TSH too low? results help please: Hi there, I... - Thyroid UK

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TSH too low? results help please

tinkerbell22 profile image

Hi there, I have the following results back today and wondered what your opinion is.

Obviously I need to somehow work on the vitamins. But I wondered if my TSH is way too low?

hs-CRP 16.27 <5.0 mg/L

Ferritin 51.9 13 - 150 ug/L

TSH 0.04 0.27 - 4.20 mIU/L

T4 Total 112.0 66 - 181 nmol/L

Free T4 18.50 12.0 - 22.0 pmol/L

Free T3 5.61 3.1 - 6.8 pmol/L

Anti-Thyroidperoxidase abs <9.0 <34 kIU/L

Anti-Thyroglobulin Abs 252 <115 kU/L

Vitamin D (25 OH) 19 Deficient <30 nmol/L

Vitamin B12 154 Deficient <145 pmol/L

, Insufficient 145 - 250

Serum Folate 5.22 8.83 - 60.8 nmol/L

I'm still extremely exhausted but perhaps this is down to the vitamins. My main concern is whether I need to change my t3 and t4 dosage.

Any thoughts welcome xx

14 Replies
SlowDragon profile image

Take these results to GP

Your Vitamin D is extremely deficient. You will need loading dose prescribed

Local CCG guidelines


Once you Improve level, very likely you will need on going maintenance dose to keep it there. Retesting twice yearly via vitamindtest.org.uk

B12 is extremely low and folate below range

So you need full testing for Pernicious Anaemia before starting on B12 supplements or most likely injections and folic acid supplements should not be started until 48 hours after first B12 injection

High TG antibodies can be due to Hashimoto's of due to Pernicious Anaemia or a few other causes

Ferritin is borderline. Probably not low enough for GP, but ask for full iron panel to test for Anaemia

Your Thyroid results are haywire because of very low vitamins

What Levothyroxine dose and T3 are you currently taking?

Thank you SlowDragon for replying so quick. I'm on 100mcg T4 and 5mcg T3

Just wondering SlowDragon ... are my thyroid results "haywire" or just progressed that way? My T3 and T4 are slightly higher than they've ever been, which is Good! And I had been working on lowering my TSH by increasing my thyroid meds as my TSH was too high. I just didn't expect my TSH to go quite as low as it has. So perhaps the thyroid results are ok, not random but have progressed that way. I'm worried the TSH is dangerously low though?

Ohh I just found this... "Any thyroid medication that contains T3, like Cytomel or desiccated thyroid, will suppress TSH levels" I am taking T3! And it's since I started t3 that my TSH plummeted! So perhaps I shouldn't worry about my TSH being so low?

Perhaps I still need More T4 and T3 as there's room for both of these to be higher than they are??

No, you should worry about it. :) If I were you, I would increase the T3 - you should never increase both at once, anyway. Once you get your FT3 to a decent level, if you still have symptoms, then you can experiment with increasing the levo. But, it's the T3 the most important.

Hi greygoose, thank you for your reply! You said I should worry about my TSH being so low? Is it dangerous to be this low?

No I wouldn't increase both T3 and T4 at once :)

Would increasing my t3 or t4 lower my TSH further? And would this be a problem as it is already so low?

How high can t3 be, can it be top of the range before some people feel well?

I'd find it easier to raise my t4 than t3 as I seem to be very sensitive to t3.

I'd love to raise my t3 more but I think I will tolerate a raise in t4 better.

What do you think, Could that work as a plan?

Thanks very much

SlowDragon profile image
SlowDragonAdministrator in reply to tinkerbell22

Essential to get vitamins optimal as soon as possible

How do you take your T3. As split dose or all at once?

Some can take as one dose

Others need to split it into two or three doses

Personally I can only tolerate as three doses per day, at 8 hour intervals.

Hi SlowDragon, thank you for your reply. I am having such difficulty with vitamins, and minerals. I am super sensitive to vitamins and have food and drink sensitivities. And on top of these I'm too exhausted to manage to cook properly for myself, so I'm stuck in such a catch 22 situation. As an example, I have tried vitamin B and though it does help me feel brighter and less exhausted, it then triggers insomnia and nightmares! It is so bad that even a very very tiny amount of vitamin B can leave me without more than a couple of hours "sleep" for weeks! (sleep being filled with constant nightmares!). I have the same reaction off antidepressants incidentally... So maybe it's a serotonin thing. But basically vitamins that help give energy make me wired (either during the day or at night). Diet would be the best way to make changes to my vitamins but as I said I am always too exhausted to cook properly, plus my sensitivities (e.g to raw vegetables and fruit) limit me a lot. I LOVE cooking. So it's not lack of motivation, passion and inspiration, just total exhaustion and sensitivity. I am Not making excuses, I 1000% understand how much I need to work on my vitamin levels, but I honestly don't know How?

There is an added layer of complexity to this too. I had been looking into root causes of my thyroid problems and did a hair analysis test. It came back (to my utter shock and disbelief) with chronic Arsenic poisoning! I have done 4 different tests this year and they all came back the same, so finally this month I have accepted it! Arsenic is Everywhere, I had no idea (e.g, rice, chicken, wine, Apple juice, even our mattresses, for starters). And it damages the thyroid and metabolism. It also blocks absorption of vitamins and minerals and mimics others. But at the same time, higher thyroid hormones and higher vitamin B particularly can help clear out the arsenic.

Re my T3, I split it into 2 doses, one in the morning first thing, and one late afternoon, early evening. I can't tolerate it later in the day than that as it keeps me awake then. I tried a 3rd dose around noon but I kept finding myself a bit hyper. I am even sensitive to the composition of t3, so it's not just about feeling hyper but also about it triggering Candida style reactions too if I have too much. It seems to burn!

My sensitivity really reduces my possibilities. But I'd read that can be caused by the liver not functioning optimally. And what attacks the liver? Arsenic!

If you have Any advice I'd welcome it as I must somehow find a solution to this. I have a lot of secondary issues as a result of my vitamin and mineral deficiencies.....

Thank you again

Sorry! I meant to say you SHOULDN'T worry about your TSH being low.

Yes, increasing your hormone would lower your TSH even further, but for a very good reason: you don't need it anymore. TSH = Thyroid Stimulating Hormone, secreted by the pituitary when blood hormone levels are low. If you raise your blood hormone levels, you don't need to stimulate the thyroid anymore, so, the pituitary produces less and less.

FT3 sometimes needs to be slightly over the top of the range for some people to feel well, if they have hormone resistance they need very high levels to get just a little into the cells. And, remember, ranges are arbitary, anyway; man-made, not set in stone by a divine being. They are just a guide. How you feel is paramount.

Raising your T4 will only help you if you can convert it to T3. T4 is a storage hormone, T3 the active hormone. And, the fact that you're taking T3 suggests that in the past you had a conversion problem. But, as I said, how you feel is paramount, and if raise your dose of T4 can make you feel better, then by all means do so. If it doesn't make you feel better, then there is no point in raising it.

Lol thank you for clarifying, greygoose!!! Well explained, thank you so much! I feel like each time I read info on this a tiny bit filters through to my brain lol! My head is a lot clearer than it was but it still gets very confused!

That's reassuring to hear about T3 being ok for some very high! I knew this was the case with T4 but didn't know if it applied to T3 too.

T4 Definitely does something for me, as when I first started t4 it gave me a boost. And increasing t4 has always helped a bit. Also when I first tried T3, I initially tried to lower my T4 before starting it, as I'd read somewhere that that was a good idea... I very very quickly felt very hypo though! Aches and pains, could barely sit up, hair started falling out more... maybe it was just a shock to my thyroid but I took this as a sign that the t4 is doing something. Also I tried a natural dessicated thyroid called Metavive and this was too high in t3 for me to tolerate. So I think I need the balance of t4 and t3. Does this make sense? It's all been trial and error but I do seem to be getting somewhere. Incidentally I have zero help from a doctor now! So I'm on my own figuring this out except for you wonderful people here :)

I started t3 because my t3 was very gradually falling, no matter what I did.

Thanks so much

Also when I first tried T3, I initially tried to lower my T4 before starting it, as I'd read somewhere that that was a good idea…

It's only a good idea if your FT4 is so high that the T4 is converting to more rT3 than T3, which would be right at the top of the range. If your FT4 was only about mid-range, then there was no need to reduce it.

maybe it was just a shock to my thyroid but I took this as a sign that the t4 is doing something

It wouldn't have been a shock or anything else to your thyroid. Once you start taking thyroid hormone replacement, your thyroid is more or less out of the loop. Taking thyroid hormone replacement doesn't have an effect on your thyroid, it is just replacing the hormone your thyroid can no-longer make. It could just have been that you'd reduced your T4 by too much, whilst not having added enough T3 to replace what the T4 was converting to - if you see what I mean. You could have, effectively, given yourself a reduction in dose.

Of course, the T4 would have been doing something, it would have been converting to T3. But the question was, was it converting to enough T3 to make you well?

It all trial and error for everyone. :)


Just to say your crp is too high, which is usually indicative of inflammation and or infection. This also means your ferritin levels are actually a lot lower than reported.

Best of luck and hope you improve soon!

Thank you Kitten44. Yes I agree it's too high. It has been since I started testing my thyroid. I didn't know that about the ferritin!!! How does that work?

I have various problems with inflammation and infections, including a constant virus around me for 2 years, so it makes sense this is high.

SlowDragon profile image
SlowDragonAdministrator in reply to tinkerbell22

So have you tried vitamin D supplements before?

Or only B vitamins?

If you find you can't tolerate vitamin D, you may need magnesium supplements first

Suggest you get some vitamin D mouth spray by Better You and try it cautiously

See my profile for info on not being able to tolerate vitamin D supplements

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