Advise please

[Healthcare321]

My mum just had these results

TSH 0.03

T4 29.9

T3 5.7

Would appreciate your help as she feels ok for 86 but go reducing her Levothyroxine and worried that she may start with other symptoms. Was in 100mcg daily

Bloods were taken in the afternoon but she wasn’t told to not take her dose either beforehand

[SlowDragon Administrator]

For full Thyroid evaluation your Mum needs TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also extremely important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if Thyroid antibodies are raised

Low vitamins are more common as we age too

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. Last Levothyroxine dose should be 24 hours prior to test, (taking delayed dose 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)

Ask GP to test vitamin levels BEFORE dose of Levothyroxine is reduced

If levels are low, supplementing to improve can improve thyroud results.

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or all vitamins

thyroiduk.org.uk/tuk/testin...

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random

Come back with new post once you get results and ranges on vitamin testing

Low B12 in elderly

healthline.com/nutrition/vi...

todaysgeriatricmedicine.com...

[jimh111]

These results suggest she might be over treated. It doesn't matter that the blood was taken in the afternoon, it can give a TSH that is a little lower but with a TSH of 0.03 getting a result 30% higher wouldn't make any difference. Taking her dose beforehand is fine as long as it was at least four hours before the blood take. Levothryoxine has a long half life of about a week so the timing of a dose has very little effect once you get past the first few hours.

It seems reasonable for the GP to reduce her dose, if she starts to feel worse they should resume the original dose. She may feel better on a reduced dose as fT4 above 20.0 can be counter productive.