Suppressed TSH but overweight

[Shug1974]

Hi, was wondering anyone on this forum experiencing Hypothyroid symptoms like being overweight, fatigue, belly bloat and constipation despite having a suppressed TSH?

[SlowDragon Administrator]

Looking at previous posts

Are you still taking levothyroxine and T3 ?

On almost any dose of T3 TSH will be suppressed, even when under medicated

Do you have Hashimoto’s?

Just testing TSH is completely inadequate

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies

Ask GP to test vitamin levels

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)

If/when also on T3, make sure to take last third or half of daily dose 8-12 hours prior to test, even if this means adjusting time or splitting of dose day before test

Is this how you do your tests?

What vitamin supplements are you currently taking

When were vitamin levels last tested

are you on strictly gluten free diet.

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

thriva.co/tests/thyroid-test

Blue Horizon Thyroid Premium Gold includes vitamins

bluehorizonbloodtests.co.uk...

[Shug1974 in reply to SlowDragon]

Thank you for the quick response. I had stoped taking the T3 three weeks before having blood test done and my T4 medication was reduced anyway due to my suppressed TSH levels but my blood test results still came back suppressed. My Endo will not believe me when I tell him I feel awful when my T4 medication is reduced. Been back and forth. One endo refused to see me and discharged me with a nasty letter because my TSH levels were suppressed, saying I am causing more harm to my self by taking T3. I have been diagnosed with a low Vitamin D levels in the past and have been supplementing this on and off but they don't test for this any more. I have had a right thyroidectomy due to a benign tumour. I also have conns syndrome bilateral with a benign tumor on the right adrenal. They will not test my vitamin levels. I am not sure I have been tested for Hashimoto's. I might get my Vitamin levels checked privately, thanks for the recommendation!

[SlowDragon Administrator in reply to Shug1974]

A suppressed TSH is frequently irrelevant on levothyroxine and especially if taking T3

TSH rarely moves after being suppressed for a long time and certainly would take minimum of 8 weeks to react at all

Testing after three weeks too soon ...though if testing Ft3 and Ft4 likely to be rock bottom

Suggest you email Dionne at Thyroid UK for list of recommend thyroid specialist endocrinologists who will prescribe T3 and have better understanding of what to expect

NHS list and private list

[e-mail]

Essential to test all four vitamins regularly

We frequently need to supplement virtually continuously to maintain optimal vitamin levels

[Batty1 in reply to Shug1974]

Here's your problem "Thyroidectomy" are you menopausal? How much T4 are you on? Did you have partial or full thyroid removal?

[Shug1974 in reply to Batty1]

Hi, my right side of my thyroid has been removed and yes I am having problems with my period where I have had only 4 days of period last year and only 1 day in January.

[Shug1974 in reply to Shug1974]

100mg of levothyroxine.

[Batty1 in reply to Shug1974]

I just read what I typed earlier today... good grief that was painful to read...lol

Could you be in menopause?

I find that having a Suppressed TSH hasn’t helped me with weight loss at all maybe weight gain (nightmare). I think this is a huge misconception for most of us without a thyroid.

I still say menopause and being thyroid-less creates the perfect hormonal storm.

[Lalatoot]

Yes. It is likely to mean that your levels are not optimal for you. TSH is not an ideal measure of thyroid function. It needs to be looked at along with FT4 and FT3 levels as they are the thyroid hormones. It is problems with the levels of the thyroid hormones that cause symptoms rather than TSH.

[Shug1974 in reply to Lalatoot]

Thankyou for your reply. I am afraid from what I have seen and been told by many Dr's and Endocrinologist they are going by my suppressed TSH. My Dr has arranged for me to see the Endocrinologist again and I am worried that my T4 levels are going to be reduced further as my Dr says I should really be on a lower dose of T4.

[Hidden in reply to Shug1974]

Are you taking a statin as they are known to suppress your TSH?

[Shug1974 in reply to Hidden]

Hiya, no I am not taking Statins.

[Shug1974 in reply to Lalatoot]

Hi, thanks for your reply. I know but how do I make my Endocrinologist and Dr to understand this fact?

[pennyannie]

Hello there Shug1974 :

In short - yes :

The TSH was originally introduced as a diagnostic tool to confirm through a blood test that the symptoms experienced by the patient might be because of hypothyroidism.

Once on any form of thyroid hormone replacement a TSH needs to be used alongside a T3 and T4 reading for it to have any bearing on your level of medication.

Sadly it does appear that T3 and T4 blood test are not actioned as routine and many of us have fallen down the insidious slippery slope into hypothyroidism due to the TSH being the only blood test actioned. Many of us, having our dose of Levothyroxine reduced so to fit into the range, irrespective of our symptoms, and then get prescribed anti depressants, or a variety of other drugs, rather than the doctor bothering to look further into our initial diagnosis and the full treatment options for an optimal outcome.

I'm with Graves where it is known that the TSH is an unreliable marker of anything :

After RAI ablation and a swift discharge back out into primary care I was only ever dosed and monitored on a TSH reading and my dose of Levothyroxine adjusted so to fit in within the range irrespective of how ill I was feeling.

After 10 years and declining ill health and then learning from this amazing website I requested a T3 and T4 blood which was reluctantly agreed upon if I paid for it.

The hospital sent me an invoice for the 2 blood tests at just over £34 with the results being sent to my doctor.

I grovelled again and was told I was lucky to have any T3 at all, and that at only 25% through the range, it was ok : although my T4 was running at 80% :

This at least forced the issue of a small increase in Levothyroxine and a referral to an endocrinologist, and by the time I saw this specialist, thankfully, my T3 had risen, my brain had started to function, I wasn't loosing words, and could hold a some sort of conversation again.

The endocrinologist refused my request for a trial of T3 as my TSH was by then suppressed and I was told I was overmedicated, to back down on my Levothyroxine dose, back down to 100 mcg daily, and I was discharged back out primary care., and myT3 then, just 55% through :

So what am I saying ?? : even with an obvious imbalance of thyroid hormones there is no guarantee you get any better medical help or advice and since these additional blood tests, to aid my recovery only cost about £1.00 each to process - the postage stamp and the cost of typing the invoice cost the most.

I have gone on to self medicate and feel so much better, as the stress in trying to get better in the most obvious way, exacerbated my symptoms, making me more ill than need be.

[ZoBo in reply to pennyannie]

How much are you taking self medicating?

[pennyannie in reply to ZoBo]

I'm with Graves and have had my thyroid ablated with RAI in 2005 and became very unwell in around 2014. I'm now taking 1 + 1/2 grains NDT and probably run a little under medicated but I'd rather that to hyper symptoms.

I don't think it actually helps comparing oneself to another - we are all different and coming from different situations with differing health issues.

I do maintain my vitamins and minerals at optimal levels for maximum conversion of my thyroid hormone replacement.

[Shug1974 in reply to ZoBo]

Hi, I am only taking the prescribed dossage of 100mg Levothyroxine but when I spoke to my Dr he says I should really be on a lower dose due to my TSH levels.

[HLAB35]

I'd pursue a new doctor who goes by clinical presentation of symptoms rather than just relying on one unreliable indicator. Your low TSH could mean you have a pituitary issue or central hypothyroidism which most doctors haven't a clue about. Alternatively you may still have Hashi's, but have a suppressed TSH due to other factors. Low vitamin D is worrying. Dr Hillary on GMB was saying that we should all be supplementing it to improve our immune response to viruses. Get that test done asap and post results when you get them.

[jigaloo]

Yes I do and it’s never been stable since diagnosed and on Thyroxine !

[AlisonL]

TSH is useless when taking T3. Mine has been suppressed now for 10+ years and unlikely to ever change, even if I stopped the T3. The best thing you can do is to find a doctor who accepts that TSH is not useful for you, and to look at your free T3 and T4 results instead.