Help please - Low TSH but hypo symptoms.

[Petalrugbaba]

Hi

I am new to the forum but read your contributions with great interest.

I am currently taking 45 mg ERFA and 50 mcg levo. I have Hashimotos.

I recently had a blood test and received the following results:

Serum TSH - 0.22 (0.34 - 5.6 mu/L

Serum free T3 4.8 (4 - 6.6 pmol/L)

Serum free t4 13 ( 7.9 - 20 pmol/L)

I fasted before the test which was taken at 9.30 am.

I had not taken any medication since 11am the previous morning so 22.5 hrs earlier than the test.

Ferritin was ok at 86 ug/L, folate normal at 23.7 ug/L but B12 very high at 1198 mu/L ( range 139 - 625 ng/L ) !! I have been supplementing B12 1000ug daily.

Just wondering why my TSH was low.

My endo switched me to ERFA with 50 mcg levo to address bad hair loss and other hypo symptoms. Previous to that I was taking 100 mcg levo and t4 was iro 19, T3 iro 4.7 and TSH iro 1.00.

I would be grateful for any ideas why TSH has plummeted after fasting ? This will help me when I discuss with my endo.

Thankyou

[greygoose]

The TSH is low because you are taking Erfa, which contains T3. It's to be expected.

You shouldn't leave longer than 12 hours for T3, so you have a false low, there, for you FT3. It's probably more like 5.6 or something. I cannot see the point of adding 50 mcg levo to one grain of Erfa as you aren't a good converter. It would have been more sensible to increase to 2 grains of Erfa, to give you more T3.

[Petalrugbaba]

Thankyou Greygoose. Your reply has reassured me and I will discuss this with my endo. He is flexible in his thinking and has mentioned that he would be prepared to increase erfa and reduce levo. We are still at the stage of trying to get a good balance. Although I have been treated for hashi for 15 yrs I am new to erfa. Thanks again 😊