Help with endocrinologist visit

[Clara62]

I am seeing the endocrinologist next week and I have to discuss my medication with him but I want to be prepared. Can anyone let me know about studies or 'scientific' writings that confirm that a suppressed TSH doesn't lead to low bone density or osteoporosis please? If you can post links it would be very helpful. Thank you.

[humanbean]

Some threads on the subject :

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

[Clara62 in reply to humanbean]

Thank you!

[SlowDragon Administrator]

This is good article

thyroidpatients.ca/2018/07/...

Osteoporosis is all about FT3 levels....not TSH

[greygoose in reply to SlowDragon]

Brilliant article, SD. It's all there in one place.

[MissGrace]

I gave posted this recently, so apologies if you have read this before.

I see a private endo, which I know puts me in a privileged position and I’m sorry that isn’t possible for so many on here. He is a thyroid specialist. I’m on Levo only.

My TSH is well below range and vanishing - my T4 and T3 in range. He sent me for a Dexa scan and my score for my hip on the FRAX scale was right up against the area of needing treatment for osteoporosis (which I told him I didn’t want) and my spine well into osteopenia.

He didn’t blame my TSH at all - after all it’s only been low for a few months - hardly time for my bones to crumble. Instead, he pointed to the blood test that showed I had just about no oestrogen, (I’m post-menopause and never wanted HRT), as the obvious culprit and the fact I’ve had a low BMI all my life. Although I’ve always been active and exercised a lot, my chosen exercises, including lots of swimming which I have done for over 30 years, is not load bearing so hasn’t ‘built bone’

He suggested supplements and load bearing exercise to help me build my bones - and advised my GP about this too. Never once did he suggest I make myself ill by reducing my thyroid medication. The other thing he has said in the past about my TSH is ‘It’ll probably never go up, let’s just ignore it.’ Magical words - but I was severely hypo (probably for a long time) and he thinks my TSH has lost the plot as a result. A bit of T4 and it finds it overwhelming! I also have hashis, which makes the TSH unreliable as the hormones from what’s left of my own wizened thyroid wax and wane. Therefore, TSH is a useless measure for anything other than diagnosis. For treatment an endo should know he/she needs to look at T4 and T3 to get a complete picture.

I also discussed with him the fact that I’d rather risk a fracture than live a half life on too little medication no matter what. But he is not concerned with the low TSH.

They really need to start treating us like adults on this kind of thing. Not only are we clever enough to know that a suppressed TSH with the T4 and T3 in range is not over-medication; that over-medication is not the same as being hyperthyroid; that suppressed TSH in a hypo patient is also not being hyperthyroid; that being hyperthyroid is a totally different condition where your own thyroid over produces T1,2,3 and 4; that over-medication has obvious (and unpleasant) physical symptoms that we would recognise (and GPs can easily test for, like heart rate, tremor etc), but also, that bone density is affected by many, many complex biological processes (and genetics) and is something we can work to improve.

We are also clever enough (brain fog or not) to assess what we are willing to risk and what we are not, for the sake of health.

Have you had a bone scan? Have you any results for T4 and T3? This endo is pretty useless if they judge everything on TSH. TBH, if I saw an endo who was TSH obsessed, I think I’d just walk out (on my budgie bones!) 🤸🏿‍♀️🥛

[SlowDragon Administrator]

Same website discussing low TSH and why its irrelevant.....FT3 is the marker to test

thyroidpatients.ca/rational...

[Clara62]

Thank you all!! It's all very comforting and helpful!