new to this.

[stephens]

I have asked my dr to up my thyroxine (on 200) but they are very reluctant. Have talked to others on 250/300 and was wondering if there was any research i could take to the drs ( might educate them).

Just fed up with being fobbed off.

[RedApple Administrator]

Hello, can you give some indication of why you feel your dose should be increased and why your GP is reluctant?

When was your last thyroid blood test and what were the results?

[stephens in reply to RedApple]

Thank you for your reply.

I am due to have another blood test today but my last one was back in november and came back normal.

I have noticed that syptoms are coming back - sleeping more, weight gain, dry skin. I attend a wellness clinic and it was there that i met a fellow thyroid person who had had problems like me and was on 250.

My Dr say that the highest dose they can give is 200 but that is obviously is not true and i wanted to have evidence to show them this. They have tried to say i am depresed and I am getting frustrated that they are not looking into the area more.

I will be getting a copy of my tests to check on line to see what Thyroid uk has to say about them.

[RedApple Administrator in reply to RedApple]

You are absolutely correct, of course your GP can prescribe more than 200 mcg. I have a sister who is now on 300 mcg, but she also had to argue this same issue with her GP. I can't recall where GPs get the 200 mcg upper limit idea from, but I've heard this one many times!

Your GP needs to understand that it is NOT SUFFICIENT for your test results to simply be within the 'normal' range. He should be taking your symptoms into account in conjunction with the test results, and fine tuning your dose accordingly.

Here is what the endocrinologist Dr Anthony Toft states in his guidance for GPs:

(You will need to register on this site to see the document, but it's simple and free)

pulsetoday.co.uk/story.asp?...

6 What is the correct dose of thyroxine and is there any rationale for adding in triiodothyronine?

The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the

lower part of the reference range – 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly

elevated – 18-22pmol/l. Most patients will feel well in that circumstance.

But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free

T4 concentration will be elevated at around 24-28pmol/l.

This ‘exogenous subclinical hyperthyroidism’ is not dangerous as long as serum T3 is

unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l).

And here is what the British Thyroid Association state in their guidelines:

british-thyroid-association...

(a) The aim of the treatment of hypothyroidism is to render the patient back to the normal or ‘euthyroid’ state.

(b) When a sufficient dose of thyroid treatment is given to lower the TSH to the normal range (reference range) for the test method used, patients usually lose their symptoms of hypothyroidism.

(c) Fine-tuning of TSH levels inside the reference range may be needed for individual patients.

As soon as you get a copy of your test results, post them here and we will be able to give you further suggestions as to how to approach your GP.

Remember, you are entitled to have details of all your tests, so do insist that you are given copies of the previous tests as well as the latest one. It is sometimes helpful to compare them.

[Muffy]

Before the days of thyroid blood tests, the doses were generally between 200 and 400mcg per day!