Thyroid UK
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Sweating/ heat intolerance? I get very sweaty when walking fast or doing exercise. The nurse is concerned im hyper. Seeing Doc tomorrow

i have my results and the nurse freaked out, saying id gone hyper by TSH result. I didnt panic and said i'll wait for FT3 result but still had to tell her i would reduce my dose :(

TSH: <0.05 (0.15-3.2)

FT4 : 14.8 (This is always low no matter what) (9.9-20.1)

FT3: 6.1 (2.7-7.0)

my last reading for DHEAs was 2.5 (1.0-11.7) im thinking adrenals are the next thing to tackle now. Not sure how this will go down with the doc tho who im seeing tomorrow. Im 14 st 4 but VERY fit and also wondering if its cause im faster and fitter but weight is still there. Which would make me think i need to increase my dose still. Any advice? Thanks guys! x

2 Replies

The nurse is wrong if she is diagnosing you only by the TSH. If you were hyper you would soon know about it with racing heart etc. and not feel well at all.

It is only natural to sweat if exercising or walking fast. Dr Toft himself has said:-

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.


If the nurse needs a copy of the Pulse Online article, you can provide one for her.

My TSH is 0.03 and am fine. She may classify your TSH as low or suppressed but messing about with your dose can cause more harm than good. The TSH varies hour by hour. Did you have your blood test early in the morning, as that's when our TSH is highest.

Read the first two questions in this link:-

This is an excerpt

Our treatment team uses the TSH level only initially to help clarify a patient’s thyroid status. But during treatment, we completely ignore the level. The reason is that the TSH level is totally irrelevant to normalizing the patient’s whole body metabolism and relieving his or her suffering. The only clinical value of the TSH level is to see the effect of a particular dose of thyroid hormone on the pituitary gland’s "thyrotroph" (TSH-secreting) cells.


The TSH level is not well synchronized with the tissue metabolic rate. (Probably most doctors falsely assume that studies have shown that the TSH and metabolic rate are synchronized. But despite my diligently searching for years for such studies, I’ve yet to find them.) Adjusting the T4 dose by the TSH level is like adjusting the speed of your car by a speedometer that's out of synchrony with the actual speed of the car. Adjusting the speed of a car by an out-of-sync speedometer, of course, will get the driver into trouble—either with other drivers who'll object to the car traveling too slowly, or with a police officer who'll object to the car going too fast. And adjusting the thyroid hormone dose by the TSH level gets most patients in trouble—almost always because their tissue metabolism is so slow that they are sick.

1 like

Thanks Shaws :)


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