Brief Answer:
Need some further details regarding..

Detailed Answer:
Hello XXXXXXX Welcome to HCM,

I've gone through your query and understand your concern..

First of all, to recapitulate, 36/F On thyroid medications since XXXXXXX 2012/ 100 mg (I think you meant mcg and not mg) of Thyronorm per day on an empty stomach- recent T3 and T4 values were within range, but my TSH was below normal (at 0.393)..
XXXXXXX I need you to tell me a few more details regarding, so that I can guide you more specifically,

1. When was your last Thyroid function test done before this ? How were the parameters (please share the specific values)..

2. Are you taking Thyronorm regularly (please feel free to share) ? When was the last time doses revised ?

3. Have you noticed any weight gain/ disturbance in sleep pattern/ lethargy or irritability / heat-cold sensitivity/ mood changes or any other health concern recently ?

4. When is your routine follow-up with the endocrinologist ? Have you got checked by the endocrinologist (not GP) recently ?

5. Any other concern that you want to share with me ?


You should note that TSH level at such lower values(at 0.393) in a known hypothyroid person is not acceptable, so the first concern in this regard is medication non-compliance..

So please let me know these answers so that I can guide you accordingly..

Awaiting your response..

Take Care
Kind Regards

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Brief Answer:
you need to get clinically examined thoroughly ..

Detailed Answer:
Dear XXXXXXX Welcome Back,

Thanks for following up,

I've gone through your responses and let me enlighten you that even considering your previous value of TSH 1.269, dose of thyroxine (100 mcg of thyronorm), was a bit higher than required which you've continued for last 1 year (unless the dose before that was ~ 175-200 mcg per day)..

Now, the first thing to do is to schedule an appointment with the Endocrinologist (which you've mentioned is there for the upcoming weekend) for a reduction of dosage of Thyroxine (50% reduction should ideally be done).. followed by regular follow-up and recheck Thyroid function(fT3 fT4 TSH) after 3 months(strictly) and monitor accordingly..

There are several other causes of weight loss, however since you haven't mentioned any other significant concern, so i'm holding the Thyroxine as the responsible factor..

You should also note that, when on thyroxine supplementation, ideally you need to follow-up with your endocrinologist at least once in every 5-6 months, which in this case has been missed twice, thus delaying it by almost 1yr 5 months..

So please don't delay any more any get yourself checked and implement the reduction in the dosage of thyroxine(considering the current scenario, you should be on 25-50 mcg of thyroxine on alternate day regime, but let the Endocrinologist decide about it further as he/she has the upper hand in it by examining you clinically)..

Let Me know how you stay in due course..

My Best Wishes..

Take Care
Kind Regards

For future reference you can always get in touch with me, below is my direct follow-up link through which you can contact me anytime anywhere, I'll be happy to help -

http://www.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=71041

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