Latest blood results.

[NotSoBizzyLizzy]

Hi, my GP has asked for a routine apt. Re my blood results. I'm currently on 100mg Levothyroxine, I'm feeling great and worried they might change dose. Your thoughts pls.TSH. 0.01. (Range 0.27-4.0)

T4. 20.2. (Range 11-25)

T3. 6.0. (Range3.1-6.8)

[SarahJane1471]

It’s probably because your TSH is a little low. However if you feel great make sure they know that!

I will ask tattybogle to add some links that you can use as back when talking to your GP.

[tattybogle]

Hi , these two posts have useful information which will help in discussions with Doctors :

healthunlocked.com/thyroidu.... tsh-is-just-the-opinion-of-your-pituitary-about-your-dose-but-your-pituitarys-opinion-is-a-bit-warped-once-you-take-thyroid-hormone.

healthunlocked.com/thyroidu... useful-evidence-that-tsh-between-0.04-0.4-has-no-increased-risk-to-patients-on-levothyroxine-updated-new-study-does-show-small-risk

assuming the results above were taken no longer than 24hrs from last dose levo , (and 8-12 hrs from last dose T3 if you take any ? ) ... and assuming you have been on same dose consistently for at least 6 wks ...... then the fT4 and fT3 results are both comfortably within range.. and the only issue is the TSH.

The first post above has evidence explaining why low TSH does not always mean overmedication once people are taking thyroid hormone replacement .

( since your TSH is below 0.04 , the second post will only be useful from the point of view of discussing Low TSH Risk vs. Quality of life).

if you feel well on this dose , and as long as you had NO symptoms that could potentially be caused by overmedication, then inform the GP that you fully understand and are prepared to accept the (alleged) risks associated with low TSH, and they might be willing to leave your dose alone .

However , they may insist on a dose reduction because your TSH is ' low enough to be classed as 'totally suppressed' and the NHS guidelines strongly warn GP's against prescribing doses that actually suppress TSH ( it's much easier to get them to agree to doses that give 'low but not supressed' TSH) ~ If they insist you try a reduced dose , then try to negotiate a very small one , eg a reduction to 87.5mcg rather than 75mcg. (total of 612mcg a week)

or even smaller than that eg. 5 days 100mcg/ 2 days 75mcg total of 650mcg week)

(87.5mcg is commonly prescribed as 100mcg one day / 75mcg then next alternate ~ people who find they prefer to take the same dose each day usually cut a 25mcg in half to get same dose each day)

if you do agree to try a dose reduction , be prepared for the first few weeks to feel undermedicated , but don't start to make your mind up about how the new dose will feel until at least 5/6 week have gone by ...in my experience of dose reductions , the feelings of undermedication sometimes start to improve after about wk 5 .. and sometimes i have been surprised and have found i did actually prefer how i felt on the slightly lower dose .. even though if i'd been asked within the first 5 weeks, i would have been adamant that it was too low.

plus .. if you definitely feel worse after you've given it a fair trial .. you have a much stronger argument for them to put your dose back up, and more to the point, leave it alone in future .

it's difficult for GP's to agree to go against guidelines and prescribe doses that supress TSH unless they have evidence that a lower dose has at least been tried .