Help TSH 0.2 T4 26

Six weeks ago TSH 77 T4 12 on Thyroxine 225mcgs, at gp for thyroid blood check this morning, doctors just called me at home as TSH now 0.2 & T4 26 he doesn't understand what is happening he's trying to get hold of endocrinologist for advice but probably not going to happen at 1700 on a Friday. Thinks there has to be something else going on for TSH to drop so quickly from 77 to 0.2 & also for T4 to rise from 12 to 26. Advised cut Thyroxine from 225mcgs to 200mcgs & will repeat blood check in 8weeks. Surprised I'm still off work but I just feel awful. I would appreciate any advice as to what these readings mean?

12 Replies

  • If you started off levo at 225mcg that's a quite unusual dose as we usually begin at 50mcg with 25mcg increments every six weeks until relief of symptoms.

    I am not medically qualified but I think your high dose of 225mcg has probably caused the quick drop.

    My TSH was 100mcg and given 25mcg of T4 and Endo said it should have been 50mcg to begin with.

  • shaws thanks for getting back to me much appreciated I have been hypothyroid for 24 uneventful years on Thyroxine 175mcgs, approx 6-8weeks ago TSH 180 & T4 12..totally out of the blue I had been bit tired & concentration bit more difficult..since then TSH 180 then measured hours later on same day & TSH 100 which no one can explain,Thyroxine increased to 225from 175 at that time,, two weeks from this TSH 77 & today TSH 0.2 & T4 26 a concern enough that gp called me at home to say he was trying to contact endocrinologist as something going on & gp perplexed as am I what is causing such variations in readings, advised reduce & thyroxine from 225 to 200 while we wait on endocrinologist..

  • I hope the Endo is a good one as your wide variations in TSH are unusual (I'm not medically qualified) but you must be worried. The TSH does have a cycle, i.e. higher early a.m. and drops throughout the day but what's causing your very, very high TSH whilst on treatment is unusual.

    This is a link and may be helpful:-

  • shaws thanks for advice & I'll go to the link you mentioned. I am in utter despair & don't know what to do or who to turn too as no one can explain huge variations in TSH & T4. I didn't realise different times can affect the readings so thanks for that info. What does having TSH of 0.2 mean & signify & especially such high T4 signs & symptoms..

  • If we are taking thyroid hormones, the TSH can usually be disregarded. However, if you are feeling different to what is usual for you there must be something going on. I think a TSH of 0.2 is fine.

    Was your blood test as early as possible? Did you take levothyroxine just before your blood test? Did you leave about 24 hours between your last dose of levo and the test as that's the recommended way. Taking hormones a short time before a blood test can skew results.

  • shaws thanks for getting back to me & I'm definitely feeling different very agitated & shaky but also incredibly tired. awake all last night so hoping tonight be different..My blood test was 1030am yesterday & I did not take any thyroxine prior to this as didn't want to skew the results, it had been over 24hours since I had my thyroxine & this has been my standard way of getting as accurate a reading as possible over the last 24years..

  • It does sound overactive but doesn't fit with a high TSH.

    I would suggest you go to the A&E and say you are feeling quite bad with your symptoms and take with you a note of your blood test results as you wont get the others for a few days.

    Hopefully they will assess you and I think it's important you are seen by someone with a bit of knowledge.

  • Such huge changes are odd .TSH of O.2 in itself should not be a problem.I think you need to get your FT3 tested to see if it is over range.

  • Treepie thanks for your advice I'm just desperate to understand what's going on & hope someone will be able to say they know exactly what's causing huge changes so quickly so all advise welcomed

  • Your T4 indicates you are hyperthyroid. As a result your pituitary gland will not release TSH and that is why you have such a low TSH reading. In terms of symptoms you may feel more anxious and have palpitations.....due to high T4 (Low TSH will not give any symptoms) Once your T4 drops the pituitary gland will switch back on and your TSH will increase.

  • ChemistryBoffin thanks for getting back to me plus your advice, it's all bit bizarre to go from hypothyroid for 24years then 6 weeks ago hypothyroid with TSH 180 to suddenly drop way down to 0.2..your right regards symptoms for hyper I have been shaking / jerking ridiculously dizzy..I had posted last week in this forum to query why felt agitated, dizzy,shaking as these all signs of hyper never thinking in such a short time frame that I have become hyper !

  • It is a massive drop in TSH and I can understand your alarm. However it is not unexpected as your T4 is high. I have graves and my TSH is 0. I feel fine because my T3 and T4 are within range.

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