Low tsh: Can anyone help I am on a combination of... - Thyroid UK

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Low tsh


Can anyone help I am on a combination of t3 and t4 I read some where if you take t3 your t4 bloods will be low Im wondering as my t3 are middle of the range 4.66 (3.10-6.80) but my t4 is bottom of scale 12 (12-22) yet my tsh is suppressed what ever my meds are changed to this is always suppressed at 0.03 ( I still have hypo symptoms but consultant says over medicated.

reverse t3 is 20 (10-24)

Reverse t3 ratio 15.17 (15.01-75.00)

4 Replies


I have been keeping a record of all my results for the last 20+ years (diagnosed and treated for 43 years). Even when on Levo only, anywhere between 125mcg and 200mcg, my TSH was way below range or suppressed. Now I am on a Levo/T3 combo, my TSH is usually <0.01, even had <0.005 - mine never comes into range.


TSH: 0.03 (

FT4: 12 (12-22)

FT3: 4.66 (3.10-6.80)

Consultant is saying overmedicated purely because TSH is low.

You don't say how much Levo and T3 you are taking, but you could possibly do with an increase in both. I can't function with my FT4 at bottom of range, I need it around 75% through range even though I take T3. I also need my FT3 around 75% through range. Maybe you need both of yours higher, there's certainly plenty of room to increase FT3 to nearer the top of the range.

Looking at your last post you didn't mention that you were taking thyroid meds and pituitary problems were being discussed. I would forget about that, I think you are just undermedicated.


As you have Hashi's are you strictly gluten free and supplementing with selenium l-selenomethionine 200mcg daily as these can also help reduce the antibodies, as can keeping TSH suppressed.

Gluten/thyroid connection: chriskresser.com/the-gluten...





You need to optimise your nutrient levels to

Vit D - 100-150nmol/L

B12 - top of range

Folate - at least half way through range

Ferritin - half way through range

You should also check for gut/absorption problems, do the home baking soda stomach acid test


and read through the information and links SlowDragon has given in her reply near the bottom of this thread


Thank you so much for your advice


Many, many patients only feel better when FT4 and FT3 are well within range. Typically with FT4 and FT3 above halfway in range.

TSH is largely irrelevant on Thyroid replacement hormones providing FT3 and FT4 are not above top of range

TSH is often very low if vitamins are too low, and/or have Hashimoto's or if test positive for DIO2 gene variation, or previously been hyperthyroid and had thyroidectomy or RAI, or any other gut issues like gluten intolerance etc

Thank you for your advice

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