Suppressed TSH- what does it mean?: My doctor... - Thyroid UK

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Suppressed TSH- what does it mean?

Mselk profile image

My doctor said that my now v low TSH is indicative of my taking my meds for hypo infrequently. Is this true? i’ve been taking metavive 2 120mg every day for 3 months- consistently every morning, though not at the same time exactly but last week - a few days before my blood tests i started getting crazy palpitations every day. i’ve since stopped taking anything andhave levelled our. T3 and T4 now in normal though lowish range. What other reasons could there be for suppressed TSH?

Many thanks

23 Replies

I don't see how it could be true. If you weren't taking your hormone regularly every day, your TSH would rise and you'd become more hypo. Usually, when the TSH drops that low, doctors accuse their patients of abusing thyroid meds by taking too much - as if anyone would want to do that!

A low TSH on its own doesn't tell you very much at all, except that the pituitary is either satisfied with the amount of thyroid hormone in the blood, or that the pituitary isn't working properly. You therefore have to consider the three readings together: TSH, FT4, FT3. Do you have the exact numbers for those three tests: results and ranges?

I think your doctor is either telling porkies, or he hasn't quite understood how it all works. Either one is a possibility! :)

Mselk profile image
Mselk in reply to greygoose

Thanks for your response grey goose.

my TSH is right down from 6.7 (0.27-4.20). to under 0.2....

free T4 was 11.3 (12-22)

now 14

free T3 3.6 (3.10-6.8)

now 5.3

Mselk profile image
Mselk in reply to greygoose

maybe i’ve been taking too high a dose? as indicated by the palpitations that came on?

greygoose profile image
greygoose in reply to Mselk

There is nothing in those numbers to say you're taking too much. Palpitations do not necessarily indicate over-medication, either, because they can also be a symptom of under-medication. And, it's quite possible that you need your FT3 higher than that. It's only just over mid-range. :)

Hello Mselk

Well as you were taking Metavive did your doctor know this fact ?

Mselk profile image
Mselk in reply to pennyannie

yes he did know and he told me it was full of other pig proteins and i should stick to levo even though he is very much an integrative doctor/gp/acupuncturist .

Full results were:

my TSH is right down from 6.7 (0.27-4.20). to under 0.2....

free T4 was 11.3 (12-22)

now 14

free T3 3.6 (3.10-6.8)

now 5.3

pennyannie profile image
pennyannie in reply to Mselk

Well your T3 result looks much better but your T4 has gone up a little.

But then you were experiencing some palpitations so stopped the dose completely.

I think go back and slowly build to a level just under where you were before and if all ok, wait 6 weeks for the hormone replacement to bed in, and then, do a blood test just for yourself , and see where you are in all this.

Maintaining ferritin, folate, and vitamins D and B12 at optimal levels will improve your chances of converting the T4 into the T3. which is the active hormone the body runs on.

However the comment on the TSH is a throw away line, when there's nothing sensible to say :

The TSH was original introduced to be used as a diagnostic tool to diagnose hypothyroidism. It was never intended to be used when on any thyroid hormone replacement, let alone in isolation, which seems to be the current ' norm ' .

Mselk profile image
Mselk in reply to pennyannie

got you. thanks. so TS4 should go up more ideally?

pennyannie profile image
pennyannie in reply to Mselk

No, not necessarily as T4 needs to be converted by your body into T3 as it is low T3 that gives you hypothyroid symptoms.

Your conversion of T4 into T3 will improve if your ferritin, folate, and vitamins D and B12 are maintained at optimal levels.

The ranges were designed to be used in conjunction with Levothyroxine :

SlowDragon profile image
SlowDragonAdministrator

GP prescribed levothyroxine in earlier post

healthunlocked.com/thyroidu....

Standard starter dose of levothyroxine is 50mcg ...dose is increased slowly upwards

As said in previous post....levothyroxine is the easiest option to start on.

Bloods should be retested 6-8 weeks after each dose increase in levothyroxine

Dose is increased slowly in 25mcg steps

Most people eventually need to increase slowly upwards until on around 1.6mcg levothyroxine per kilo of your weight

You can’t rush it ....

Essential to test vitamin D, folate, B12 and ferritin regularly and they all need to be at optimal levels

Metavive will suppress TSH...It’s inevitable

If taking Metavive you would need to do FULL private thyroid testing 6-8 weeks after each dose increase

Mselk profile image
Mselk in reply to SlowDragon

Hi slowdragon, thanks for responding. yes they prescribed levo. i’ve since been supplementing and slowly increasing metavive them all of a sudden the palpitations case on. my vitamin D is within range but low- 80something. folate and b12 fine. they are happy to keep taking my bloods at the gp.

SlowDragon profile image
SlowDragonAdministrator in reply to Mselk

Sent you a private message

SlowDragon profile image
SlowDragonAdministrator

It will take 8-12 weeks for a TSH to respond to stopping any thyroid hormones

The use of the term 'suppressed ' to describe tsh is thrown around with wild abandon by doctors! and means different numbers to different people in different contexts, with different (or no )idea what they mean by it. So beware!

As i understand it (!) , a test that shows [0.27-4.20] as its range will be capable of measuring accurately down to much below the lower lab ref range[0.27]

So when you say 'under 0.2' , how was that written on the actual results ? <0.2 ? which could ? mean 0.0 which is suppressed (in my understanding). Or was it something different ?, or was it how the doctor described it to you verbally ?

There is a long way difference between 0.0 and 0.2 in the context of TSH and lots of people spend years in the 0.0# range without problem .

Regarding your doctors suggestion of low TSH/ missing meds, either;

a) they have got muddled about what goes up and what goes down ! or,

b) they are just reading line 1 of 'Thyroid for Dummies' (GP version) ,which invariably suggests 'check patient compliance', when faced with an unexpected/ dont know what it means result.

In either case i would be tempted to 'check GP knowledge' :)

Also (just to be awkward ,sorry SlowDragon) , tsh has been known (once , by me) to rise much quicker than 6 weeks even from as low as 0.05 for years. But in general, i agree , it can lag behind actual events by weeks.

Mselk profile image
Mselk in reply to tattybogle

Yes as you said <0.2 and i imagine i have to go private to get this further broken down...? so we want TSH to be low but not suppressed? i’m still trying to get my head around what is optimum x

tattybogle profile image
tattybogle in reply to Mselk

My NHS results regularly record tsh as low as 3 decimal places ie 0.061, 0.046 etc even 0.018 once [0.34-5.6]. i've only had '<0.05' a couple of times ,years ago , when i thought the machines didn't have the accuracy to measure low ones, which has improved now i believe .

So i cant figure out if your TSH is really suppressed or not i'm afraid .

But i do agree with pennyannie's advice re. how to proceed now. I wouldn't see any need to worry about TSH at all in the short term , i believe all the concerns about suppressed TSH,(as long as not accompanied by over-range FT3) are to do with Long Term timescales , not a few weeks, so i would follow the advice above and re.test after 6 weeks on stable dose of slightly less than before.

And Keep Researching.... Until you know more than your GP about thyroid hormones T4/T3/NDT History of thyroid treatment , HPT Feedback loops ,and autoimmune disease or whatever you have that caused you to need replacement. Even TSH and 'risks'. (but i suggest you learn the rest first:) )

It probably wont take as long as you think !

I have suppressed TSH too and it too me ages to find a good endo who understood this. She gave me lots of tests for cortisol, adrenals, etc. I have a dysfunction with the HPA thyroid axis. TSH is irrelevant for me. My doctor says it's most important to make sure that T4, FT4, T3, and FT3 are functioning properly and that my weight stays static. So many endos are tied to TSH without really understanding what it does and does not. For me the best thing that ever happened was NDT and a good endo who wasn't lazy.

Mselk profile image
Mselk in reply to Debon

ok. amazing. was that a private endo?

Debon profile image
Debon in reply to Mselk

Yes. I don't live in the UK, I live in Argentina. I went to probably 15 endos before I found one that would listen to me. I had one Endo say "Juggling hormones is too complicated." BTW my TSH is 0.01. Best of luck to you.

There's a mention of "pig proteins" earlier in this thread, as if a doctor found that horrifying. As a meat eater I regularly swallow "pig proteins", "cow proteins", "sheep proteins", whenever I eat pork chops or bacon, steak, and lamb chops. They haven't done me any harm.

The other comment I have to make is that doctors use heart valves from pigs in treating human heart problems, and they've been doing it for quite a long time. So the doctor mentioning "pig proteins" was using stupid scare tactics, that as far as I'm concerned just make him sound like an idiot.

Mselk profile image
Mselk in reply to humanbean

lol. appreciate your perspective. getting a second opinion on monday :-)

No, that's completely wrong. A high TSH would indicate (most likely) undermedication or a failure to take your meds regularly (aka "blame the patient"). It sounds as though this doctor knows nothing about the thyroid. Low TSH is very common when taking meds containing T3. Since it is not a thyoid hormone is just means that the pituitary gland does not see the need to (or cannot) signal the thyroid to make more hormones. If your actual thyroid hormones are low in range, it probably means you need a dose increase regardless of TSH. Post your full results with ranges and people will comment

Full results were: from 6 months ago

my TSH is right down from 6.7 (0.27-4.20). to under 0.2....

free T4 was 11.3 (12-22)

now 14

free T3 3.6 (3.10-6.8)

now 5.3

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