Hashimoto's for over 10 years lower dosage now required why?

Hi my TSH has now become too low 0.25 despite lowering my medication twice and with T3 and T4 within range. This is the bit that is baffling me, I have previously required a higher dose of Levothyroxine to bring my TSH levels down? Why could this be as the condition will never be cured! The only difference in my life is that I am not stressed as I used to be but don’t know if this would have any impact on this disease? Can anyone please shed any light on this?

[SeasideSusie Remembering]

JewelsP

my TSH has now become too low 0.25 despite lowering my medication twice and with T3 and T4 within range.

Who says it's too low?

What is the range?

When did it become "too low"?

What was it before?

In this post you told us your TSH was 0.14, and that your TSH is normally below range, so how come 0.25 is "too low" now:

healthunlocked.com/thyroidu...

What are your FT4 and FT3 results, being "in range" doesn't mean they're optimal.

How do you feel?

Do you always do your thyroid tests under exactly the same conditions, i.e no later tha 9am after an overnight fast (breakfast after blood draw) and drinking water only before test? This is the only way you can accurately compare results.

Also, you have Hashi's and fluctuations in results (and symptoms) are the norm with Hashi's.

[Hidden in reply to SeasideSusie]

Thanks for your reply. GP says reading too low however she may be right as I have had heart palpitations and dry mouth which can indicate over medication can’t it!

[SeasideSusie Remembering in reply to Hidden]

I have had suppressed TSH - not just below range but suppressed as in <0.1 or <0.2 or <0.005 for most of my TSH results for the last 25 years, the 3 that weren't suppressed just about scraped into the very bottom of the range. I have never had palpitations due to this. So it's not necessarily that overmedication/low TSH that causes palpitations.

But did you have palpitations when your result was 0.14? How were you then.

In any case, when taking thyroid hormone replacement the TSH result is of little importance as it's not a thyroid hormone, it's a signal from the pituitary if it detects there's not enough hormone. The only results that count once on thyroid hormone replacement are FT4 and FT3, with FT3 being the most important one. If FT3 is in range you are not overmedicated.

As I said in my original reply, what are your FT4 and FT3 results, being "in range" doesn't mean they're optimal.

Iron deficiency can lead to palpitations, have you had ferritin, an iron panel and full blood count tested?

Also, there are many causes of dry mouth.

[Angel_of_the_North in reply to Hidden]

It can also indicate low T3, esp palpitations.

[Tina_Maria]

Please do not reduce your medication without seeing the results. Adjusting the dose on TSH results alone is very common place these days, but it is based on the non-understanding what TSH actually is and can leave people hypothyroid! TSH is a useful marker in people without thyroid disease and to diagnose, but then it becomes useless, as supplementation can have different effects on the TSH in different people.

I had my TSH suppressed as long as I can remember, but as long as your free T3 and free T4 are in range and you feel okay, this should not be a problem. Also, in many cases, patients feel well when their T3 and T4 are about 2/3 through the range (not just somewhere in the range).

I would demand more explanation as to why this adjustment is necessary. And listen to yourself, if you feel okay - why change?