Tsh 0.5

[sparkleface]

Been hypothyroid for over 30 years. My tsh level at the moment is 0.5. Is this a heading a little towards being over active ? I was taking propanolol for a few months but was careful to take it much later in the day than thyroixine.

[shaws Administrator]

How are you feeling? If you feel well, there's no reason to worry.

Rather than testing the TSH the doctor should test free T3 and Free T4 both of which should be in the upper part of the ranges.

Do you get your tests done following this method:

The earliest possible test?

Fasting (you can drink water).

Allow a gap of 24 hours between your last dose of levo and the test and take afterwards?

A low or very low TSH is o.k. if you're taking thyroid hormone replacements. Many doctors adjust the patient's dose according to the TSH but the main question should be 'how do you feel'. If fine with no clinical symptoms you're on the right dose.

Adjusting doses according to the TSH can make us unwell.

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

[sparkleface in reply to shaws]

Just wondered if your ft3/ft4 are low and tsh is fine what is the next step?The only time I had my ft4 and 3 tested was when my mum paid for me to go privately about 4 years ago as I was feeling terrible. My doctor says the range is ok whatever it is obviously within the normal parameters. My gp has constantly told me the labs don't test FT3 and FT 4 anymore.

[shaws Administrator in reply to sparkleface]

I have a low TSH and no T4 and a slightly higher T3 because I take T3. I don't produce T4 neither do I have a prescription for it. Your GP is correct they don't test FT4 and FT3 but if you're not feeling well and they only go by the TSH how on earth are we, the patient, to know why we are still symptomatic. Both should be in the upper part of the ranges.

I only have an annual blood test.

[greygoose]

You can't become over-active if you are under-active. It doesn't work like that.

And, once you are on thyroid hormone replacement, and the TSH gets below one, it is pretty much irrelevant, it doesn't tell you much at all.

Is that all your doctor tests? No FT4? If not, he has no idea what he's doing. Your TSH could be 0.5 - which is good, by the way - but your FT4/FT3 still too low. So, the most important question is: how do you feel?

[sparkleface in reply to greygoose]

Thanks for that. I was wondering because I have been having severe fatigue. I sleep for a good 8 hours and still have a nap after work. Brain fog is much worse after lunch. I go all spacey and yawn my head off. Not good whilst teaching! Funnily enough had to start taking a high dose of steroids last week because I thought my bells palsy was coming back and the steroids made me feel so energised like my old self( well about my 30 year old self!)

[greygoose in reply to sparkleface]

Sounds like you're under-medicated, whatever your TSH says.

[MaisieGray]

sparkleface Propranolol is a beta blocker that has an anti-thyroid effect in that it's metabolite can increase RT3 levels and obstruct its elimination from the body; so even if you hadn't kept it away from your Levo any effect would have been to move you towards becoming more hypo not less. But as greygoose says, if you've had a failing thyroid for 30 yrs, it cannot suddenly become overactive; although you can of course be over-medicated but that is different.