Recent blood tests/what options now?

[BlueMundo]

Please can you give your opinions on my latest blood test results:

TSH 0.08 0.35 - 5.5 mu/L

FT4 19.9 9 - 22.7 pmol/L

FT3 4.6 3.5 - 6.5 pmol/L

I was on 125mcg Levo at the time.

The previous test result from April was TSH only and if I recall correctly 0.06 on 150mcg. I can't seem to get my TSH unsuppressed - for my doctor to be happy - and at this rate I will be on 25mcg Levo trying to achieve that!

My new endo is debating with a diagnosis of CFS because of my continued symptoms. I have had improvement of shortness of breath on 150mcg but that is irrelevant to my endo and doc.

I am now wondering if I should try either Thyroid S or go back to a T3/T4 combo. If TSH in range is the be all and end all of my thyroid treatment I don't think I will reach it without further detriment to my health.

Why is my TSH still suppressed? Any ideas?

Thank you.

BM

[shaws Administrator]

If you email [e-mail] and ask for a copy of the Pulse online article by Dr Toft (ex President of the BTA) in which he says some of us need a very low or suppressed TSH. I don't know why they get all hot and bothered about the TSH instead of the patient's continuing symptoms.

This is a link and it is Part 1 and Part 2

thyroiduk.org.uk/tuk/thyroi...

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

Some people's TSH doesn't rise high enough to be diagnosed yet have lots of clinical symptoms. Whereas before the blood tests were introduced they would have been given a trial of NDT until symptoms abated. Doctors then were trained in recognising patients' symptoms for a diagnosis.j

[Clutter]

BM, Your TSH is low, suppressed is <0.03. TSH alone should not be used to guide dosing and dosing shouldn't be reduced to force TSH into range. The TSH of some members is suppressed on 75mcg Levothyroxine. Your FT4 is good and FT3 mid-range but neither are anywhere near the top of range so you definitely aren't overmedicated.

Your FT4 will probably have been top of range on 150mcg which may be too high for your comfort and why you were breathless. If you felt better on T4+T3 then go back on it or try Thyroid-S. It might be helpful to raise your T3. Be advised that T3 is likely to lower TSH.

Have you had ferritin, vitamin D, B12 and folate tested?

[BlueMundo in reply to Clutter]

Hi Clutter, thanks for your comments. I wasn't breathless on 150mcg but started with this symptom when they dropped my dose to 125mcg.

I spoke to the endo about why if I'm over medicated on 125mcg and breathless, why wasn't I breathless on 150mcg? He said he didn't know.

My TSH was always suppressed whilst on T4/T3 combo and although I wasn't fully well I was a lot better than whilst on levo only. All my current problems have started since removing T3 but my GP is adamant it's unnecessary. Interestingly my endo has said that using T3 is controversial but new evidence suggests it maybe beneficial to some. He says he's not at the point he wants to try it on me yet but who knows in Sept when I next see him?

I've tested all the other things and ferritin was low but with supplements moved into the lower part of the range. I've started supplement again to try and push it up again. Vitamin D was low last year and probably needs retesting (privately) as no idea what it is now.

Thank you.

BM

[Clutter in reply to BlueMundo]

BM, Breathlessness may be caused by overmedication, undermedication and low ferritin. You need to continue supplementing until it is halfway through range.

Worth testing vitD. I felt very unwell when it was deficient.