Thyroid UK
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TSH

Having spoken to a friend about thyroid issues I thought I would pass on the gist of our conversation .

It was a couple of weeks ago , very cold day.I do better now myself with that,

Anyway after a bit of general stuff he went on to tell me that the GP wanted to reduce his dose because of a very low TSH (he didn’t know what that was) he was reluctant because he thought he had been better on a dose that was higher than the current one.

He went on to tell me of several symptoms I would believe to be caused by being under medicated . I asked him how he took his hormones.

But , here’s the rub, he then told me he took them with ALL his other tablets whilst eating breAkfast. Had always done so.

So very low TSH (reported by doc). Symptoms of undermedication, PUZZLING

Back to the drawing board ?? I mean for the relevance of the blood test.!!

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The TSH is totally irrelevant. Plus, without the actual number, we've only got his doctor's word that is is very low - and a doctor's idea of low isn't always outs! So, without knowing the rest of his results, plus quite a few other details, it's impossible to comment.

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But if GPs are dosing on that what chance do some people have

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Well, as you can read on here, not much of a chance at all.

But, I have to say, I don't really understand what you're getting at here. What has your friend taking his levo with breakfast got to do with doctors dosing by TSH?

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Well I make sure I dose on empty tum and I was surprised his TSH is , so say,too low when doing everything wrong. Just a comment showing how wrong that test is!

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But it does rather depend how much levo he is taking. If you take enough, you're bound to absorb some, even when you take it with the wrong things. And, as I said, the TSH is irrelevant, it may be low, but what is his FT3 like? That's the one that counts. And, how does he feel? What does he have for breakfast? What other pills does he take? As I said, not enough information to come to any conclusions, because the TSH doesn't prove anything.

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He mentioned have had his dose reduced and not feeling so good. Pretty likely to have low vitamin levels as result

That causes low TSH, high FT4 and low FT3, but as NHS rarely tests FT3 most GP's have little idea.

Essential to test vitamin D, folate, ferritin and B12, especially after dose reduction

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I take levo with breakfast, it depends on what you eat and the individual. If you are not showing absorption problems don't bother starving yourself before taking thyroid hormone. The other tablets may not matter, only some medications have an effect.

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Cow’s milk interferes with levothyroxine absorption

mdedge.com/clinicalendocrin...

endocrine.org/news-room/cur...

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Not for me. Perhaps because I use half fat milk. Thyroid hormone is lipophillic, it attaches to fat. More likely because the study was not much use.

1. They measured absorption of 1000 mcg levothyroxine. This is a large amount to absorb and perhaps 100 mcg might not present a problem.

2. The effect was small 67.26 vs. 73.48. So, although a real effect it would just mean being on a prescription 110 mcg instead of 100 mcg. Wouldn't really notice the difference.

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Oh. It’s so hard. He grows all his on veg. Wild swims. Slim.

So much to learn. !!

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