Thyroid UK

my TSH is .07 reference range is 0.5-5.5

I am 53 years old and have been on thyroid med since late 30s and am going through perimenopause and I have taken at least 2 blood tests since August 2017. I feel energetic, fit, very little anxiety. My doctor(s) has changed my dosage from 120mcg to 88mcg to 75mcg. My TSH is now .07 but it was 12 on 10/30/2017. I am tempting to see a naturopath doctor because these doctors don't know anything. I don't know why I am feeling great but my test result swing from the extreme left to the extreme right of the spectrum.

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JUNEHEALTH

Are your blood tests always done at the same time of day and u see the same conditions? We always advise to have tests done at the earliest appointment of the morning, fast overnight (water allowed) and leave off Levo for 24 hours. Results can be compared accurately if conditions are the same each time.

Also, have you had thyroid antibodies tested? Raised antibodies (TPO and/or TG) confirms autoimmune thyroid disease aka Hashimoto's which causes fluctuations in symptoms and test results.

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I did not fast. I asked if I should fast but my doctor said no. But I think it is good idea. I believe I tested my blood about the same time of the day but I will do so in the future. I will ask my doctor about thyroid antibody test. I emailed my doctor and they reply when she wants to. My insurance is Kaiser Permanente. Does anyone has the same experience? I used to have a caring doctor when I had Regence insurance but I switch to Kaiser due to lower monthly premium.

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Then you are in the USA and this is a UK site ..whilstbwe help everyone our ranges can be fifferent as are our health systems

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Your doctor has absolutely no right whatever to change your dose using TSH

Its freet4 and freet3 that matter and they must learn that

TSH is irrelevant when the pituarity thyroid feedback loop is satisfued

T4 should be around 19 or 21 (10-24)and freet3 5 or 5.5 ( 3-6)

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When I asked my doctor if I should see a naturopath doctor, my doctor did not bother to reply. Did I hurt her self esteem? This is my life and I want to know what is happening to me.

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Ask GP to test vitamin D, folate, ferritin and B12.

Highly likely to be too low, especially since they have reduced dose (almost certainly erroneously)

See Box 1. Towards end of article

Some possible causes of persistent symptoms in euthyroid patients on L-T4

You will see low vitamin D, folate, ferritin and B12 listed

onlinelibrary.wiley.com/doi...

Important to know if you have raised antibodies too

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 articles from Thyroid UK email dionne.fulcher@thyroidUK.org. print it and highlight question 6 to show your doctor.

Prof Toft - article just published now saying T3 is likely essential for many

rcpe.ac.uk/sites/default/fi...

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Its very likely due to surges in thyroid antibodies but without freet4 and freet3 we simply cannot tell

No doctor ot endocrinologists should ever rely on or adjust dosage on TSH alone it is a totally meaningless test and unless its always done at same time of day every time means zip

TSH done at 5am or 9am or 3pm will all be different its a bilogic fact TSH is highest on waking

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