Suppressed TSH

[Gillybabe48]

Just interested. Is it okay to have a suppressed TSH if t4 and t3 are mid range normal.

[diogenes Remembering]

Short answer: yes.

[SeasideSusie Remembering]

Longer answer

From thyroiduk.org.uk/tuk/about_... > 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.

The booklet is written by Dr Anthony Toft, past president of the British Thyroid Association and leading endocrinologist. It's published by the British Medical Association for patients. Avalable on Amazon and from pharmacies for £4.95. Also -

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 1.0-2.2nmol/l)."

You can obtain a copy of the article by emailing [e-mail] it's question 6.

It's more usual to have higher than mid-range Free Ts with a suppressed TSH.

[Gillybabe48 in reply to SeasideSusie]

Yes I agree with this because on 75 mgs my TSH is 0.2 t4 is 17 and t3 4. Reference ranges they use are 0.35 to 5.0 TSH T4 9.0 to 22 and t3 3.5 to 6.5. and I feel well. On 50 mgs my TSH was 6.9 t4 was 10 and t3 2 and I definitely felt unwell. When my TSH was 0.2 a locum doctor tried to put me on 50mg one day and 75mg the next and I said I feel better on 75mg daily and reluctantly he agreed and said get tested in three months.