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[Monasingh]

Please help me read my results as doctor said I am over medicated. He wants to reduce my 125mcg levo to 100. He said my TSH is LOW.

[SeasideSusie Remembering]

Monasingh

Yes your TSH is below range, but that is not important when on thyroid replacement hormone. Your FT4, and most importantly FT3 because you take T3, results are what's important.

The doctor who prescribed your T3 should know that taking T3 tends to lower TSH and often suppresses it so it really is irrelevant in your case.

Your Vit D has improved, we know from your previous post that the unit of measurement is ng/ml and it is now within the recommended range of 40-60ng/ml. You should now take a maintenance dose of D3 (plus it's important cofactors) to keep it at this level.

Ferritin is dire, it's below range. You should ask your GP to do an iron panel and full blood count to see if there is any anaemia. As it's below range, you should ask for an iron infusion, this will raise your level in 24-48 hours whereas iron tablets will take many months. Once it's at a good level (recommended is half way through range) it needs to be maintained there and eating iron rich foods (including liver, liver pate, black pudding) will help do that, or your GP may recommend a maintenance amount of iron supplementation.

B12 - not bad. If the unit of measurement is pg/ml or ng/L then according to an extract from the book, "Could it be B12?" by Sally M. Pacholok:

"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".

"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."

You need folate testing, this works alongside B12.

[Monasingh in reply to SeasideSusie]

Thank you so much 😀😀

[greygoose]

Your doctor should also know that it's the Free T3 that is important. He's tested the Total T3, which gives you no useful information.

[Monasingh in reply to greygoose]

I don't know why he didnt test me for that...I am gona repeat it in few months. Thank u

[greygoose in reply to Monasingh]

Are you in the US? For some reason, they don't tend to test the FT3 in the US, but do the TT3 instead. I cannot imagine why, but there it is.

[Monasingh in reply to greygoose]

Yes I am in new jersey

[greygoose in reply to Monasingh]

OK, so you're probably going to have to insist on having the FT3 tested, rather than the TT3, if you want to know how well you convert, etc. But, at the moment, you're under-medicated, so your FT3 is probably low, anyway.

[Hidden in reply to Monasingh]

I'm in Virginia. My Endo will test everything because I complain but then reminds me like a child that I'm not going to treat the ft3,ft4 just the tsh which for me is always below level because I'm on Armour Thyroid and then the fighting starts to not reduce my meds.... I refuse med reduction every 4 months if they had it their way I be without meds on life support...little dramatic but certainly feels like they want me dead. I have no thyroid...my life's biggest regret.

[greygoose in reply to Hidden]

But, that's just the point, you shouldn't be treating just the TSH! The TSH is the least important number - especially once you are on thyroid hormone replacement. The most important number is the FT3, and he should be 'treating' that, increasing your dose until the FT3 is in the right place for you, until you feel well and the symptoms are gone. This endo is never going to make you well, so I would ditch him, if I were you, and find someone who actually knows something about thyroid.

[Hidden in reply to greygoose]

Hi grey goose

I did see outside very recommended high review Endo and that was and epic failure....she didn't even understand Armour Thyroid dosing and googled everything..can you imagine my shock to her googling my meds....panic attack. You right they shouldnt look so hard at tsh sadly here in US thats the stupidity most of us deal with.

[greygoose in reply to Hidden]

It's not just in the US, it's almost everywhere. I did see a couple of doctors in Paris that ignored the TSH, but all the GPs I've seen don't know anything outside of the TSH. That's all they learnt in med school. I had one wanted to reduce my dose when my TSH was at 0.45, still inside the range! He said, ohhh, we've gone too far with the increases! He was terrified! lol But, it's not funny, of course. And, I don't really know what we can do except stick to our guns: we will not be dosed by the TSH, and we will test the FT3!

[vocalEK in reply to Hidden]

If you are in Northern Virginia, I have a doctor to recommend. PM me.

[Hidden in reply to greygoose]

How interesting. I’m in Australia and i don’t think the lab even does tt3 any more.

[greygoose in reply to Hidden]

It's a growing universal trend, I'm afraid. If I were a cynic (who? me?) I would say it's because if patients/doctors understood T3 and tested for it, more people would get well, and Big Pharma can't afford for that to happen!

[Hidden in reply to greygoose]

Growing trend to do fT3 as standard like here? Or tt3?

[greygoose in reply to Hidden]

Oh, sorry! I thought you were saying they didn't test T3 at all. They very rarely test T3 in the UK - either FT3 or TT3. And, in France, where I live, they used to test FT3 each blood test, now they are refusing to do it. Two doctors have told me that there's no point in testing it because they don't understand the results. I just say well, I understand them, so just do it.

[silverfox7 in reply to greygoose]

What a pathetic answer GG! I applaud your reply!

[greygoose in reply to silverfox7]

Thank you, silverfox.

[Hidden in reply to greygoose]

I think total t3 has gone as a lab test, though perhaps other labs do it. What my doc now orders as ‘t3’ is actually ft3. I assumed total t3 isn’t done any more as fT3 has overtaken it as more useful. My doc always does fT3 these days but I’m in NDT so he needs to keep tabs on it.

[Heloise]

Remind your doctor that TSH is a pituitary test and is only inhibited due to your Levothyroxine. Your FT4 more appropriately tells your level of actual treatment and THAT is what is low....too low to deliver enough T3 as you can readily see in your results.

[Boon79]

Ignore TSH, go by T4 and T3 which most feel better when these are towards the top of the range. As seaside Susie says. Get iron optimal and maintain Vit D.

[Hashihouseman]

Don’t ignore tsh or the total hormone as well as the free, all useful info. All together these results could be teling you some key things such as...... your buffer store of t4 is low making you susceptible to reduced ft4 if it is further reduced by lower total t4 dose. However Your tsh may indicate a failed attempt to signal t4 excess because individual dose floods your system - not only would this suppress tsh it is also likely to suppress your t4 to t3 conversion in itself. There is some research and clinical opinion that suggests tsh affects the over arching reguti9n Beyoncé just thyroid gland signalling Alf if suppressed could be down regulating other feedback loops to slow or reduce thyroid mediated metabolism. If you split your t4 dose these affects could be ameliorated and deiodinase activity may become more optimal (balanced) thereby increasing total t3 production and therefore free t3. If t3 levels don’t rise and hypo symptoms persist then you may need thyroid equivalent t3 supplement ie no more than the t3 which used to be secreted by your thyroid or a normal thyroid, if there is such a thing;). If anomalies and symptoms persist further investigations such reverse t3 and thyroid tissue activity outcomes like cholesterol, pulse rate and body temperature may be relevant......

[Dadondadda]

I doubt you're over medicated but something is messing up thyroid metabolism.

I suggest you RAISE FERRITIN

It's very low. You MUST supplement. 50 mg elemental iron 3 times a day for a month or so.

[Magda75]

Your TSH is low - how are you feeling? Do you experience lots of symptoms or feel ok? My understanding of your Vit D, B12 & Ferritin (Iron) is that they are all low and I would advise you to start taking high dose supplements - my Endocrinologist would say the same - they are factors in biochemistry of thyroid and medication. You want to see those at the top of range, right now they’re at the bottom.