Suppressed TSH

[HilaryW]

Hello, could I ask members views on suppressed TSH. I had what I was told was Hashimoto’s (currently no antibodies) and have been on various doses of T4 plus Armour. Now I am on Armour alone. My T4 is low end of reference and my T3 mid-range but my TSH is almost undetectable. I am constantly being told by doctors (even a functional medicine doctor) that this is not good long-term.

I have just read a post from a month ago by diogenes headed ‘A suggested gift to a doctor diagnosing hypothyroidism or treatment’ that states: suppressed TSH when one has some working thyroid left means something quite different (and undesirable) as opposed to those that have no working thyroid at all’.

What can I do to raise my TSH without my T4 and T3 becoming very low. I still feel very tired at times and don’t feel less Armour is the answer but do worry about long-term possible consequences of a suppressed TSH.

Thanks for reading all this.

[diogenes Remembering]

It is true that the consequences of suppressing TSH when you have some working gland left is different from when you have none at all. However, that is merely a statistical likelihood rather than a certainty. It's likely at best you have only a little working gland. So that a mild overdose re suppressed TSH will not be too serious, especially as things won't stand still, and in all likelihood you'll lose your thyroid altogether eventually. The problem is you don't know whether you have any gland left or not. This therefore a difficult one to answer. The best advice I can give at the moment is to go on how you feel, experiment with different doses SLOWLY to find the minimum at which you function efficiently. If that involves suppressed TSH then unfortunately sobeit. All patients have to make a judgement between feeling well now as against possible (and not certain) problems in future. Its not a zero sum game.

[HilaryW in reply to diogenes]

Thank you for your reply. I can see the difficulty I knowing how much working gland there is. I have very low antibodies now so hope there will be no further damage - unless of course there is already no thyroid. I think there was considerable damage already when I was diagnosed. Yes, it doesn’t seem a precise science. Also so many other issues impact on thyroid health so one cannot look at thyroid in isolation.

Thanks

[shaws]

When we were all prescribed NDT before the introduction of Levothyroxine along with blood tests at the same time, we were given NDT which was slowly raised until we were symptom free. Symptoms were the priority. Therefore dose was slowly increased and there were no blood tests then. It was all about symptoms, symptoms, symptoms.

It wasn't until the introduction of levothyroxine (T4 only) along with blood tests that, gradually, the emphasise became all upon the TSH instead of our clinical symptoms.

Therefore if we take NDT - add T3 to T4 - blood tests cannot correlate to levothyroxine alone. It is our symptoms and relief of.

[HilaryW in reply to shaws]

Thanks for your reply - I don’t know how to send a global thanks to everyone who has replied. There must be a way!

[shaws in reply to HilaryW]

To send a Global Reply you put an @ sign and then select a 'name' - you only need to put an @ sign and as you put the first couple of letters a selection will appear below it and select the one you want. It will turn blue which alerts the member(s). Such as HilaryW

[SlowDragon Administrator]

If taking any T3, either as Liothyronine or NDT, TSH is almost always suppressed

But TSH is largely irrelevant when on any T3, most important is that FT3 and FT4 are within range

All thyroid blood tests should ideally be done as early as possible in morning and fasting. Do not take Levothyroxine dose in the 24 hours prior to test, delay and take immediately after blood draw. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

If also on T3, or NDT make sure to take last dose exactly 12 hours prior to test

What are your vitamin D, folate, B12 and ferritin levels? If these are too low, improving to optimal with supplements can sometimes raise TSH slightly

Add vitamin results and ranges if you have them

[HilaryW in reply to SlowDragon]

My B12 is ok 527 ng/L (ref 197-771 ng/L)

Ferritin 94 Åmcg/L/ (ref 30-400 Åmcg/L) - sorry don’t understand these odd units - seems to be a printing error on the results

D is low at 30.5 ng/mL (doctor wants this 60-80 and I have started supplementation again) However, I have had much higher levels and still had suppressed TSH.

Thanks

[SlowDragon Administrator in reply to HilaryW]

So vitamin D is bit low

getting vitamin D should help

Plus magnesium often needs supplementing too

What about folate level?

Low B vitamins linked to low vitamin D

drgominak.com/sleep/vitamin...

[HilaryW in reply to SlowDragon]

Thanks for you reply. I am supplementing D now, I take Mg and folate was good. I was told my rT3 was a bit high so now am on DHEA to balance this.

I think stress may be playing a role. After years of having very low cortisol (adrenal exhaustion) throughout the day, I now have very high morning cortisol. So interesting how the body can change.

[Meadowsmom]

Why wait “exactly” 12 hours for testing after NDT? If you wait longer than 12 hours how does it effect the test results?

[SlowDragon Administrator in reply to Meadowsmom]

Your FT3 result will probably be lower than it really is

Graph showing why to take T3 approx 12 hours before blood test

healthunlocked.com/api/redi...

Research Paper data comes from

ncbi.nlm.nih.gov/pmc/articl...