After my last consultation with my endo and backed by the fibro specialist I managed to persuade them to put my thyroxine back up (having had it reduced and felt dreadful). Just been to see her and am really upset. She said that it was far too high now at 29 and a TSH of less than 0.014. She said I was in danger of broken bones, stroke etc etc and that no doctor who knew what they were doing would allow someone to be so over replaced! I have no palpitations and feel a lot better on this does (150 daily). When they reduced it last time I felt dreadful and could not lose any weight and it made my fibromyalgia much worse. I told her about all the stuff I had read on here about over emphasis on the TSH figure and she just said that very very few doctors in this field would continue to over replace thyroxine. Exactly how much danger am I in at a level of 29? Any comments on above welcome.
As a matter of interest my blood pressure, cholesterol etc is all fine.
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QueenBee53
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""Some women are told to be wary of taking thyroid medication because it can leach the calcium from bones. This assumption is now outdated. The research on people taking extremely high doses of thyroid hormone is mixed, but it is now known that thyroid pills in appropriate doses are good for your bones. Moreover, it has recently become apparent that the fairly common situation of undetected and untreated low thyroid is the cause of bone calcium depletion. Dr. Richard and Sharilee Shames
In the 1970’s and 1980’s, many faulty studies were published that led to the erroneous conclusion that TSH-suppressive dosages of thyroid hormone decrease bone mineral density in most patients. Some conventional endocrinologists wrongly extrapolated from these studies that TSH-suppressive dosages lead to osteoporosis and increased risk of bone fracture. Among our patients who have used TSH-suppressive dosages of T3-containing preparations from 1-10 years, bone densitometry has shown that their density is HIGHER than other men and women for the same age.
The finding of higher bone density among patients taking higher-end dosages of thyroid hormone suggests that under-treatment with thyroid hormone can contribute to lower bone density. The lower bone density is likely to result from patients being unable to engage in weight bearing exercise due to low motor drive and decreased metabolic capacity. Hypothyroid patients using T4 replacement dosages commonly lack the drive to engage in weight bearing exercise, indicating that replacement dosages are often tantamount to gross under-treatment. Dr. John Lowe, Boulder Colorado (119)
Optimising the serum dialysis free T4 and T3 levels in all my patients has not contributed to osteoporosis at all (on the contrary, serial DECCA scans have usually shown dramatic increases in bone density despite my never prescribing any drugs for osteoporosis but using nutritional and metabolic corrective approaches instead); and cardiac arrhythmias are taken care of by making sure there is no functional deficiency of the pertinent minerals in the appropriate fluid spaces (RBC/packed cell levels in the case of magnesium and potassium). Not doing these things, and assuming that a “normal” TSH always means normal – even optimal – thyroid hormone function, is causing vast under-diagnosis and under-treatment in millions of patients in the US and around the world. Surveys of patient satisfaction with treatment, and websites devoted to this topic, invariably show deep distrust of the adequacy of their treatment, Dr John Dommisse, Tucson, Arizona""
It does sound like your blood results are showing that T4 is not ideal for you
If you have to take so much T4 that your TSH is in your boots before you feel half decent then it may be that your conversion is not very good or there is another issue
I would
A) get your Vitamin D and Transferrin Saturation tests done.. If you have a low Vitamin D you can't absorb Thyoxine properly in your cells and the transferrin thing tells you something similar so a simple Vitamin D and Iron supplement could make all the difference
B) consider the adrenal insufficiency theory by Barry Durrant Peatfied in his book Your Thyroid and how to keep it healthy, if you have the symptoms then you'll need to address this before the T4 can work for you
C) other causes of feeling rubbish... if you're auto-immune then maybe there's another "ism" making you feel rubbish
The main thing is that you have a listening practitioner.. you're not making it up, you feel rubbish so someone needs to do something.. I would try all these three and if no joy then try NDT
I had a similar experience with my doctor a while back - low TSH and heart palps/missing beats (I was on a T3/T4 combo) had her warning me of strokes and heart attacks. I came out of her surgery white.
Have you, or your endo, looked in a conversion problem. Have you had all the normal vitamin tests done - VitD, Iron, Ferritin, B12 - and if so what were they like?
I presume that 29 is FT4? You cannot tell if someone is over-medicated from an FT4 or a TSH. You need to have the FT3 done. If that is very high, then yes, perhaps you're over-medicated. But one still needs to take symptoms into consideration.
On the other hand, it might be low, which would mean you can't convert that T4 into T3. But she'll never know unless she does that FT3.
Suppressed TSH on its own is no threat to your bones, your heart or anything else. This is a medical old wives' tale that ignorant doctors love to trot out to scare the bejesus out of you! It can't happen. The TSH (Thyroid Stimulating Hormone) is a pituitary hormone that only does what it says. It stimulates your thyroid to make thyroid hormone. It does not protect your heart or strengthen your bones. It does nothing but stimulate the thyroid. If you are taking your thyroid hormone by mouth, you don't even need it. I think there must have been some crossed wires somewhere in med school and the story has spread (or else it's a conspiracy by Big Pharma to keep us sick!). But don't worry about it. It's not true.
Thank you so much for this reply. I have only had my ft3 checked twice and it was 4.4 then 4.1 I think the range goes from 2-7 so it is mid- range. I think what she is trying to tell me that a very low tsh indicates being over medicated or hyperthyroid. This clearly is a load of bunkum as I have no symptoms whatsoever of being hyper thyroid. I can understand that if you were first diagnosing someone then looking at the tsh would be an indicator but I have had Hashimotos for over 20 years. I got quite upset today (I normally try to be very up beat) but she will not listen to me when I ask why there is so much emphasis on the tsh figure. She insists that I reduce my dose again by scaring me half to death saying I have an increased risk of stroke etc etc. I only had palpitations when on a lower dose!!! How annoying. ??
Yes, such ignorance is sad, isn't it. You're highly unlikely to be over-medicated with an FT3 at mid-range! Are you going to reduce your dose? I wouldn't if I were you. You know your body best and how you feel. She knows nothing about thyroid.
“First of all, TSH is not a blood pressure. Blood pressure is a surrogate endpoint for clinical effectiveness and blood pressure has been correlated with mortality and morbidity. TSH has not been correlated in any prospective study that I’m aware of with clinical symptomatology of thyroid disease. (Toft A. Which thyroxine? Thyroid 2005; 15:124-6)
British Medical Association book, Family Doctor Guide to Thyroid Disorders,
by Dr. Anthony Toft ( past physician to the Queen) where he states,
In the paragraph, Thyroid Blood Tests, Dr. Toft states that, " Typical results would be FT4 24 pmol/l and TSH of 0.2. In some patients a sense of well-being is achieved only when FT4 is raised, e.g. 30 pmol/l and TSH is low or undetectable. In this circumstance, it is essential that the T3 level in the blood is unequivocally normal in order to avoid hyperthyroidism."
," Fraser points to, “The flaws of population based reference intervals are due to the biological individuality presented by all. Hence the use of 95% reference intervals is questioned; both due to changed probabilities according to repeated testing and due to misuse of reference limit as decision limit i.e. ‘cut-off point’. Further, the use of population-based reference intervals is criticised as individual reference intervals for each single individual are preferable if available.”
“The Fraser study showed that among 18 clinically hypothyroid patients, the free T4 like the TSH led to false interpretation of the patients’ status. In 4 of the 18 patients, (22%), the free T4 was above the upper limit of the reference range. This gave a false signal that the patients were overtreated when in fact they were undertreated.”
Are bioichemical Tests of Thyroid Function of any Value in Monitoring Patients receiving Thyroxine replacement?
W D Fraser, E M Biggart et al
Discussion of thyroid readings when on thyroxine
Suggests when on thyroxine ranges for -
TSH of <0.1 – 13.7
FT4 of 12 – 36
FT3 3.0 – 8.6
Hypothyroidism: Treating the Patient not the Laboratory
Damien Downing
Journal of Nutrional & Envionmental Medicine, June 2000 Vol 10 Issue 2. P 101-3
Thyroid Hormone and the Heart
Dr. John C. Lowe, Dec 12, 2005
…..’we ran so many in years past that the results forced us to a conclusion: it’s the rarest exception when the ECG rhythm of a patient is of concern. …Some cardiologists said that the therapy would most likely improve the patient’s cardiac health. Etc.
Thyroid Hormone and the cardiovascular system.
Danzi S., Klein I
Minerva endocrinolol. 2004 Sep;29(3):139-50
T3 mediated effects on the systemic vasculature include relaxation of vascular smooth muscle resulting in decreased arterial resistance and diastolic blood pressure. Etc.
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Help me – desperate for advice. Feel so uncared for by endo :( 
Baffled by blood results, please help me work out what on earth is going on!
Seeing an Endo and might be in trouble so please help
Steam is coming out of me ears.
