TSH sharp drop, FT4 and FT3 not budging upwards at all

[richar03]

Hi Folks,

I'm pretty disappointed by my last set of results:

50mcg Levo, 13/02/2017, TSH 0.8 (0.27-4.2), FT4 14.1 (12-22), FT3 3.7 (3.1-6.8)

75mcg Levo, 28/03/2017, TSH 0.08 (0.27-4.2), FT4 13.98 (12-22), FT3 3.71 (3.1-6.8)

My endo said my TSH must not drop below 0.3 so these results will alarm him.

I also had my vits done on 28/03/17:

D: 76 (50 - 200), B12: 586 (140 - 724), Folate: 19.98 (3.89-26.8), Ferritin: 126 (13 - 150)

I'm currently supplementing 5000iu D3 and 1000mcg B12. 200mcg Selenium, magnesium and K2.

Any suggestions? I'm an avid follower of this forum and have made tonnes of diet, lifestyle, stress and sleep changes to boost health, but I still feel very fragile and prone to energy wipe-outs if I do too much. Very frustrating.

Context - as well as Hashi's I have low TSH, low FT4 and low FT3 - some sort of pituitary shut down, though MRI is clear.

I know there are no silver bullets, but I would appreciate some testing or medication advice if anyone has any ideas?

With massive thanks.

[SlowDragon Administrator]

Might find adding vitamin B complex helps. Partly to keep B's in balance as also taking B12. Also its suggested by Dr Gominack that it's good idea if supplementing vitamin D

drgominak.com/vitamin-d-hor...

Assume you are gluten free?

[Greentrees1 in reply to SlowDragon]

Could you take t3? It's very low. My ft3 has risen with 10mg t3 added to 50mg levo.

[richar03 in reply to Greentrees1]

Thank you that's helpful to know and I will certainly start to think about that now. It's a bit upsetting when nothing's moving upwards.

[Hidden in reply to SlowDragon]

SlowDragon the info in the link is a treasure trove. Worth sharing as a separate post 😊.

[SlowDragon Administrator in reply to Hidden]

Yes - I have posted it a lot over last 6 months.

I had terrible peripheral neuropathy after starting vitamin D. Good B complex (and B12 for short while) gave almost immediate relief

I still take B complex daily.

You need to stop B complex 4-5 days prior to a TSH test if it has biotin in (most do) - biotin can falsely affect TSH test result

endocrinenews.endocrine.org...

[Hidden in reply to SlowDragon]

So pleased I read it - bookmarked to go back to.

Yes the biotin I read about, though only after my last blood test 😯. Note on test paper to stop Bs 5 days prior. Oh what a merry-go-round it is!

[richar03 in reply to SlowDragon]

Hi, thank you. Yes I've been gluten free for 4 months. That's a terrific article - thank you. Lots of very useful information in there to digest.

[Joesmum]

Change your endo....

.... and seek another opinion.

You could very likely have secondary hypothyroidism which means your TSH will be completely suppressed probably by the time you have raised your thyroxine enough to have decent FT4 and FT3 figures.

In other words the problem is in the pituitary gland.

It is shamefully underdiagnosed.

The next time you see your endo I would have this conversation.

[richar03 in reply to Joesmum]

Thank you I will do that. I don't think I'll be getting any more Levo rises from what's he's already said about low TSH. He may even want me to reduce down from 75mcg which will really leave me at a loss. Feels like I may be yet another one of us on the way to self-medication.