Everyone I know living near and far have had their thyroxine reduced by 25mcg, how many on here have had theirs reduced. I am shattered

[alysbach]

[helvella Administrator]

No idea where you are, but I have not had my thyroxine reduced.

[shaws Administrator]

Unfortunately it is very wrong of GP's to reduce medication due to the TSH. I cannot give a link at present to Dr Lowe as he explains why they should not due to the effect it has on our metabolism which can result in making us even worse if that is possible which appears to be happening to you.

[alysbach in reply to shaws]

i would appreciate it if you could find the link

[shaws Administrator in reply to alysbach]

I am away from home at present and I am using someone else's computer. I will send you it on Monday.

[shaws Administrator in reply to alysbach]

If you cursor down to the answer to the question dated January 25, 2002 I hope it gives you the explanation you require. There are other topics at the top of the page which may be helpful too.

web.archive.org/web/20101224231327/drlowe.com/QandA/askdrlowe/...

l

[alysbach]

I live in North Wales and i have five friends who are on thyroxine and they have all had it reduced. i spoke to a friend who lives 100 miles away and she knows of four people who have had a phone call off their GP telling them to reduce their thyroxine

[saints]

I have a few more problems, like my pituitary gland doesn't work and i have had my throxine reduced by 25mcg after being on the same dose for over 20 years. i thought it was due to me getting older( i am only 46 haha) , never thought to query it, I live in merseyside x

[Willowluv]

Me too over the years, I am beginning to believethat they are so scared of over medicating they reduce to cover their backs cos they don't understand how to treat. My doc abroad did this to the point it had an adverse affect on my health, my blood sugar rose along with cholesterol, I developed psoriasis in my ears, gained weight and retained water!!! I ignored him in the end I increased my own dose to what it was before!

[mummytina]

I live in Essex and 8 weeks ago when my tsh level was high (17.16) they increased my levo from 125 to 150mcg and 4 weeks later my tsh had gone down dramatically (in such a short space of time) to 1.4 he has cut it down to 75mcg I have never been on such a low dose in 18 years of being on it.

[alysbach]

So it is being reduced on a large level ~i will visit my GP and ask on what basis they are doing this. I have recently 6months ago started having psoriosis in my ear and didnt think to link it with my thyroid gland as I have had it in my head for years but have been on thyroxine for years too, i purchased some iodine plus 2 but have been told i cant take these I too am over weight

[helvella Administrator]

If you are simply being told to reduce your dose, out of the blue and without explanation, then this appears to fly in the face of this provision of the NHS constitution:

4. NHS services must reflect the needs and preferences of patients, their families and their carers. Patients, with their families and carers, where appropriate, will be involved in and consulted on all decisions about their care and treatment.

dh.gov.uk/prod_consum_dh/gr...

Also have a look round here:

thyroiduk.org.uk/tuk/NHS_In...

It might be useful to have this in order to back up your position - though simple discussion would be a better first step, using this only if you cannot get satisfaction without.

[coolbeans]

I live in Cambridgeshire and have just had my dose increased to 100mcg. I've not heard anyone local getting a reduction.

[Glynisrose]

Why would you agree to that if you still did not feel well? NO doctor can reduce or change your medication without discussing and agreeing it with you no matter what the blood tests results say!!

[Hidden]

I was fine for years on 175mcg then, on my last test, GP suddenly reduced me by 25mcg saying i was over-medicated. He said that the government guidlines have been changed and they've changed the measure of meds we need? I'd really like to know if it was a specialist's advice or just a general panel that is trying to find a way to save money on lifelong prescriptions? I'm really tempted to go back to what I was on before because I'm very slowly going downhill, tired, gone up 2 dress sizes (which is really upsetting) and hairloss. Cx

[helvella Administrator in reply to Hidden]

Please ask your doctor for a reference to this advice. Only by getting that do we stand a chance of appreciating what is happening and doing something about it (other than on an individual case-by-case basis).

[Hidden in reply to helvella]

I'll do my best. I'll ask him exactly what he meant, Cx

[helvella Administrator in reply to Hidden]

Thanks - I do appreciate it is not always easy.

But I do think this is the only way that the issue will be bottomed out.

[Muffy in reply to Hidden]

There are no government guidelines! NICE has never produced any on hypothyroidism.

[Barbaraj in reply to Muffy]

There are European Thyroid Guidelines that I can send in pdf format if the link below doesn't take you to them, I also have one of studies that demonstrates the combination T4/T3 replacement therapy is effective in many instances where T4 alone has not brought about resolution of symptoms.

The link to the guidelines is below.

content.karger.com/Produkte...

[Muffy in reply to Barbaraj]

I was referring to Craftingbird's message where she said that her GP had said that the (UK) government guidelines had been changed and they have changed the measure of the meds we need. That is the reason I stated that NICE have no guidelines for hypothyroidism. Many other countries of course do have their own guidelines.

[NBob]

Under Section 2(4) of the Health Act 2009,

each person who—

(a)provides NHS services under a contract, agreement or arrangements made under or by virtue of an enactment listed in subsection (6), or

(b)provides or assists in providing NHS services under arrangements under section 12(1) of the National Health Service Act 2006 (c. 41),

must, in doing so, have regard to the NHS Constitution.

The NHS Constitution says

You have the right to be involved in discussions and decisions about your healthcare, and to be given information to enable you to do this.

Furthermore the NHS Constitution pledges the NHS to work in partnership with you, your family, carers and representatives.

So the doctor has a legal duty to involve you in discussions about your health care i.e. discuss with you any changes to medication not just reduce it at the doctors whim. Plus the doctor has a legal duty give you information to enable you to discuss properly any reduction in medication. Any change should be with agreement based on real evidence and be logical.

As research posted on this site shows, many doctors are unaware of the NHS Constitution and their legal duties.

[RedApple Administrator in reply to NBob]

Hi, thanks for posting this but could you please provide a link to the document you've quoted from.

[NBob in reply to NBob]

nhs.uk/choiceintheNHS/Right...

[NBob]

THe GMC guidance document "Consent: patients and doctors making decisions together"

states:

All healthcare involves decisions made by patients and those providing their care.

If patients have capacity to make decisions for themselves, a basic model applies:

(a) The doctor and patient make an assessment of the patient’s condition,

taking into account the patient’s medical history, views, experience and knowledge.

(b) The doctor uses specialist knowledge and experience and clinical judgement, and the patient’s views and understanding of their condition, to identify which investigations or treatments are likely to result in overall benefit for the patient. The doctor explains the options to the patient, setting out the potential benefits, risks, burdens and side effects of each option, including the option to have no treatment. The doctor may recommend a particular option which they believe to be best for the patient, but they must not put pressure on the patient to accept their advice.

(c) The patient weighs up the potential benefits, risks and burdens of the various options as well as any non-clinical issues that are relevant to them. The patient decides whether to accept any of the options and, if so, which one. They also have the right to accept or refuse an option for a reason that may seem irrational to the doctor, or for no reason at all.

(d) If the patient asks for a treatment that the doctor considers would not be of overall benefit to them, the doctor should discuss the issues with the patient and explore the reasons for their request. If, after discussion, the doctor still considers that the treatment would not be of overall benefit to the patient, they do not have to provide the treatment. But they should explain their reasons to the patient, and explain any other options that are available, including the option to seek a second opinion.

[RedApple Administrator in reply to NBob]

Hi, thanks for posting this but could you please provide a link to the document you've quoted from.

[Hidden in reply to RedApple]

gmc-uk.org/static/documents...

This is the full guidelines the above comes from

[NBob in reply to NBob]

gmc-uk.org/guidance/ethical...