Thyroid function test

[Saayan]

Results said higher TSH levels & levothyroxine dosage reduced to 200mcg from 250mcg please advise if its ok to reduce dosage at this stage

[humanbean]

With a TSH level > 50 your doctor should have been RAISING your levothyroxine dosage, not lowering it!

Find a doctor who can read, and then make a complaint about the idiot who lowered your dosage.

[helvella Administrator in reply to humanbean]

Completely agree.

It even says "under-replacement".

Saayan, Do you have the ranges for the Total T3 and Free T4?

Rod

[Saayan in reply to humanbean]

T3 1.00 - 2.70

T4 10.50 - 24.50

Thanks for ur reply

[helvella Administrator in reply to Saayan]

So very much towards the bottom of both of those ranges. Clearly you must not have your dose cut.

[humanbean]

Hi Sayaan,

My apologies for my abrupt post earlier. I was angry on your behalf!

I don't know how much you know about hypothyroidism, so I'm sorry if I'm telling you things you already know.

TSH = Thyroid Stimulating Hormone.

In healthy people TSH would be around 0.5 - 1 or possibly 0.5 - 1.5. The pituitary makes TSH to prompt your thyroid to do its job of producing mainly T4 with some T3 which are the main thyroid hormones. Levothyroxine is an artificial substitute for T4. T4 is a storage hormone, believed to be mainly inactive. In order to be useful it has to be converted by the body to T3.

If the thyroid fails to produce enough T4 and T3 then the pituitary creates more TSH. In primary hypothyroidism, when the thyroid gland starts to fail, the pituitary starts to produce more and more TSH to try and flog the thyroid into doing its job. This is why your TSH has risen so high - your thyroid is not producing enough T4 and T3 (at least it appears so - the reference ranges are needed to be absolutely sure).

If you were adequately medicated with sufficient levothyroxine your pituitary would stop producing so much TSH.

There are lots of other things to take into account that might prevent you from feeling well, but we'd need more information from you before we could be helpful.

Hope this helps.

HB

[Saayan in reply to humanbean]

Hi HB thanks for ur reply my T3 & T4 in range as I mentioned clinical range but still TSH levels not coming down it does the least I got to was 8.5 couple of years ago but Dr. is of the opinion to lower the dose to look impact in 4 weeks time. The higher dose of 300mcg is affecting my body like little tremor in my fingers. So I hope this will help

[minsterlady in reply to humanbean]

Thank you so much for your explanation of TSH which has helped me enormously to understand my own test results so much more clearly. I shall also be able to use this to get my doctor to increase my level of levothyroxine. I am so very grateful to you.

[humanbean in reply to minsterlady]

I'm glad you found my explanation helpful, minsterlady.

I stripped it back to the bare bones, so there are a lot of bells and whistles I missed out. And it really only covers the case of primary hypothyroidism. But the usual reason for TSH rising and falling, and the effects it has on T4 and T3 production, is the basic fact that all other understanding hinges on. Learning everything else becomes easier once this falls into place.

[Glynisrose]

How do you feel? That is more important than numbers!!

[Saayan in reply to Glynisrose]

I feel lethargic & restless difficult to walk long , putting on weight & difficulty in sleeping. Most annoying is getting irritated so quickly which is colliding with my nature of job being in public relations but fingers crossed I will overcome these issues hopefully. Looking forward to seeing all good.

[Muffy]

Yes, dose should have been raised.

[Ambar26]

TSH for my wife was 40 at one time! In India the limit is 5. She was recommended 25mcg and with that her TSH has redued to around 10 in 3 months. Now she has been advised to take 50mcg on week ends and 25 mcg during weekdays.

Regarding the TSH explaination. It was nicely explained. However the command that raises the T3&T4 is TRH coming from Hypothalamus.

There is also the question of FT3 and FT4 (old fashioned).

Please review and explain in detail.