Query over amount of levothyroxine?

[Cairnperson]

I recently had a throat ultrasound scan and the radiologist informed me that the thyroid was shrunk and dead. My last blood test showed TSH 1.47, T4 20.4.

I was on 100 levothyroxne and now GP has reduced this to 75

I am achy, tired and breathless. However, he feels that I am on right dosage?

Have been underactive thyroid for 22 years.

[helvella Administrator]

It would help if you posted the reference ranges - for FT4 it varies hugely across the country.

That TSH would be no reason in my book to reduce dose. If reducing dose has had this impact on you then it is self-evidently too little. (Unless he can come up with another valid reason for your deterioration.)

Rod

[Cairnperson]

Reference range for serum TSH is 0.35-4.94

Reference range for serum free T4 is 9-19

Says it is the reference range from 2/11/2011 so hope that helps.

[helvella Administrator in reply to Cairnperson]

So apparently slightly over-range on FT4.

Now, I am going to ask, when do you take your levothyroxine? And did you take it before your blood test?

I have a suspicion that the FT4 level is inflated by you having taken your levothyroxine in the hours before the blood draw?

(Please do NOT take this as a criticism, or "it's your fault", if no-one ever told you to do otherwise, why wouldn't you do that?)

I always suggest having the blood draw as early as possible in the morning, and not taking levothyroxine before it. Then taking the levothyroxine straight afterwards.

Rod

[Cairnperson]

Well, did not know the GP was going to send me for blood test, so had taken levothyroxine early morning and the blood was taken about 4 hrs later. Have realised this from comments I have read on forum so next time see him will not take it until after the appointment!

[helvella Administrator in reply to Cairnperson]

I suspect that you need to get back onto 100 micrograms asap!

(If you click on the blue "Reply to this" the person you are responding to gets an email alert so they know you have done so. Don't worry - everyone makes this mistake to begin with. )

[Cairnperson]

Well will be seeing GP again shortly but have to wait until I have had endoscopy for reflux again as that has been troubling me too.