Hi guys
My blood test tsh result is 0.05, the other levels, vits etc are norm, was taking 100mcg thyroxine for over a mont and previously fluctuating amounts and my hair was coming out constantly, now the gp told me to lower it to 100 and 75 alternate days which I was on before and I wasn't feeling that bad. I have Hashi and the symptoms are hell! Can anyone advice pls?
Dose of levothyroxine shouldn’t be adjusted on just testing TSH
Request FULL thyroid and vitamin testing before reducing
Especially as you have Hashimoto’s
For full Thyroid evaluation you need TSH, FT4 and FT3 plus tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12
Low vitamin levels are extremely common, with Hashimoto’s
Ask GP to test vitamin levels and retest Thyroid including Ft4 and Ft3
Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .
Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)
Is this how you do your tests?
Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins
List of private testing options
thyroiduk.org/getting-a-dia...
Medichecks Thyroid plus ultra vitamin
medichecks.com/products/thy...
Medichecks often have special offers, if order on Thursdays
Thriva Thyroid plus vitamins
Blue Horizon Thyroid Premium Gold includes vitamins
bluehorizonbloodtests.co.uk...
What vitamin supplements are you currently taking?
Dr said the T3 cannot be done and upon request would be sent back! My vit levels are all norm, and also taking all the necessary vits for Hashi and also had a fasting test and didn't take my thyroxine prior to the test. I am due to see an endocrinologist in August but they don't do any tests just change the dosage :((
Then like thousands on here you need to test yourself privately
Come back with new post once you get results
Likely to see low Ft3
When were vitamin levels last tested?
Can you add actual results and ranges
I had them all two weeks ago or so, have to get them printed out though thank you for your help
Come back with new post once you get results
Often they are within range, but not optimal
NHS only tests for deficiencies
Are you on strictly gluten free diet?
No it's very hard as I am not keen on eating meat and fish regularly prefer vegetables
Then likely low B12 and ferritin if virtually vegetarian .....unless supplementing
They are all low
Then you need to supplement to bring all to optimal levels
Low vitamins leads to low TSH
Then GP (only looking at TSH) lowers levothyroxine dose ...then vitamins drop further and dose gets reduced further and further
We see that circle of events regularly on here
On levothyroxine we frequently need to supplement virtually continuously to maintain OPTIMAL vitamin levels
Vitamin D at least around 80nmol and around 100nmol maybe better
Folate at least over ten
Serum B12 at least over 500
Active B12 over 70
Iron and ferritin are complex and may need full iron panel test by GP for anaemia....depending on how low ferritin is
Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption
Links about iron and ferritin
irondisorders.org/Websites/...
drhedberg.com/ferritin-hypo...
This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.
So taking 100mcg is better than alternate days? As my tsh is 0.05 which they say is very low
TSH is not a thyroid hormone...it’s the message from pituitary
On levothyroxine the most important results are ALWAYS FT3 followed by Ft4
First step is to get TSH, Ft4 and Ft3 tested privately
ALWAYS do all thyroid tests as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test
Come back with new post once you get results
You need to get thyroid test BEFORE you reduce dose
Otherwise you would need to wait 8-10 weeks before testing
Do you always get same brand of levothyroxine at each prescription?
Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,
"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.
In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l.
Most patients will feel well in that circumstance.
But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.
This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."
You can obtain a copy of the articles from Thyroid UK email print it and highlight question 6 to show your doctor please email Dionne at
tukadmin@thyroiduk.org
Low TSH no heart issues
academic.oup.com/jcem/artic...
In summary, patients on long-term T4 with either an increased serum TSH (>4 mU/liter) or a suppressed TSH (<0.03 mU/liter) have an increased risk of cardiovascular disease, dysrhythmias, and fractures when compared with patients with a TSH within the laboratory reference range. Patients with a low, but not suppressed, TSH (0.04–0.4 mU/liter) had no increased risk of these outcomes in this study.
Thank you will do
p.s. Dr Toft is physician to the Queen when she's in Scotland. Dr Toft also made the following statement:-
Yes I take Mercury as I don't get on with Teva
I used to run regularly still trying to do pilates but I have 0 energy, tired and sleep also my glucose levels are 46 borderline diabetic although I don't eat sugar levels still won't go low
My results are norm sorry typo error
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