TSH 0.08, T4 14.6 & T3 3.7 - Hair falling out

[Topaz123]

Hi, new to the forum but after some advice if possible.

I was diagnosed with an underactive thyroid around 5 years ago and gradually my dose of Levothyroxine has been increased over the years.

I'm currently taking 100mcg of Levothyroxine but have still been feeling rubbish - tired, brain fog, constipation and excessive hair loss.

I went back to the doctors after my tests came back normal (above results) and explained how I was feeling. My doctor has increased my dose to 125mcg but said my TSH level was a little strange and that if my next lot of tests were similar she'd consider referring me to a specialist.

I've read a lot of post over the years but still find it all very confusing so any advice would be appreciated!

My B12 was 369 and Vitamin D was 51 (I take a supplement) in case this is relevant.

Thanks

Lisa

[SeasideSusie Remembering]

Topaz123 Well, your TSH is nice and low but it not possible to comment on FT4 and FT3 because you haven't given the range, so we don't know where they fall in the range or how well you're converting. Can you please edit your post and put the ranges in.

Your B12 is too low. Anything under 500 can cause neurological problems, the recommended level is very top of it's range, even 900-1000. You need to supplement with sublingual methylcobalamin to raise your l.

Was folate tested? Folate and B12 work together. Folate should be at least half way through it's range.

Vit D is also too low. Recommended level is 100-150nmol/L. What is the dose of your supplement? Are you taking D3's important cofactors K2-MK7 and magnesium?

How about ferritin? Was that tested?

All vitamins and minerals need to be at optimal levels (not just in range) for thyroid hormone to work properly.

[Topaz123 in reply to SeasideSusie]

Thanks SeasideSusie, my full results are shown below - they all fell in the normal range according to my GP which shows the normal range in brackets.

I'm taking 800 IU of vitamin D but no other supplements other than some Hair, Skin and Nails tablets that I bough online.

Lisa

Serum TSH level 0.08 miu/L [0.3 - 5.5]

Serum globulin level 28 g/L [25 - 41]

Serum total protein level 67 g/L [60 - 80]

Serum albumin level 39 g/L [35 - 50]

Serum sodium level 140 mmol/L [133 - 146]

Serum potassium level 4.5 mmol/L [3.5 - 5.3]

Urea and electrolytes

Serum free T4 level 14.6 pmol/L [12 - 22]

Serum free triiodothyronine level 3.7 pmol/L [3.1 - 6.8]

Serum alanine aminotransferase level 17 iu/L [< 40]

Blood haematinic levels

Serum ferritin level 50 ng/ml [15 - 150]

Serum adjusted calcium concentration 2.33 mmol/L [2.2 - 2.6]

Serum calcium level 2.27 mmol/L [2.2 - 2.6]

Serum total bilirubin level 8 umol/L [< 21]

Serum alkaline phosphatase level 61 iu/L [35 - 104]

Serum vitamin B12 level 369 ng/L [197 - 771]

Serum folate level 13.3 ng/ml [3.89 - 26.8]

Serum urea level 4.7 mmol/L [2.5 - 7.8]

Serum total 25-hydroxy vitamin D level 51 nmol/L [50 - 144]

Serum creatinine level 64 umol/L [45 - 84]

GFR calculated abbreviated MDRD > 60 mL/min/1.73m*2

[SeasideSusie Remembering in reply to Topaz123]

Topaz123

TSH: 0.08 miu/L [0.3 - 5.5]

FT4:14.6 pmol/L [12 - 22]

FT3: 3.7 pmol/L [3.1 - 6.8]

Your FT4 and FT3 are too low. The aim of a treated hypo patient generally is for TSH to be 1 or below and FT4 and FT3 to be at the upper end of their respective reference ranges. You need an increase in Levo which your doctor has done (big tick ).

There is absolutely nothing strange about your TSH, your GP just doesn't know enough. From ThyroidUK's main website > Hypothyroidism > Treatment Options:

' According to the BMA's booklet, "Understanding Thyroid Disorders", many people do not feel well unless their levels are at the bottom of the TSH range or below and at the top of the FT4 range or a little above.

Dr Toft states in Pulse Magazine, "The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l. Most patients will feel well in that circumstance.

But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1. '

Dr Toft is past president of The British Thyroid Association and leading endocrinologist. You can obtain a copy of the Pulse Online Magazine article by emailing [e-mail] which you can print off to show your GP, it is question 6 that is relevant.

**

B12: 369 ng/L [197 - 771]

Folate: 13.3 ng/ml [3.89 - 26.8]

You can supplement with sublingual methylcobalamin lozenges 5000iu daily. When you've finished the bottle (usually about 60 lozenges) buy some 1000mcg dose and take one daily as a maintenance dose.

When taking B12 we need a B Complex to balance all the B vitamins. One with 400mcg methylfolate will help raise your folate level (as will eating plenty of leafy greens). Have a look at Thorne Basic B or Metabolics B Complex.

**

Vit D: 51- 800iu D3 isn't enough to raise your level, it's less than a normal maintenance dose for someone with a decent level. You can buy some D3 softgels like these bodykind.com/product/2463-b... and take 5000iu daily for about 8 weeks then retest. Once you've reached the recommended level of 100-150nmol/L then​ reduce to 5000iu alternate days as a maintenance dose, you may need less in the summer. Retesting once or twice a year is recommended.

When taking D3 there are important cofactors needed vitamindcouncil.org/about-v...

D3 aids absorption of calcium from food and K2-MK7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems. D3 and K2 are fat soluble so should be taken with the fattiest meal of the day, D3 should be taken four hours away from thyroid meds.

Magnesium comes in different forms, check here to see which would suit you best and as it's calming it's best taken in the evening, four hours away from thyroid meds naturalnews.com/046401_magn...

**

Ferritin: 50 ng/ml [15 - 150] - ferritin needs to be at least 70 for thyroid hormone to work properly, recommended is half way through it's range and I've seen it said that for females 100-130 is best. You can supplement with iron, which needs to be taken with 1000mg Vit C and four hours away from thyroid meds and two hours away from other medication and supplements as it affects their absorption. With your level it will be a lot easier to eat liver once a week to raise your level, and you won't have the problem of trying to fit iron tablets around thyroid meds and other supplements.

**

All other results are in range.

**

If your Hair, Skin and Nails supplement is H&B own brand, the best place for it is the dustbin. They are renowned for using the cheapest and wrong form of ingredients, plus the B Complex and other supplements suggested will cover what you need.

[Topaz123 in reply to SeasideSusie]

Thanks soo much for this I will look at getting the suggested B12 and Vit D and go from there! ☺

[SlowDragon Administrator]

Does your supplement for hair, nails contain biotin? (Very likely it does)

Nothing wrong with biotin (it's a B vitamin) BUT if you were taking it when TSH is tested it can give false results

You need to stop any biotin at least 4-5 days before any TSH test

It's also in most vitamin B complex

endocrinenews.endocrine.org...

[Topaz123 in reply to SlowDragon]

I've only just started taking it so it wouldn't have shown on the test - but yes it contain biotin.

[Joesmum]

Your TSH is very low which might suggest that you have secondary hypothyroidism as opposed to primary hypothyroidism.

Secondary is where the fault lies with the pituitary gland. It fails to produce enough TSH to signal the thyroid gland to produce T4.

Your GP propbably will not understand this and you should ask for a referral to an endocrinologist.

Secondary hypothyroidism is treated with levothyroxine too but the TSH is irrelevant when determining correct doses of levo because it does not work properly and therefore is not an accurate reflection of thyroid status.

[Bluecat101]

l can only comment on hair; tho mine is thick it was always falling out daily and embarrassingly over dark coat collars etc. Since reading of it on amazon got the Dlux spray -also from Health shops - after seeing the reviews there. starting with 2x sprays/day for 2 weeks it has helped stop or slow down the loss considerably and writer said it helped thyroid. dont know about latter. lf i stop spray, does tend to fall out again - maybe l dont sit out in eough sunlight

[Topaz123 in reply to Bluecat101]

Thanks i'll give it a try ☺