Confused

[lizziep]

I have had underactive thyroid for over 20 years and I have just been to the doctors because of all the symptoms rearing their ugly head again (tiredness, unable to lose weight, hair loss, dry skin etc) She said that my blood test had come back as TSH 1.4 which she said means I am being over medicated ! and she was puzzled that I had the symptoms I was describing, she said she would hold off decreasing my dosage for a month and I was to have another blood test and see her again. She said all other results were normal but didn't say what.

Does a TSH result of 1.4 mean over medicated ? Thanks for any advice.

[SeasideSusie Remembering]

lizziep

What is the range for your TSH test? I don't believe that you are out of range. You should ask your doctor what is it about your TSH that indicates overmedication.

The aim of a treated hypo patient generally is for TSH to be 1 or below or wherever it needs to be for FT4 and FT3 to be in the upper part of their respective reference ranges when on Levo if that is where you feel well.

When you have your next test, ask for FT4 and FT3 to be tested too. If FT3 is above range, that's the only indication that you are overmedicated. If FT3 isn't tested, or comes back within range, refuse to lower you dosel and say that you're not overmedicated if FT3 is in range.

See Dr Toft's article in Pulse magazine (Dr Toft is leading endocrinologist and past president of the British Thyroid Association):

"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 article by emailing Dionne at

[e-mail]

print it and highlight question 6 to show your doctor.

[lizziep in reply to SeasideSusie]

Range was 0.2 -3.0

Thank you for your reply I will follow up on the article

[SeasideSusie Remembering in reply to lizziep]

lizziep

So your TSH is 1.4 (range 0.2-3.0).

Your GP needs to go to Specsavers. There is no way you are overmedicated with that result. But still important to get FT4 and FT3 tested.

[lizziep in reply to SeasideSusie]

That’s what I thought ? Will make sure I ask for ft4 and 3,to be tested

[Treepie in reply to lizziep]

They will probably refuse to do FT3 despite it being the active hormone.Might be better getting full suite of thyroid tests privately.