitamin levels were good last year

Is that naturally good, or do you supplement

Have you ever had ultrasound scan of thyroid

Central hypothyroidism

bestpractice.bmj.com/topics...

ncbi.nlm.nih.gov/pmc/articl...

endocrinologyadvisor.com/ho...

academic.oup.com/jcem/artic...

ec.bioscientifica.com/view/...

academic.oup.com/jcem/artic...

Suggest you retest vitamin levels before seeing a thyroid specialist endocrinologist

most endocrinologists are diabetes specialists

Here’s link for how to request Thyroid U.K.list of private Doctors emailed to you, but within the email a link to download list of recommended thyroid specialist endocrinologists

Ideally choose an endocrinologist to see privately initially and who also does NHS consultations so that might eventually transfer to NHS

thyroiduk.org/contact-us/ge...

[RhubarbWR in reply to SlowDragon]

I’m 65, female. I take vit B complex with D (for glaucoma). I’ve never had an ultrasound scan of my thyroid.

Thank you for the links.

[SlowDragon Administrator in reply to RhubarbWR]

IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 3-5 days before ALL BLOOD TESTS , as biotin can falsely affect test results

endocrinenews.endocrine.org...

In days before blood test, when you stop vitamin B complex, you might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg) and continue separate B12 if last test result serum B12 was below 500 or active B12 (private test) under 70

[SlowDragon Administrator in reply to RhubarbWR]

How long ago was last full test including vitamin levels

Suggest you retest vitamin levels at least annually alongside thyroid