Tsh 0.25 (0.4-4.0)

[audb70]

Just had a phone call from docs to say my tsh is a bit low. I have admitted to taking 25 t3 and 100 thyroxine. He can't understand why I've self medicated and wants me to stop t3 and go back on 150 thyroxine. I feel better on the t3. Any help would be grateful x

[marram]

No, the TSH is not low considering you are taking T3. The TSH at that level means that your pituitary thinks you have enough thyroid hormones in your system. The most important question is, do you feel OK? if you do, then why rock the boat? the purpose of thyroid medication is to replace what your body lacks and make you feel well, not to get your TSH to the 'acceptable' level.

If you feel the need to reduce anything, then reduce the Levo by 25mcg every other day. BUT if you feel fine, then leave things as they are. You are a better judge of how well you feel, rather than a figure on a piece of paper.

It is good to be observant though, and if you start to feel hot much of the time, have sweaty palms, constantly racing heart, and a fine tremor in the hands, that could be the time to reduce the Levo.

Marie xxx

[haggisplant in reply to marram]

Yes I think am every other day thing would work well

[audb70 in reply to marram]

Thank you I asked if I could drop the levo to 50 but he said no drop the t3. he is sending me to get a ecg scan I also asked if after 6 wks could I go back on t3 lol

[marram in reply to audb70]

I would not drop it so much, that is a huge difference and it could give your body a nasty shock.

Before I went on T3 I was on 150 Levo and feeling pretty ill (T4 doesn't suit me) but my GP felt that a TSH of 1.4 was too low (I was very ignorant then) and dropped my Levo to 100 - a drop of 50.

In 8 weeks my cholesterol soared to 9.7 from 4.7 and I started having mini-strokes. 50 is much too much of a change in one go. With the thyroid, softly softly is always best. This is a major player in your overall well-being.

Marie xx

[audb70 in reply to marram]

Should be strong and say to my doc that I feel better on the t3. Thank you so much xx

[shaws Administrator in reply to audb70]

The problem is he is trying to protect you as per the guidelines laid down by the BTA. I didn't get better on T4, in fact I felt so much worse with more clinical symptoms than ever. Now I am on T3 only and feel great. These are a couple of links and on the second one you can pick whichever topic you want.

I agree completely with Marram - we've been there - done that and don't want to go back.

Be honest with your doctor and say that you feel so much better and also that T3 is required in every one of the billions of receptor cells in our body, the brain containing most. We cannot function without a proper quota of T3 and all of us are different. My TSH was usually about 0.01 and the Endocrinologist didn't bat an eyelid.When I was on levo only I felt far more unwell than before diagnosis. I now don't care where my TSH is.

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

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

[haggisplant]

Could you possibly ask for a referral to an endo to discuss this? My referral simply confirmed that a Tsh of this level was ok though there can be risks of over replacement eg bone density etc.

You could show nice guidelines which simply say that the t4 T3 combo treatment did not have clinically significant results BUT that is a financial thing as I think something like 1/3 patients found no difference, 1/3 felt worse but 1/3 felt better. <<<< this means for a few it does help.

[audb70 in reply to haggisplant]

I went to an endo who because he only had my notes from 2002 said It was pnd I was diagnosed in 2001 and my results were 150 (0.4-4.0)

[audb70 in reply to haggisplant]

Where would I find these guidelines x

[shaws Administrator in reply to audb70]

These aren't the NICE guidelines but is a scientific document. The gist of it is that we are kept on too low doses most times rather than a decent dose.

web.archive.org/web/2010073...

[shaws Administrator in reply to haggisplant]

This is a short link re osteoporosis.

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

[helvella Administrator Thyroid UK in reply to haggisplant]

There are no NICE guidelines for hypothyroidism.

What are often mistaken for NICE guidelines are some older Clinical Knowledge Summary pages which are now under the umbrella of NICE - but they do not conform to the standards required of formal NICE guidelines.

[audb70]

Lol my heart is racing. I don't want to stop t3 as I feel better. dreading going back on levo alone. X

[shaws Administrator in reply to audb70]

They cannot force you. That's the best way to judge whether or not a thyroid hormone replacement suits you. i.e. do you feel well. If yes, you're on the right one/dose.

[audb70 in reply to shaws]

I do feel better but just the last few weeks I've been feeling anxious Heart palpitations x

[Clutter]

Audb, TSH below range doesn't mean you are overmedicated. If GP thinks you are overmedicated he should test FT4 and FT3 in addition to TSH. If FT4 and FT3 are within range you are not overmedicated.

If you are feeling anxious and having palpitations since adding 25mcg T3 (equivalent to 75mcg Levothyroxine) the dose may be too high and your FT3 over range. If your GP won't test FT4 and FT3 in addition to TSH you can order private tests from Blue Horizon and Genova via thyroiduk.org.uk/tuk/testin... Leave 24 hours between last dose and blood draw to avoid skewing results with T4 or T3 peaking in your blood afer a dose.

If you take 25mcg in one daily dose you could split into two doses 8-12 hours apart to see whether the symptoms improve.

[audb70 in reply to Clutter]

Thank you I'm going to go in and speak to the doc as I pd to get my bloods done last year. It would be good to see if there's any difference from then x

[Angel_of_the_North]

What's your Free T3 and Free T4? Those are the important ones.

I'd refuse to change and suggest that the doc prescribes T3 for you.

I wouldn't have confessed - just refused to reduce levo.

You could just say OK and not do it. That would mean that you had some spare levo for when he tries to reduce your meds. Why doesn't he want you to feel better?

[penny]

My doc stopped my T3 with no notice; I now self-medicate. The GP went into the usual funk about heart and osteoporosis - nothing wrong, as I expected. Then he said that I was not hypo. as my tsh had not diagnosed me as such. I gave up and went my own way.