TSH: Hi everyone today had my T3/T4/ done I... - Thyroid UK

Thyroid UK
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Hi everyone today had my T3/T4/ done

I checked and it’s at TSH- 0.01 as you can see

It just keeps going down. Why is it the way it is ? I just don’t understand this I’m on 125- Levothyroxine 1x a night. I see him tomorrow morning at times my heart will race and lows down feeling cold my hair is not coming out as much I had RAI last year or year before why is TSH going down like that?

14 Replies

For full Thyroid evaluation you need TSH, FT4, TT4, FT3 plus TPO and TG thyroid antibodies.

Plus very important to test vitamin D, folate, ferritin and B12

Low vitamin levels can lower TSH, yet FT4 and/or FT3 can be too low

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies


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. When on Levothyroxine, don't take 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)

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 print it and highlight question 6 to show your doctor

 please email Dionne at


Professor Toft recent article saying, T3 may be necessary for many.

Note especially his comments on current inadequate treatment following thyroidectomy or RAI



I see you are in USA. Lots of functional doctors recognise after RAI that you may need T3 or Armour (or other NDT equivalent)

Strictly gluten free diet can help too

All these are USA based medics






Looking at your reaults there are at different times thoughtour the day! Your TSH levels naturally vary throughout the day so that's possibly the reason. It's best to have your blood drawn as early as possible before food as this ensures your TSH is as high as possible and we don't want the doctor to consider lowering your dose! Taking food before lowers your TSH.

I don’t eat first thing in the morning not till later in the day I’m also constipated and have a bile duct blockage and that that also makes me not go I take mineral oil when I need to I have been that way since I was a kid ( Constipated )

Well that sounds as though morning is best for you anyway. Consistency is always good in Thyroid matters but adding the right time for you as well will be a great bonus.

Hi Diamond 60, I see your last TSH test was done in the afternoon that is why it's lower than your previous one as that was done in the morning, really need to try and have them done in the morning and fasting if possible as slow Dragon has mentioned.but it's not just about the TSH more importantly where your levels are for t4/t3 and how you feel.im post RAI for 8 years now and have just been prescribed t3 as well as t4 can't tell you what a difference it has made for the first time in years I have energy to spare, my TSH is same as yours and for me that's where it needs to be to feel well.

Thanks for the info I usually have it done in the morning but I didn’t have a ride until my grandson was from work. The other test for t3/4 was fine at 1.74 and I feel fine at times my feet will feel cold I read the if TSH is really low it’s not good and can go into a coma or heart failure

in reply to Diamond60

TSH should be in lower part of range. If too HIGH then dose of Levothyroxine needs increasing

Medics like TSH above 0.2 or 0.4, but often patients TSH is low on Thyroid hormones. As long as FT4 and FT3 are within range you are not over medicated

Testing vitamins is important, because if vitamins are too low then TSH can be too low.

in reply to Diamond60

When I had my thyroid removed it was recommended to my doctor by my surgeon that my TSH should now be suppressed which it is as is yours.

I feel fine I am 72 years old and have just walked my four dogs for over 1.5 hours. My heart rate and BP are fine too I had them tested only last week.

If you are over medicated your heart rate can rise you need your FT3 tested to find out if you are now over the top of the range which can make your heart race.

I also started to lose too much weight when over medicated as well!

in reply to Bunnyjean


Great Info . Thank You .

Thank you for your response

I also walk just to clear my mind and hopefully lose weight walking is a great way to lose weight maybe I shouldn’t read all the stuff online as it stats low TSH can cause me to have a coma or heart failure I’m 57 and I’m not ready to go yet I just have to many issues going on with my health.

Thanks everyone for your comments

Had my appointment and now he wants me to just do five days of meds I was doing six until this appointment also said I was borderline.

If your T3 was too high then you could have heart failure or go into a coma, but you would have to be quite over medicated and you would have symptoms of atrial fibrillation and would not be able to regulate your temperature. Without testing the free T4 and free T3, your doctor is just guessing.

Mine has been low like yours 0.06. From what Ive been told is that if you have Hashimotos your TSH needs to be suppressed to under the usual range so that your body stops creating an autoimmune response thus raising your antibodies.

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