Hello all you wise and very clued up people, please can I ask what’s best to do.
I have my results via my Nutritionists from Thriva and my TSH is low. Please see below for a screen shot with results and ranges. My question is, do I go back to my GP and ask him what he would recommend or do I take my usual 50mg Levothyroxine but now every other day and 25mg on the inbetween days as I’ve seen suggested on here with other queries? Then retest privately in say 3 months?
Thank you in advance.
Anna
How do you feel? Are you self medicating? How clued up is your GP? Your results are still in range.
I feel better but had a blip Jan-April and just coming out of it now. I finally got to the bottom of part of the issue, my body doesn’t agree with the TEVA brand so swapped it. No, not self medicating, my Dr has been great with diagnosis but not keen on supplementing and was sceptical when I was diagnosed privately with Hashimotos so I am cautious when approaching him.
Ok, that’s great info. In that case if you now feel you’ve got your brand sorted and you don’t feel Hyper then carry on as you are. Once you begin medication TSH results are useless (and often when trying to get medication it’s also useless but that’s another story 😬) what you need to keep and eye on are your FT3/4. As was said by another poster a lot of people in this forum would love your results. But mainly you need to get in tune with your body, monitor your symptoms and adjust accordingly, blood tests are only necessary to feel that we’re understanding our symptoms properly and perhaps applicable when we’re not sure if our symptoms are either over/under medicated because the two states of being can mimic each other.
Just so we’re on the same page, when you had this blood test were you on 50mcg x 7? Have you switched to 50/25 alternate days? Or are you just thinking about it based on your TSH?
Thank you for the reassurances and explanation. Yes the blood test was taken whilst on 50mg x 7, I was just thinking if it was worth alternating based on the Nutritionists comments and from reading on the forum. I’ve changed so much of my lifestyle to make sure I’m supporting my my Thyroid so I know I am just a little over anxious that it stays stable. I’ll relax again now! 
Never change your dose simply on the basis of a low TSH. It's OK as it is. Only lower your dose if you feel over-medicated.
If you do feel over-medicated, I would advise you to reduce it yourself, without getting your doctor involved. Because, if you feel worse on a lower dose, you might have trouble getting it raised again by your doctor!
I'm having that exact problem! I was told to decrease the dose of Levo slightly because my TSH was "Rock bottom". It came up a bit but was still under the official range. I had a "Reprieve" for a further decrease last time, but if the next blood test is still low I might have to go back down to 75 mcg. I am still feeling hypo, slightly more so than before but in the official guidelines it seems only the TSH matters and however bad we may feel they are determined to get the TSH in range 
Well, I tell you straight, any doctor that suggests I reduce my dose gets the reply 'over my dead body'. I would never, ever reduce my dose just because my TSH was low - in fact, I haven't had a TSH for years, but I'm on T3 only. They don't know what they're doing, they don't understand how it works. Why would I wreck my health just to feed their TSH obsession? I will not. It has led to many arguments, over the years, and I've done my best to educate, but don't know if it worked, but I've also had two doctors that agreed with me that it didn't matter if my TSH was suppressed because I was taking T3. I realise that when on T4 only the TSH is more important for conversion, but if you aren't converting well when your TSH is around 1, then it's not going to make much difference if it drops to zero. And that's something they just don't understand.
But what can you do if they refuse to prescribe the dose you need? No way can I afford to go private.
Also, on 100mcg T4 was slightly over range and T3 quite high but not quite over. Since decreasing Levo TSH is slightly up and T4 slightly down (they didn't take T3) So from that viewpoint I don't have a leg to stand on.
But if you still have symptoms, then you're obviously not optimal. And, you don't have to go private to buy levo on-line and increase your dose yourself.
How do you go about that? need a reliable supplier and reasonable price. If all else fails I will try it. The practice pharmacist is good in many ways but, like nearly everyone they are afraid of going beyond the official guidelines and are convinced that low TSH, or T4 a bit over range, is a bad thing
Just thought, have to be careful not to take too much Levo because of increasing RT3. A little over is probably OK though, as Dr Toft says
What do you think rT3 is going to do to you? Your FT3 will reduce a bit, but that's all. Anyway, I was only suggesting your go back to your old dose, nothing drastic.
I thought Rt3 would make things worse because it reduces the T3. But as long as it's not by too much.
Was really reminding myself that I am determined to be sensible, lol.
No, it's not the rT3 that reduces FT3, exactly, it's about the enzymes that control conversion. When your FT4 gets to a certain point, there's a safety machinisme that produces more enzyme to convert to rT3 than FT3, but rT3 is the result, not the driving force. Not sure I'm explaining this very well. But you're right that if your FT4 gets too high, the result will be more rT3 and less T3. But, if you get your FT4 up to the maximum, and you still don't have enough T3 to make you well, then it's a difficult choice.
My apologies to Twopoint4 for squatting your thread.
My apologies as well, Twopoint4 . We all have our questions and worries I suppose.
This is your first post on the forum and we don't know anything about your thyroid journey.
As Paula says, how do you feel?
Why are you concerned about your low TSH?
Your results are pretty near perfect, FT4 and FT3 in the upper part of their ranges, TSH below 1 - many members dream of results like this.
Your nutrient levels are pretty good, maybe nudge your Vit D level up a bit to reach the level recommended by the Vit D Council and Vit D Society - 100-150nmol.
Show these results to your GP and ask his advice will see him freaking out about your TSH, your dose of Levo will be lowered and the very real possibility of you not feeling well.
Hello SeasideSusie, I didn’t want to bombard everyone with a long post, so I kept it brief, so thank you for replying. I was diagnosed in 2017 with Underacvtive Thyroid after feeling very low mentallly and physically, muscle aches and tiredness. I was prescribed 25mg and decided to find a good nutritionist to help me understand it more and knowing it has affected all the females on my mother’s side of the family going way back. I went gluten free for the last year and reduced my antibodies massively. But Jan-April I had a huge blip with awful physical fatigue after having what the Dr thought was Flu (face ballooned up, slept on and off for 5 days) and an increase of Levothyroxine to 50mg. I then caught a battery of colds and it’s taken until April to feel better hence new results. I read on here symptoms I was experiencing and checked my brand of prescription which had changed mid December to TEVA. I tracked down a pharmacy which stocks my old brand so swapped back and have felt so much better. My nutritionist suggested a new blood test and has sent them over with a comment saying “TSH is below range so it could be worth discussing with your GP the dosage again for thyroxine - are they planning to retest any time soon.” So I wanted to seek advice on here. Thank you for any advice, this forum is brilliant.
I’m so glad you’ve had success with a nutritionist but unfortunately she doesn’t appear to understand thyriod health a much as she could. If you have a good relationship with her then perhaps you could point her in the direction of some good reading material as to why TSH is not always the best indicator of thyriod health (useful in the beginning when trying to work out problems but then pretty much irrelevant 🤗)
50mcg is a starting does for many people! You should have had a test and an increase every 6-8 weeks if needed.
In your place, if I felt ok I would let it be. And by ok I mean adequately but not overly medicated.
My TSH rarely goes above 0.029 and that’s on Levo alone. Luckily last time the GP I saw listened to the symptoms. Di
Low TSH and GP wants to lower liothyronine.
Self Medicating didn't go so well for me, I have had to go back on Thyroxine - for now anyway!
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