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
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! 
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
your results are quite similar to mine. Are you still struggling with lack of energy? I can work full time but it's a struggle and just glad I'm based at home. I am desperate to have my social life and exercise back though. I had this on metavive. I am concerned about my TSH being 0.01. I'm led to believe this is dangerous. If I lower my meds my T4 my TSH will improve but my T4 will be under the normal range. No idea what to do now..
maybe i’ve been taking too high a dose? as indicated by the palpitations that came on?
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 ?
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
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 ' .
got you. thanks. so TS4 should go up more ideally?
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 :
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
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.
Sent you a private message
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.
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
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.
ok. amazing. was that a private endo?
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.
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
Hi, I am having a similar issue... and at my wits end as I am still shattered most days and I don't do much.
I was on metavive for 2 years. Finally got my life back!!!!However, towards the end, I was taking too high a dose (nearer 300mg daily as I was having to gauge myself what dose to be on. All was well until I was biking one day and I realised my heart rate was reaching 200bpm. Slightly alarming. Therefore, I came off metavive and reverted back to my GP (who I gave up on previously).
My GP finally accepted I had an under active thyroid after having 2 months off metavive. A very tough 2 months of no energy. This past year I've been now been juggling levothyroxine and now T3 as seeing an now too endocrinologist. I am still at a loss.
TSH 0.01, T4 normal but very low end of the range and T3 average. I am still struggling with low energy. I just had my pituitary tested and all seems fine there. I am tempted to revert back to metavive but take a lower dose. Just hard when GP's won't allow me to revert back to metavive and no one else can advise or test me re what dose to be on. Just a bit concerned about my very low TSH. Having to manage this myself is scary. I am not a Dr. Reached a cross roads really..
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