Me again with my mum's case
Hi everyone me again disappointed from endo,because i don't know what to do.
My mum is 74 years old,TSH 0.37, FT4 13.26, FT3 4,24 should i raise the levo!
She on levo 100 .
She's old and TSH is very low from last time 2.47. Any advice please!
It’s so difficult for you - I looked back at your last two posts. Your mum has diabetes and low B12 too? It’s so complicated with more than one condition.
There is room within the fT4 range for an increase in Levo and this might raise fT3 and might eliminate some of your mums symptoms. You can try it and see and revert back later if no improvement. TSH doesn’t always relate that closely to fT4 levels and many of us need TSH very low to feel well. The endo may be more sympathetic than you might expect if you raise Levo. Think Endo can’t recommend raise but it might be what your mum needs. You can only really find out by increasing dose on a trial basis. Good luck x
Thank you so much for your response Aurealis,you made me feel good.
I'm exhausted i have no choice.
Yes my mum is diabetic and on b12 injectoins,feeling very good for the moment.
I'm worried she's old and i really don't know if TSH 0.37 it's Ok,on her age.
Yes I'm thinking to raise the levo 25 mcg.
Now she's on 100 + 25,hopping TSH won't be suppressed.
Thank you dear Aurelalis 😊
Why not ask the question on this site - how many aged 74 and overs have below range or suppressed TSH? There may be a few. But it’s irrelevant really, because we all need to be optimal for us, and that’s what you’re aiming for for your mum.
I suspect the doctors comment is an example of age discrimination in the nhs 
it’s endemic.
I'm nearly 74 - and I don't consider that to be 'old'! - and my TSH has been suppressed for years. And, woe betide any doctor that tries to make me raise it!
The TSH is pretty much irrelevant if your FT3 is still in-range - it's over-range FT3 that makes you potentially over-medicated. But, then again, depends how much is getting into the cells. And, you really, really cannot know that from either a blood test or by looking at the TSH.
So, forget the TSH unless it goes high - which would mean she's under-medicated.
Glad her levothyroxine has been put up as many advised of this in your other post very recently posted.
How often does she now receive B12 -is it injections or supplements?
Thank you waveylines.
She's on injections 1000mcg,for a month. Lab test before injections was b12-518.
She has some improvement on feet aches,warmer than before..
Thank you reallyfedup123.
Well doctor says the older you get TSH should be higher, i don't know why my mum's TSH rised,earlier TSH was 2.47 usually 3.2 sometimes higher.
TSH drastically changed,is it any sign or what?
Yes I've read somethere that b12 suppress TSH ,but she was also supplementing with liquid iron,for 20 days, i don't if this could be reason.
Woah!! 74 is NOT old...!! I am interested to read about the comment your doctor made re TSH needing to be higher the older you get?? I have never heard of this, so I would love to hear if that is correct???
They want it everywhich way - use TSH as the ‘gold standard’ / holy grail to guide thyroid treatment ... except when they don’t want to ! My TSH has been suppressed for over 20 years. I am seriously poorly at every attempt to raise it. No more! No matter how old I am! The test is flawed as explained by diogenes on this site.
Thank you... I had never heard of that before either. I find it VERY interesting that you say that you feel better with your TSH 'suppressed'? I felt VERY much better when my TSH was much higher (around 4.5), I feel a lot worse since it has been lowered (to the 'CORRECT' level (!?) of 0.1. The 'correction' was brought about by a change of GP. Confusion reigns!
The ‘correct’ level is level where you feel best. Otherwise, what is the point of treatment? Test results vary with the wind, for me anyway. My tsh became suppressed as soon as I started Levo 
I don’t think I’m alone in this. Celebrate your higher tsh, it makes the relationship with most GPs much easier, unfortunately perhaps not yours 😱 xx
Thank you... no, definitely NOT MY GP. He said that the original level of 4.5 when I was taking 150 mcg was putting too much strain on my heart etc. Hence the level had to be brought down to o.1. Go figure! I am actually increasing it to 125 mcg again and will see how it goes. It's a bit like wading through mud!!
Hold on ... are you saying that GP has lowered your dose in order to try to lower tsh! That’s the wrong direction !
No, your doctor has misunderstood.
If we're talking about people over 70 without thyroid problems - meaning that the FT4 and FT3 are euthyroid - the TSH is sometimes higher than in a younger person.
But, if we're talking about a hypo of over 70, on thyroid hormone replacement, the TSH is just as irrelevant as it is for someone of 20. It's the FT3 that is the most important number. And if getting that up to a level that makes her well causes the TSH to drop, then so be it. The TSH has little to do with age, but will react differently to exogenous hormone than it does to endogenous hormone. So, tell him to stop comparing hypos with euthyroid people, and to stop dosing by the TSH!
Time to change your Doc they say - when they say you are old I am 72 and finding better and better health as the years rush by.
Yes I agree, mine suggested retirement at 50, but he declined to pay my mortgage off for me (!) so reluctantly GP accepted that I wasn’t going to go away that easily and I’d need referral.
I also feel better as the years pass by. I think thyroid conditions are easier to manage once oestrogen has settled down. Well ... with T3 anyway! 😂😂
Hi. There has been a quote by the BTA stating that falls are more likely on high doses thyroid medication and that it should be prescribed at a lower dose for over 65's Unfortunatly a lot of doctors trust the thyroid association and will accepts its assertions with out much investigation. I did however read the 'study' and felt embarrassed for the whole of the medical profession. It was a very small study taken from a small group of patients, only about 15 I think that demonstrated that elderly people on thyroid medication were more likely to fall. However this is the embarrassing bit. The dose of thyroid hormones that the elderly people who had fallen were taking was not recorded and neither were their bloods taken so there is absolutely no idea if they were on to much or too little. I imagine they were on too little as I fall if on too little and having too little seems to be the problem for most of us not too much. Your endo may have read this 'survey' quoted as a study and accepted it to be proper evidence.
I have found that the best way for me to titrate dose is too keep an eye on my pulse and I do not let it get above 100. A low TSh does nothing to affect the heart but high levels of thyroid hormones can. Your mums levels are lowish and it looks like she needs a small increase. I do think that if your heart is racing at 120 beats a min this is not good if allowed to continue for weeks on end whatever the cause. So keep an eye on your mums pulse as you make increases. Elderly people are if they are frail sometimes rather sensitive to meds so you may have to increase very slowly so try 25mcg and if this sends her pulse to high reduce to 12.5 for a bit and then increase again after a few weeks.
It also looks to me that her B12 is still too low and that she could do with some more injections. Have you tried some B12 patches to boost her intake?
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