Tsh level

[butty]

Hi please can someone clear this up for me as I don't understand it all , my doctor says my thyroid levels have improved from 1.2 mu/L 0-30 -4.50 mu/L, last time to this year's 2.13 0.30 mu/ L-4.50 mu/L can some tell me if that is true because I don't feel right thank you

[SeasideSusie Remembering]

butty With TSH, the lower the better, most treated Hypo patients feel best when TSH is 1 or below.

However, TSH is not the whole picture. You need to know where your FT4 and FT3 levels are, most treated Hypo patients feel best when they're in the upper part of their respective reference ranges.

If you don't feel right then you are either undermedicated, not converting T4 to T3 well enough, or your vitamins and minerals aren't optimal and they need to be for thyroid hormone to work properly. Ask for the following to be tested:

Vit D

B12

Folate

Ferritin

[butty in reply to SeasideSusie]

Thanks for your reply seaside Susie I am going to see Dr to see if I can have that blood work done 😊

[greygoose]

Well, a TSH of 1.2 is an improvement on 4.5 and 2.13. But, not as good as 0.3. But, that's irrelevant, anyway. He should be testing the FT4, because that's more important than the TSH. He should not be dosing by the TSH, that's not what it's meant for.

And then the FT3. Has he ver tested that? If not, then he has no idea of your thyroid status. Your TSH could be 0.3, but your FT3 could still be low, and that's why you're still not feeling good. He obviously has very little understanding of how the thyroid works.

[butty in reply to greygoose]

Hi grey goose so is 1.2 better than 2.13

[SlowDragon Administrator in reply to butty]

The lower the better, but if it goes too low they then get bothered about suppressed TSH ( but we usually feel better)

TSH is largely irrelevant on Thyroid replacement. The most important thing is what the FT4 and FT3 are. FT4 should be right towards top of range and FT3 at least midway.

But as you have only had TSH tested, it tells you virtually nothing

Are you say LAST year TSH result was 1.2 . THIS year is gone up to 2.13

If so then yes, it's got WORSE. TSH needs to be around one.

You might need to do private tests, you need FT3 and FT4 tested, plus vitamin D, folate, ferritin and B12 too

If you can't get full thyroid and vitamin testing from GP

thyroiduk.org.uk/tuk/testin...

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have money off offers. DIY finger prick test or option to pay extra for private blood draw. Both companies often have money off offers.

All thyroid tests should be done as early as possible in morning and fasting and don't take Levo in the 24 hours prior to test, delay and take straight after. This gives highest TSH and most consistent results

[butty in reply to SlowDragon]

Thank you slow dragon I thought it was worse than last time but Dr said it had improved I am going to ask next week if they will do the bloods for the t4 and t3 wish me luck , thanks for your reply 😊

[SlowDragon Administrator in reply to butty]

Just given another post this graph, you might find it useful

web.archive.org/web/2004060...

Dr Toft, past president of the British Thyroid Association and leading endocrinologist, 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] print it and highlight question 6 to show your doctor.

[butty in reply to SlowDragon]

Thank you 😊

[greygoose in reply to butty]

It depends what you're testing. But, in the case of TSH - and I presume those levels are for TSH because of the range - the lower the better.

TSH - Thyroid Stimulating Hormone - is a hormone produced by the pituitary gland to stimulate the thyroid to make more hormone. The lower the thyroid hormone levels in the blood, the higher the TSH. The higher the thyroid hormone levels in the blood, the lower the TSH. Basically, without going into the details, what doctors assume is that if your TSH is is low-range, your thyroid hormone levels will be good. They don't understand that it doesn't always work out like that, but that is the assumption. So, your doctor sees a TSH of 1.2 and thinks 'must be good levels of thyroid hormone, job done! well done me!'. He's totally wrong, of course, but that's the theory.

If your TSH is 2.13, he might think your need an increase in dose - he probably won't, of course, but whatever - and they don't like increasing doses. So, he's happy, and thinks you ought to be happy too. So, if you aren't happy yet, you must tell him, loud and clear.

[butty in reply to greygoose]

I am going to see anthour doctor because he told me today that at 2.13 was a improvement from 1.2 so I was a bit confused as I have put weight on and slowing down , thanks grey goose

[greygoose in reply to butty]

You're welcome.

[SeasideSusie Remembering in reply to butty]

butty

I have slightly amended my original reply as I misunderstood. I now realise that your doctor is saying that a TSH of 2.13 is an improvement on 1.2. As the other replies have said, that isn't the case and the lower your TSH is the better.

The reason you have put weight on and are slowing down is because your TSH has risen to a point where hypo symptoms have come back. You need an increase in dose.

Apologies for adding to your confusion

[butty in reply to SeasideSusie]

No worries lol just pleased that I've had answer thank you 😁

[Catseyes235 in reply to butty]

Yep even good doctors can get it wrong! It us confusing and that us NOT an improvement. It's kind if counterintuitive. The higher the reading the lower go and vice versa.

[Angel_of_the_North in reply to butty]

Yes. The majority of healthy people without thyroid problems (and not on meds) have a TSH of around 1.2 (when on meds lower is better)

[Renpet]

The Family Doctor Books "Thyroid Disorders" may help you to understand & clarify some of of your queries. See familydoctor.co.uk

Hope this helps you. Yes. It is a minefield but persevere.

[butty in reply to Renpet]

Thanks 😊

[Angel_of_the_North]

No, they have got worse - but you can't really tell with just TSH, you need free T4 and free t3 as well. The aim of thyroid hormone replacement is to get rid of symptoms which is usually achieved when free t4 and Free T3 are in the top quarter of their ranges, which will usually mean that TSH is under 1 or even under range.

[butty in reply to Angel_of_the_North]

Getting the Dr to do the t4 and t 3 is hard hopefully my medical practitioner will do it cos my Dr seems to think it was a lot better , thanks angel of the north for your reply 😊

[SAMBS]

Butty, the acceptable and now normal range levels have changed since last year, that could be why you are confused.

All seems fine to me on your current TSH, however as others have said, TSH is not the be all and end all, so do ask your GP for the other tests as well.

[butty in reply to SAMBS]

Thanks 😊