Test results

[Alice70]

Am I right in thinking that TSH test results of 0.18 is bordering hyperthyriod ,I have taken levothyroxine for over thirty years ,always at a dose of 100 one day 125 the next taking this amount on alternate days ,my new gp told me to take 125 everyday,after three months I had my TSH tested ,the test result came back at the level of 0.18 ,I feel a little sweaty in bed ,I would like to know peoples opinions on this level as I would like to go back to my dosage of 100 to 125 on alternate days

[NWA6]

Morning Alice 👋 how have you been over the 30yrs of treatment? How do you feel now on 125mcg per day? Why did your new GP tell you to start taking it everyday? Did you feel better on 100/125 alternate days?

All these questions are relevant because TSH is not a good indicator of health once you’ve been established on Levo. What is relevant is how you feel. If your symptoms aren’t stable or you begin or start to feel symptomatic then FT4 and FT3 blood tests are better to give you an idea of what/why you are symptomatic.

Although saying that some people who do well with Levothyroxine (approximately 80% of the Hypothyroid population I believe) can often use TSH blood tests to work out if they’re on the right dose. Staying at the very lowest range of the test is often best. For example TSH test has a range of about (0.35-5) and Hypothyroid people live symptom free if their result is around 0.35 - 1.5.

This is very generalised and everyone’s ‘sweet spot’ is unique. As your TSH is just under the standard range this *may* be the reason for your night sweats and maybe going back to your previous dose of 100/125mcg might work best for you but your TSH score certainly doesn’t mean you are ‘hyperthyriod’.

You maybe be slightly over medicated but it doesn’t make you hyperthyriod, that’s a separate issue and one you don’t have.

But back to my original question, how do you feel?

[MaisieGray]

No you aren't right in thinking that 😊😊

You have been hypothyroid for 30 yrs, you can't suddenly become hyperthyroid. You can however, be over-medicated, and that's judged by the level of thyroid hormone in your blood, not the level of pituitary hormone ie the TSH. It is poor doctoring to make dosing decisions based on the TSH, although unfortunately for patients, so many medics do. You need to know the level of the largely inactive storage pro hormone FT4, and in particular, the level of the active thyroid hormone FT3, in order to judge if your body has access to an adequate supply or if you have too much. The TSH alone cannot tell you that, and certainly can't make you feel sweaty, although too much thyroid hormone might. So the question is, why did your Dr increase your meds and what were your TSH/FT4/FT3 levels that led him to do that; and having had your meds increased, what are those levels now; and if only the TSH was tested, neither you nor he will have sufficient data on which to make dosing decisions. In any case, after any dose change, bloods should be tested after 6 weeks, 3 months is too long. Additionally, how our body reacts to a dose increase can be affected by several other factors, adrenal functioning being one, for instance; and it's possible that you were previously undermedicated and needed to increase your dose, but that your sweating is evidence of something else going on, rather than of the thyroid hormone levels now being too high. But again, you won't know that by simply considering the TSH. What so many of us do, is to have more comprehensive thyroid blood testing carried out by private labs - a simple finger prick test suffices or you can opt to have the blood drawn venously if you prefer - which includes some basic but important nutrition factors such as Vit D, Vit B12, folate and ferritin; with which we can have a fuller picture that helps us understand what might be going on.

[SlowDragon Administrator]

Sweating at night can be due to low B12

Low B12 is common when hypothyroid and very common as we get older too

Just testing TSH is completely inadequate

For full Thyroid evaluation you need 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

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

Last Levothyroxine dose should be 24 hours prior to test, (taking delayed dose immediately after blood draw).

Ask your GP for full Thyroid and vitamin testing

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

The other consideration......is do you always get same brand of Levothyroxine?

Many people find different brands are not interchangeable. Teva brand of Levothyroxine upsets many people