0.03 serum tsh result : Advice please. I was... - Thyroid UK

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0.03 serum tsh result

karenmyring profile image
5 Replies

Advice please. I was 0.02 I actually feel well can t go back to feeling I'll again gp has requested an appointment

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karenmyring
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SeasideSusie profile image
SeasideSusieRemembering

Karen

Is that all that was tested? No FT4 or FT3? TSH on it's on doesn't tell us anything.

Your GP wont like your TSH at that level, and will most likely want to reduce your dose of Levo saying you are overmedicated. Best advice, if FT4 and FT3 haven't been tested then refuse to reduce until they have been and if FT3 is in range then you aren't overmedicated.

I've had this discussion many times with my GP who is TSH obsessed.

karenmyring profile image
karenmyring in reply to SeasideSusie

I agree x

SlowDragon profile image
SlowDragonAdministrator in reply to karenmyring

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

tukadmin@thyroiduk.org

Professor Toft recent article saying, T3 may be necessary for many otherwise we need high FT4 and suppressed TSH in order to have high enough FT3

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

So would your GP rather pay to prescribe T3 instead??

Official NHS guidelines saying TSH should be between 0.2 and 2.0 when on Levothyroxine

(Many of us need TSH nearer 0.2 than 2.0 to feel well)

See box

Thyroxine replacement in primary hypothyroidism

pathology.leedsth.nhs.uk/pa...

Aurealis profile image
Aurealis

Go in with a smile and explain how well you’ve been feeling. Thank GP for making you well again.

If asked to reduce, explain how poorly you felt before and how inappropriate it would be to reduce back to that dose as you have already eliminated it as the right dose for you.

As for the test, ask about the confidence interval / margin of error. Suggest that they may have made an error with the test, it wouldn’t be appropriate to reduce on the basis of a faulty test would it. Everyone makes a mistake sometimes. Concede that the test could be repeated later for you have to.

The goal of treatment is to make you well, and you are, your GP is a genius!

Good luck!

Wildbird profile image
Wildbird

I am surprised that the lab who did the test did not look at your free t4 and free t3. I had a low tsh reading recently 0.26 (0.3-5.5) but my free t4 21(12-22) and free t3 4.3(3.1-6.8) were in the reference range, so I was able to stay on the current dose. You may need to impress on your Dr, that it is what your thyroid hormones are measuring that matters, as opposed to your tsh. If your levels are not suppressed, that is probably where you need to be to feel well.

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