Hello everyone.

[bertiesmum]

In the last four months I have torn both knee cartilage had an arm which would not lift and my thumb would not bend. My GP tells me I have Hashimoto disease. He is not treating me with anything as he believes early intervention is not a good thing and my thyroid is "on its reserves". I have told him there are 4 generations of low thyroid in my family, I have dry skin and a bad case of misery (this is most unlike me). His reply is that I will be depressed due to not being able to walk. Any advice would be most appreciated.

[helvella Administrator]

Change doctor.

I know that comes across as a trite answer. One that can be much more difficult to do than it should be (and there can be circumstances which add to that difficulty).

But he will utterly fail to convince me, or many people here, that it is a good thing to keep a patient untreated. Damage from low levels of thyroid hormone are cumulative. If they are reversible, it can take a long time - and the longer you have been hypothyroid, the longer reversing takes.

However, I am assuming that your thyroid hormone levels are dropping. Do you have your test results? Could you post them, with reference ranges?

[shaws Administrator]

Helvella is right - change your doctor. Your health is being compromised.

This is an excerpt of Dr Toft's advice and if you wish a copy of the whole Pulse online article, email [e-mail]

The combination of a normal serum T4 and raised serum TSH is known as subclinical hypothyroidism. If measured, serum T3 will also be normal. Repeat the thyroid function tests in two or three months in case the abnormality represents a resolving thyroiditis.2

But if it persists then antibodies to thyroid peroxidase should be measured. If these are positive – indicative of underlying autoimmune thyroid disease – the patient should be considered to have the mildest form of hypothyroidism.

In the absence of symptoms some would simply recommend annual thyroid function tests until serum TSH is over 10mU/l or symptoms such as tiredness and weight gain develop. But a more pragmatic approach is to recognise that the thyroid failure is likely to become worse and try to nip things in the bud rather than risk loss to follow-up.

Treatment should be started with levothyroxine in a dose sufficient to restore serum TSH to the lower part of its reference range. Levothyroxine in a dose of 75-100µg daily will usually be enough.

Dr Tony Toft is consultant physician and endocrinologist at the Royal Infirmary of Edinburgh, and a former president of the Royal College of Physicians of Edinburgh and of the British Thyroid Association