My doctor says she will only prescribe thyroxine as long as my TSH is not suppressed. I have been on 1.5 grains of armour and my Tsh is 0.75

I have heard that most people need 3 to 5 grains before they feel well. I feel really ill and am worried my treatment will be stopped because of TSH suppression before I have been on a large enough dose. My doctor has agreed to increase to 2 grains. Any comments?

[shaws Administrator]

There is really no hard and fast rule, except that when you feel well it's the optimum medication for you. Many of us need a suppressed TSH to feel well but GPs have been told differently, unfortunately.

Dr Toft of the British Thryoid Association has said that some of us need a suppressed TSH or the addition of 10mcg T3. If you email [e-mail] and ask for a copy of the Pulse Online article by Dr Toft. He was referring to levo only as the BTA are against the use of NDT through false statements they make.

I missed one day's dose before my blood test and did not take my a.m. dose on the morning of the blood test until afterwards. If we have a blood test as early as possible, usually the TSH is at the highest then. If only we had doctors who thought like the following excerpt. In fact before the blood tests were introduced, doctors could only follow these guidelines with their patients:-

web.archive.org/web/2010103...

[Heloise]

Hi mandy, I wish I could find the source but I've read most patients need an average of two grains of replacement hormone. A person without hypothyroidism may produce 325 mcg. naturally. I was taking one grain of Armour myself.

[Clutter]

Mandyjane, if the T3 in the NDT suppresses your TSH you may have to argue your case with your GP on the basis of improved/improving symptoms. There is some scaremongering over the increased risk of osteoporosis and atrial fibrillation but a Dexa scan and ECG will usually allay concerns. As Shaws says, many need a suppressed TSH to feel well and TSH is suppressed in thyCa patients for 5 years to prevent recurrence.