I recently took some good advice from Marz and Slow Dragon and had my blood tested privately. My results show a TSH of 0.434 (normal range 0.27-4.2). A free T3 of 4.62 ( normal range 3.1-6.8) and a Free thyroxine (T4) of 20.8 ( normal range 12-22).
I know that I fall within the normal ranges but my TSH is on the low end of normal and my T4 on the high end of normal. I am wondering if this now means I could afford to lower my levothyroxine (I take 75 daily). I think that now that I am 70 years old I could manage on less. I am being investigated for a fast heart rate and think over-medication could be the cause?
Any advice from forum members would be appreciated.
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GP will only prescribe to bring vitamin D up to 50nmol. Aiming to improve vitamin D by self supplementing to at least 80nmol and around 100nmol may be better .
Once you Improve level, very likely you will need on going maintenance dose to keep it there.
B vitamins best taken in the morning after breakfast
Igennus Super B complex are nice small tablets. Often only need one tablet per day, not two. Certainly only start with one tablet per day after breakfast. Retesting levels in 6-8 weeks
Or Thorne Basic B or jarrow B-right are other options that contain folate, but both are large capsules
If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before any blood tests, as biotin can falsely affect test results
Ignore the Polish. Just fill in your test result and the bottom and top of the range on the FT4 line and then on the FT3 line. Then click the button (Oblicz). The results will be displayed below. This is what mine look like:
FT4 72.73% [ wynik 1.4, norma (0.6 - 1.7)]
FT3 50% [ wynik 3.2, norma (2 - 4.4)]
My FT4 looks fine, but there is room for improvement in my FT3.
Did you find your historic blood test results from when diagnosed
You are legally entitled to printed copies of your blood test results and ranges.
UK GP practices are supposed to offer online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.
In reality many GP surgeries do not have blood test results online yet
Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up.
Ask GP to test vitamin D, folate, ferritin and B12 levels (and antibodies if never been tested)
About 90% of all primary hypothyroidism in Uk is due to Hashimoto's.
Low vitamins are especially common with Hashimoto's. Food intolerances are very common too, especially gluten. So it's important to get TPO and TG thyroid antibodies tested at least once .
What makes you think you are overmedicated? Your TSH is within range, as is your FT4. It's FT3 that tells us of we are overmedicated.
I am 71 years old and have been treated for hypothyroidism for 45 years. In recent years I have discovered and addressed severe Vit D deficiency, low Folate and Ferritin. I also discovered poor conversion of T4 to T3 and now add T3 to my Levo.
Looking at your nutrient levels, your Vit D level is very poor, it should be 100-150nmol according to the Vit D Council and the Vit D Society, your Folate is low and would be better in double figures, your Active B12 isn't bad but I would want mine over 100 (below 70 suggests testing for B12 deficiency) and Ferritin should be half way through range so yours is just about there.
Your fast heart rate may or may not be connected with your thyroid and/or it's treatment. Like myself, you are getting older and things start wearing out and going wrong.
Thank you for responding Seaside Susie. I have had these awful palpitations for four months now. Still being investigated by Cardiology Department. I am just desperate to find the cause. It probably isn’t my medication but I thought I’d see if anyone had any ideas. I will address the deficiencies in my results. Many thanks for the advice.
Palpitations can be a symptom of under-medication. And, with your low FT3 I wouldn't be surprised if that were the cause. I'm 74 and take 75 mcg T3 only, and I would not tolerate any doctor trying to reduce my dose on the pretext that you don't need as much when you're older. You need what you need to make you well, no matter your age. And, whilst it's true that euthyroid older people might be perfectly healthy with a higher TSH, being hypo changes everything. We should not allow them to compare us hypos with euthyroid people because we're different, we're not the same.
Thank you for your reply. Others on the forum agree with you. I am just trying to self-diagnose my fast heart beat. I will take all of this information to the Cardiologist and get him to refer me to a thyroid specialist. Thank you once again.
Are you in the UK? If so, you should be aware that there are practically no actual thyroid specialists. What you would probably get sent to is an endo who is a diabetes specialist who knows very little about thyroid but may have some very strange ideas about thyroid. Do your research carefully before committing to any type of endo.
If I were you I would alternate 75 and 50 to bring your heart rate down. If my TSH gets below 1.00 my heart races constantly and skipped beats all the time. It wouldn’t hurt to give it a trial run for a few months to see
Then there’s your answer to why your heart is acting up. If that’s the only thing really different. If my tsh was that low I would be aging rapid heart rate non stop. Some people can’t tolerate tsh that low
Lowering thyroid medications as the patient gets older seems to be the idea of those who have observed that the requirements of those without any thyroid issues reduces with age.
My faith in any suggestions or recommendation made by "experts" delving into this sort of area has ceased to exist.
I will keep taking the identical dose of NDT that I know will keep me well.
Well, I'm 74 and I take 125mcg T3-only.....I don't believe age is a factor!
I have the Dio2 polymorphism/homozygous (see below) plus Thyroid Hormone Resistance (RTH)....hence the huge dose.
You need what makes you feel well....has your GP ever asked you how you feel?
Sadly when it comes to thyroid disease medics are frequently clueless....were it otherwise this amazing forum would not exist!
I was wrongly medicated for nearly 20 years!
Palpitations can be caused by both over and under medication....I've had palpitations with both. Perhaps not a very helpful response...sorry.
75mcg levo is not a huge dose
Your FT3 is far to low...you are undermedicated. That means your cellular level of T3 is low which is where it gets to work. Your cells (trillions of them) need a constant and adequate supply of T3.
Your T4 to T3 conversion is poor ( high FT4 low FT3)
Medics tend to dose by TSH and consequently patients are often wrongly medicated....as follows,
Are your nutrients all optimal.....Vit D, vitB12, folate and ferritin. They support conversion.
I suspect you may benefit from the addition of T3.
Sadly many medics are reluctant to prescribe it but they sometimes offer a trial if you have a positive result for the Dio2 (thyroid) genetic test. You may find this paper helpful.
Thank you for your advice. I get a routine yearly check of my TSH and T4 levels. I ring the practice for the results and for the past 10 years have been told they are ‘normal’. Since joining this forum I have found out so much useful information which I have already acted on. I think you are right that age isn’t a factor. I need to do some work on my vitamins etc. I hope they can sort my heart out. I will raise T3 with my GP. Many thanks for your response.
Not sure I can offer any useful information but I too, age 75, have started with palpitations and atrial fibrillation. Doctors say it is because I am overmedicated with levo. However, I have reduced the dose and have had three boughts of very high resting heartrate in one week. I was to be referred to an endo, to see if I need T3 and less levo. However, in my mind there's more to it. The AF seems to be brought on by various things, medication, strenuous exercise (just fine while I'm doing it), stress - even good stress? Therefore, I have asked the doctor to refer me to a cardiologist because, in my opinion, it seems the problem is more with my heart than with the different triggers. It seems there is a procedure called ablation which can burn away the part of the heart that is causing the problem. If this is applicable to me, I would rather deal with the source of the problem than going through life avoiding every possible trigger.
"I'm on 175 mcg daily of thyroxine. Have been for years. But my doctor wants to cut dose right down to 125mcg cos my T4 is high. But I am not hyper. Feel fine, no symptoms. I will be ill at a lower dose. Really stressing me out."
I would suggest that your medics are mistaken about your current situation when they suggest you are overmedicated.....as I and others have suggested you are undermedicated.
Your high FT4 may be caused by poor conversion of the storage hormone T4 to the active hormone T3.
It would help if we had current FTT results.
You say "I have reduced the dose and have had three boughts of very high resting heartrate in one week"......you are clearly undermedicated and AF is a symptom of that.
We have to be careful about what we read on - line and about how we interpret and use the information. " Dr Google" can be very useful but on-line info can have it's limitations.......and can cause unnecessary worry.
Your medical practice could offer an ECG as an alternative to a visit to a cardiologist....
If you are hypo you cannot become hyper.....any symptoms you experience may be from over or under medicatiom.. Symptoms can be common to both, which is why FT3 is necessary. Its inclusiom gives a more accurate, but possibly not definitive, picture....
I'm not a medic but like many of us on the forum have had to do a lot of personal research, supported by TUK, before starting to recover.
Please let us know how you get on, shared experiences are valuable.
You may find that the cardiologist knows very little about thyroid matters. Connecting different ‘parts of the body system’ is, unfortunately, a rare attribute amongst the medics I have met.
Yes, you're right. In this case I'm hoping the cardiologist will be able to rectify the source of the problem with my heart, rather thanaltering/avoiding the triggers that keep tipping me into AF
We are both having similar problems. I wish you well and will let you know if I learn anything from my experience of getting this awful tachycardia sorted out by a Cardiologist.
I have heard that other things wh ich may be involved are overproduction of adrenaline (or cortisol?) or possibly connected with low B12. These are things I will want to discuss with a cardiologist
Yes. I had a 24 hour urine test (huge bottle) to see if my adrenal glands were working properly. I haven’t heard anything back so I am presuming it was ok. I will check when I next see the Cardiologist at the end of December. My B12 is a bit low so I have ordered ‘Slow Dragon’s’ recommended tub of Super B complex tablets. I am hoping they will help.
It looks like you need less T4 and more T3. Your T3 should be closer to 5.8 to be optimal. I would decrease the T4, but you need to find someone to prescribe T3, as that will drop even more with the less T4.
As far as less when you age, it is different for everyone. Many elderly people in general without thyroid disease end up needing thyroid medication just due to the fact they become hypothyroid.
It's so odd how behind the UK is in treating with T3. Many of the doctors were taught it will cause heart problems and believe it's hard to dose. It's not and will make a world of difference in your energy level.
You will also get the ones that tell you Fre T3 doesn't matter. It's the most important level to test as it shows the active hormone in your blood, plus it will show if you're converting T4 to T3 adequately. Thyroiduk.org has information for recommended providers that will prescribe T3 or NDT if you need a new one. Thyroidchange.org also has recommendations.
The median TSH in women under 40 is 1.3, 95% of women of that age in the research cohort have a TSH between 0.37 and 3.3.
The median TSH for women in their 70s is 1.7, 95% of women of that age in the research cohort have a TSH between 0.39 and 3.7.
Obviously those numbers are based on results from a specific testing kit and a change in the testing kit would give slightly different results. But TSH reference ranges don't vary massively, so the data is still very relevant.
I wouldn't change thyroid medication based on age.
...
There are quite a lot of things that can affect heart rate that have nothing to do with the thyroid.
Based on personal anecdote :
1) Low iron and/or ferritin will raise my heart rate. It doesn't need to be below range to make my heart speed up, just being well below optimal will do it.
2) High blood sugar from binge eating sugary junk will raise my heart rate, sometimes quite dramatically. I'm always working on trying to keep my sugar intake down but I fail fairly often. I'm not diabetic... yet.
3) Magnesium supplements help to calm down my heart. I don't take more than it says on the bottle. There is no point in testing magnesium - most of the body's magnesium isn't stored in the blood so the test result is very misleading.
4) Potassium supplements also help to calm down my heart. I never take more than it says on the bottle, and I really ought to include more potassium-rich foods in my diet. I do know that my potassium levels are well within normal range and I keep tabs on it with testing.
Read some of the replies and good replies, but you may want to consider you have low stomach acid and digestive enzymes... a BetaineHCL with pepsin, and a digestive enzymes too. This is a big reason we have poor absorption of nutrients, stomach acid not only breaks things down but ionizes them for absorption everywhere else in the body as needed...
Low B12 and an MCV (mean corpuscular volume) above 85 would indicate this... MCV is the size of your red blood cells...
Also your Zinc and/or selenium may be low as these are needed for thyroid hormone conversion...
Personally I use the Solgar brand off Amazon hope this helps...
If your FT3 is low, as yours is, and your FT4 is high, as yours is, and the whole purpose of the FT4 is to convert to FT3, why would you then think you need to lower your FT4? You need, if anything, to raise it or add some T3, I would think. Peace be with you.
Apologies for late response as I have only just seen your reply. You are right about my not decreasing my dose. I have learned so much from this forum. Thank you.
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Do I need a medication?
Do I need more t3 or more t4.. or less? 
