TSH

[Faniah]

My TSH has dropped from 5.3 to 0.02

Why could this be?

I’ve been hypo for over 20 years on 150 - last few years gone gradually up to 200

[humanbean]

Have you ever had thyroid antibodies measured? If you have, and the results were positive, then you have autoimmune hypothyroidism, also known as Hashimoto's Thyroiditis.

With this type of hypothyroidism the blood test results can fluctuate. The amount of Free T4 and Free T3 in the body rises and falls due to the activity of the antibodies and this alters the TSH. Then when the antibodies stop being so active your results return to "normal for you".

.

There are other causes of changed results :

1) You might have developed thyroid nodules which are producing greater than normal quantities of thyroid hormone.

2) If you have changed your diet, this might change your results.

3) If you have changed how you take your medication - the timing, or started taking it on an empty stomach when previously you took it with food, then that could change results too.

[Faniah in reply to humanbean]

Thank you for your rep,y.

No - I have never been tested - I will ask my GP.

I don’t think I have changed my timing (I take it at night) or my diet - it’s quite random at the moment.

Do I need to ask my GP about nodules?

[humanbean in reply to Faniah]

I don't know anything about nodules on the thyroid, apart from the fact that some people have them. Your GP wouldn't know whether you had them unless you were referred for an ultrasound scan (I think).

I would think antibodies were your most likely issue, and that is just because they are very common in people with hypothyroidism.

I agree with greygoose that your low TSH is not surprising given your dose of Levothyroxine.

What is more surprising is that previously your TSH was as high as 5.3. What dose were you on when your TSH was 5.3?

[greygoose]

Actually, on 200 mcg levo, it's not at all surprising that your TSH is suppressed.

[Faniah in reply to greygoose]

Thank you for replying.

Is that not good that it is so suppressed?

Is 200mg a high dose?

GP has lowered it a couple of times now - currently on 125 - but it’s only gone up to 0.04.

GP suspects overmedication?

[greygoose in reply to Faniah]

GP is probably totally ignorant about thyroid! Does he only test the TSH? He should be testing at least the FT4. But, you're not really over-medicated unless your FT3 is over-range. Does he ever test that?

It doesn't mean anything when your TSH is suppressed. If it's suppressed it's because you don't need it anymore. It's rediculous to try and raise it by reducing the dose if the FT3 is still in range.

200 mcg is not a particularly high dose. Most people take less, but then most people are under-medicated. You need what you need. Not what your doctor thinks you ought to need. But, you do need to get your FT3 tested.

[SlowDragon Administrator]

For full Thyroid evaluation you need TSH, FT4, TT4, FT3 plus TPO and TG thyroid antibodies. Plus vitamin D, folate, ferritin and B12.

Essential to test thyroid antibodies, FT4 and FT3 plus vitamins

Private tests are available

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.

All thyroid tests should ideally 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, lowest FT4 and most consistent results. (Patient to patient tip, GP will be unaware)

If antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).

About 90% of all hypothyroidism in Uk is due to Hashimoto's and low vitamins are especially common