Help please with results.

[Maeli24]

Hi, I haven't posted for a while as have been feeling well. However, I have just got off the phone to my doctor who rang because she wants to reduce my thyroxine from 100 to 75 as my TSH level has gone down to 0.80 (0.24.4.5). No T4 or T3 levels as lab won't run them. After heated discussion she has agreed to leave my dosage as it is for another 2 months and then retest. Could someone please advice me if this is for the best or should I think about reducing? Is 0.80 too low? Any feedback would be greatly appreciated.

[Clutter]

Maeli, I don't understand why your GP is concerned. Your TSH looks good and is comfortably within range, Most people are comfortable with TSH just above or below 1.0. Most importantly you are feeling well on your current dose.

Dr. A. Toft, ex-president of the BTA, discusses dosing and thyroid levels in this link thyroiduk.org.uk/tuk/about_... If you want a full copy of the article to show your GP email [e-mail]

[Maeli24 in reply to Clutter]

Thank you Clutter and CarolynB for replying so quickly. I have just realised though that I put my TSH as 0.80 and should have put 0.08. Is 0.08 too low or ok in your opinion?

[Clutter in reply to Maeli24]

Maeli, TSH 0.08 is low but not technically suppressed ie 0.03 or lower. Ask for FT4 and FT3 to be tested as if both are above range you may be sightly overmedicated. If only FT4 is slightly above range, according to Dr. Toft it shouldn't be seen as a problem.

If your GP won't order FT4 and FT3 you can order private tests fromBlue Horizon or Genova via thyroiduk.org.uk/tuk/testin...

[PinkNinja]

Your TSH is within range. In fact it is pretty much perfect for someone on thyroxine. What earthly reason could he have for wanting to decrease your dose while your TSH is in range?

There is recent research (from the people who created the current t4 test, no less) that shows that TSH is not a good indication of optimal dosage in people on thyroid treatment. Your doctor has no good reason to decrease your dose. If he tells you that you'll get osteoporosis, this is incorrect and recent research shows the opposite to be true. You are more likely to get osteoporosis if he decreases your dose, according to more recent research.

If you are feeling well, it is likely you are on the right dose for you. Your TSH is near the lower end of the range but you might like to remind the doctor that TSH has a logarithmic relationship with t4, not a linear one.

I hope you manage to convince your doctor.

Carolyn x

[Maeli24 in reply to PinkNinja]

Maeli24

a few seconds agoMaeli24

Thank you Clutter and CarolynB for replying so quickly. I have just realised though that I put my TSH as 0.80 and should have put 0.08. Is 0.08 too low or ok in your opinion?

Reply

[PinkNinja in reply to Maeli24]

It really depends. that is low but then it will be low on thyroxine in many cases. If she won't test t4 and t3 how can she possibly know whether you age on too high a dose?

TSH is not a good indicator of thyroid hormone levels once you are on thyroxine. This is coming from the people who developed the current t4 test. It is also what many thyroid patients find. Dosing by TSH alone is never a good idea for so many reasons. As long as your t3 is in range you are at no increased risk of heart problems or osteoporosis. In fact under dosing is more likely to cause problems. Maybe the t3 test can be your next argument. After all , TSH can be affected by so many things other than thyroid function.

[PinkNinja in reply to PinkNinja]

Also remember to have your next blood test first thing in the morning and don't take your thyroxine until afterwards because otherwise your TSH may be artificially suppressed and your t4 artificially raised.

[Maeli24]

Thank you both again for such a swift response, I really appreciate your thoughts and feedback.

I think I will book an app and see if I can persuade them into doing T3&T4 bloods so I can gadge what is going on properly. If it does come back as slightly over medicated do you think a good way forward could be to have 100 Levo one day and 75 the following to tweak my levels up a touch? Just don't want to reduce Levo too much and end up feeling lousy again! x

[PinkNinja in reply to Maeli24]

That would be a good compromise and probably a wise course of action IF your t4 and t3 are above range.

You may find that if you make sure your next blood test is first thing and you don't take your thyroxine until after the test to avoid spurious results, your TSH may be a little higher anyway

All the best x

[Maeli24]

Ok I will do, thanks CarolynB. I appreciate your advice...this site is a blooming life saver xx

[Glynisrose]

NEVER let a doctor reduce your meds based on blood tests alone,. You can reduce yourself if you feel you need to but if you let the doctor do it you will probably not get them to raise it if you need it!!