I wonder if someone can point me in the direction of good quality articles, research etc regarding TSH levels?
In particular, I am looking to research suppressed TSH in Hashimoto's and whether this poses a real risk or if it is potentially beneficially for those who are Hypo due to AITD.
My results, since treated, have shown a suppressed TSH in order for me to feel well. My Dr recently asked me to 'trial' alternating doses to reduce my overall dose down. After just 10 days joint pain and headaches returned. I resumed my previous dose and within a week was back to 'normal' and feeling well again.
My problem, you've probably guessed, is that my dr doesn't seem keen to put me back up to my other dose (which is 12cg daily- he lowered me on 'trial' to 100mcg/125mcg alternating).
I'm due to see him next week as am anticipating a struggle to get my original dose back, even though I was somewhat duped into trialling an alternative. So I'm wanting to try to be educated or at least be able to confidently argue my case for remaining suppressed.
I am of course open to being told to do as I'm told of it turns out it is indeed dangerous or ill advised for me to be suppressed long term etc. I am also open to advice.
I don't have recent blood tests as I'm collecting these at my apt next week.
Any advice gratefully accepted.
Thanks, Kate
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I’ve posted the below before a few times so apologies if you’ve read it already, but just in case it helps - I’m on T4, you might find the comments about hashimotos and over-medication useful in your battle to be well.
I see an endo privately which I know isn’t an option for everyone, but he’s very understanding and is a thyroid specialist.
Last time I went to see him my blood results showed my TSH is now plunging into the nether regions, my T4 and T3 are about 50-55% of the way through the range and I still feel like cr*p, though not as cr*p as the cr*ppest I’ve felt. He is happy for me to continue to increase Levo despite the fact that my TSH will go lower and it is already below the reference range.
What he said was interesting - he said most Doctors understand underactive thyroid as that is relatively straightforward, but they don’t understand hashimotos, which is more complex to treat as it is difficult to stabilise your levels. GPs just treat it in the same way as underactive thyroid but it isn’t the same. He said that the TSH does strange things with hashimotos as the pituitary doesn’t know WTF is happening as the thyroxine from the thyroid waxes and wanes. So basically the pituitary loses the plot and TSH tends to go low. Also, if you have been hypothyroid for a long time before being diagnosed and treated that also makes your TSH react in less stable ways and makes it an unreliable measure.
My endo also acknowledged what I have always thought that despite doctors saying synthetic thyroxine is just the same as our own, it isn’t and many struggle to convert it. This means the TSH responds to the level of T4 and goes low, but we actually struggle to manufacture T3, so need to take more of the synthetic T4 stuff than we would have to produce of our own - even more than the normal range for T4 for some people to be able to make/convert into adequate active energy and therefore to feel well. This is the reason the T4 and T3 test are so important. If your GP isn’t testing T3 he needs to explain why not if you are on what seems an adequate amount of T4 but still symptomatic. It may be a conversion issue.
The combination of hashimotos and synthetic T4 creates a perfect storm. Your pituitary goes AWOL and you may struggle to do anything with synthetic T4. Ultimately your feeling of ‘wellness’ depends on T3, T4 alone does nothing if it isn’t converted. Therefore other than T3, patients should not be assumed to be well just because they fall within the ranges and a low TSH is fine if there are no signs of being over medicated e.g. high FT3, heart racing, tremor etc.
There are physical tests your doctor can do to check if you are over-medicated - pulse rate, check the heart rhythm, extend your arms and see if there is tremor in the hands etc. You can take your temperature and heart rate on waking every morning and record these to show your doctor as proof too. Despite my TSH being low, on waking my temp is usually 35.2 and my heart rate 56! If he hasn’t done these tests the question is why?
He should be investigating why you are not symptom free and feeling better despite the stupid TSH reading. Not responding to a piece of paper rather than a patient. The other thing I would say to him is that if he is going to reduce your T4 because of the TSH and therefore make you unwell as your hypo symptoms will return, what is he going to put in its place to tackle that? The obvious answer is he needs to refer you to an endo for a trial of T3.
The last time I saw my endo, I pointed out my TSH was now 0.07 and he said ‘Oh let’s just forget about that, it’ll probably never go up again.’ What magical words they are!
Do battle - and good luck. Tell your doctor to dose the patient not the blood test. If you were over-medicated, believe me, you would know. When I was over-medicated it was scary, heart racing and pounding if I just stood up, feeling nauseous etc- you would want to reduce if that was the case! 🤸🏿♀️ #fightforyourthyroid
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Has the Junior Dr given me the correct advise based on TSH readings???? Any advice would be greatly appricated!
What does Armour do to TFT results?
Very suppressed tsh, on T3 10, years 
Have broken my brain again, TSH and NICE
Suppressed TSH - Reasons
