Is GP over worrying about my TSH level?

[Lovecake]

Hello

I wonder if anyone could answer my question?

I see a private endo, and in June he added T3 and lowered my Thyroxine.

75mcg Thyroxine and 10mcg of T3

6 weeks later bloods were:

TSH 0.07 (.55-4.78)

T4 12.8 (10-18.7)

T3 5.3 (3.5-6.5)

I saw the GP as thought I had a urine infection (cut a long story short, wasn’t, she said maybe a virus). Then she just focused on my TSH result. Insisted on another test.

TSH 0.07 (as above)

T3 5.2 (as above)

She didn’t request anything else.

Just spoke to her (3 weeks later on phone). She is not happy that my TSH is that low.

She is going to write to the endo. (He’s on the thyroid uk list). She said having it too low can cause long term health issues. (She specialises in the heart).

So, is she right? I don’t feel over medicated. In fact as the temperature has dropped my feet are constantly cold and I’m a bit fatigued. I do feel miles better with the addition of T3. But she is on about lowering my T4 dose.

Would that actually raise the TSH level when I’m taking T3? And then, my FT3 might drop do I’d need more T3?

Appreciate any advice and your time spent reading and answering. Lovecake

[diogenes Remembering]

The trials that your doctor relies on to indicate very low TSH (by itself) on treatment have implications for heart problems are fatally flawed. Indeed there are trials that variously say that there is a link and others that disagree. In any case the risks are small if they exist at all, and relate most to elderly people. You have normal range FT4 and FT3 (the latter being pretty healthy in the range). On treatment, studies have shown that a TSH range 0.03-0.5 gives healthy euthyroid levels in the body, whilst less than this is (statistically on average) mildly, and I repeat mildly overtreated. This however is an average. We are all individuals and our response of TSH to treatment is exactly that - individual. A TSH bad for one person may be perfectly all right for another. The TSH range typical of health is not appropriate to patients on treatment and cannot be used as a target for treatment change. Both the T4 and T3 you take together control the TSH so it is the total load of both rather than either that is important here. Finally - a question for you. Suppose there is a small extra risk of heart effects in the distant future. Would you rather have a life of best health now and risk problems later, or a life of inferior health over a long period and still not be certain you won't get heart problems later anyway for quite other reasons?

[Lovecake in reply to diogenes]

Thank you Diogenes for your explanation.

In answer to your question, I’d rather be healthy now! I have already missed out on too many family events, evenings out with friends (even just a simple lunch and chat) and let people down. I hope to have grandchildren in the next few years. I want/need to be able to be part of their lives and help out where I can. So if I have no energy I will miss all that and be a VERY sad grandma. And to top it all, my husband isn’t fighting fit, he has a heart condition (and other things) and I do almost everything around the house and help him on some things. I need to be healthy to cope if he becomes more ill.

Thank goodness I can afford to see a private endo and get the t3 or I would be resigned to doing less than my 80 year old mum most weeks.

So hopefully the endo will not let me down and suggest my meds are reduced.

Diogenes, I really appreciate your time today. 🙂

[MissGrace]

I have had exactly the same issue recently. My TSH went below normal range and my T4 and T3 still had plenty to gain. Fortunately I see a private endo and the people on here directed me to some excellent clinical studies - Diogenes was. very helpful. Also a search of ‘low TSH’ on the internet will throw up lots of info. My endo checked me over (I have been overdosed and hyper before which caused real heart problems), accepted what I said that I was still hypo - I took my temp and resting heart rate every morning on waking as evidence. Temp was well under normal. He checked my heart. Said he trusted me as I am well informed and is allowing me to slowly to continue to increase the Levo providing I watch out fir racing heart and pull back if it happens. He is writing to my GP so my records indicate I will have low TSH. Hope you can do the same, I really do.

[Lovecake in reply to MissGrace]

Thank you for your reply. I really don’t feel over medicated. I’ve been taking my temperature, but the thermometer might not be totally accurate (it’s new, under arm or oral digital) but rarely goes over 35.4 C

I have a Fitbit and my average resting heart rate is between 60 and 63 (when very under medicated was 56-59)

I am going to ask that the endo sends me a copy of his reply to the GP so that she doesn’t pull the wool over my eyes by not telling me everything. (GPs have a habit of on telling us part info).

I will search a bit more info on low TSH and make sure I don’t have any issues that might crop up.

Many thanks again 🙂

[tzracer in reply to Lovecake]

Slightly off topic, but have you looked much into low body temperature? I took mine a few months back and was shocked to see it was 35.2°c tried 3 thermometers with same results. I was trying probiotics and didn't get expected results and friend asked about basal temp which is why I checked. Said good bacteria can't thrive in cold environment and might explain my poor guy function.

Reading this article at the moment

davidjernigan.blogspot.com/...

Hope it works out with endo letter

[Lovecake in reply to tzracer]

Really interesting article. Thank you. I will keep a better eye on my temp and talk to the endo (maybe GP too) if it goes lower. I sit many evenings with a heat pad at my back/shoulders to keep me relaxed and warm. Just seems a normal thing for me. Couldn’t live without socks that’s for sure ☺️

[Lovecake]

So am I, will you explain please or point me in the right direction to find out. As with your name, I’m really fed up with the GPs not knowing and acting as though they do, then messing things up when it’s just beginning to get better. ☹️ Starting to worry now that I am over medicated (even though I don’t think I am). Stressing will lower my TSH I’m sure!

[silverfox7]

When taking any form of T3 then resultsare read differently. TSH will be suppressed, FT4 can fall in its range but FT3 should be higher in its range but never over.

[Lovecake in reply to silverfox7]

Thanks silverfox I think I’m at that stage. I’ll wait for the endo to reply and see what he says. Hopefully he’ll say things similar to you on here and I can relax and get on with trying to be well and living. (Bit out of practice on that, so hopefully things will improve) 🙂

[silverfox7]

I can remember his saying on our first meeting -now about your TSH and I thought here we go again! But after he had finished I could have kissed him!

[Lovecake in reply to silverfox7]

Keeping everything crossed that I get a sensible answer 😊

[silverfox7]

I hope it works out for you!

[Lovecake]

I got a copy of the letter my endo sent to the GP. Unfortunately, I don’t know what she wrote.

Anyway, he thanked her for her helpful letter. (?)

“It May take some time to de-suppress her (my) TSH. It is not undetectable so that epidemiologically speaking she is not at increased risk. I would carry on with these doses and repeat tests in 6 weeks”.

So I’m none the wiser. But feel fine most of the time. I think I might use up more energy as the temperature drops, so maybe that will please the GP if my TSH rises a little. 🤷‍♀️ (?)

(Certainly got cold feet at the moment).