HELP! Need "reputable" references on suppressed TSH and FT3 levels when on Armour. Seeing Doctor tomorrow. Im having panic attacks :(

[BexyLS]

she will freak about my 0.6 TSH result. unfortunately my FT3 still hasn't come through. my previous TSH was 4.73 and she didn't want to up my meds but i persuaded her. I'm doing well.

I have toft but cant find the page of him saying low tsh or suppressed is best for us and any other good references would be great. Thanks xx

[shaws Administrator]

I haven't read Dr Toft's booklet but this is an extract from Pulse online and if you email [e-mail] she will send you a copy. She is off on holiday today so may not be able to send it straight away.

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

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).

Even while taking the slightly higher dose of levothyroxine a handful of patients continue to complain that a sense of wellbeing has not been restored. A trial of levothyroxine and tri-iodothyronine is not unreasonable. The dose of levothyroxine should be reduced by 50µg daily and tri iodothyronine in a dose of 10µg (half a tablet) daily added.

[BexyLS in reply to shaws]

thank you! I have a fear of doctors these days and it sends me into a panic even thinking about going to see them!

[shaws Administrator in reply to BexyLS]

It's no wonder as many of us have lost confidence

[Heloise]

Are people in the UK FORCED to have appointments? If you feel good and don't think it's necessary, why can't you just cancel the appointment? Do you need to see her in order to get your prescription refilled?

If your FT3 is in range, there is no need to have your dose reduced.

[nostoneunturned]

P88 of Understanding Thyroid disorders by Dr A Toft refers to low/undetectable TSH plus advice on other levels. Will supplement Shaws advice.