Hi i’m new to the forum but have had under active thyroid for 20yrs i’m afraid to say i’ve never really looked into it until now i put on 3 stone 20yrs ago and can’t shift it and basically i’ve just put up with it!
I’m on 150 levo and my dr wants to drop me down but i’m so scared i will put on more weight i said no i wouldn’t do it so he’s ordered a battery of test but i know next week when i talk to him he’s still going to drop me down 😢
i’m active i run on average 15/20 miles a week and walk about the same i don’t really drink but will admit i can binge on treats occasionally 😬
Serum TSH level (XaELV) 0.13 miu/L [0.35 - 4.5]
Below low reference limit
Patient stated to be on thyroxine.
Comment: Optimum TSH for patients on thyroxine is within the reference range. Information about this test
i can see i’m below limit but i’m still always tired and my hair is a constantly falling out
can anyone give me some pointers please 😊
Written by
M0t0
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So your TSH is low. So what? TSH isn't a thyroid hormone, it's a message to the thyroid from the pituitary. What you need to know is how your actual thyroid hormones are doing. Your doctor ought to test free T4, the inactive thyroid hormone, but has probably never got around to testing free T3, the active thyroid hormone, needed in every cell in your body. You are only over-medicated when your free T3 goes over-range.
I'd say you are likely under-medicated - and need more levo - but to know for sure you need proper blood testing. You will see lots of posts here about private testing if your GP won't do what you need. A full suite of tests would be: TSH, free T4, free T3, thyroid antibodies [if you haven't had these done before] and key nutrients - ferritin, folate, vit D and B12, as your levo works best when these are nice and high.
You should have an early morning, fasting blood test, 24 hours after your previous dose of levo. And to make the best of the levo you are on at the moment, you should take this on an empty stomach - 2 hours after or 1 hour before eating or drinking anything except water.
What vitamin supplements are you currently taking, if any?
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
Do you know if you have autoimmune thyroid disease, ever had thyroid antibodies tested??
Ask GP to test all four vitamin levels
Or get FULL Thyroid and vitamin testing privately
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
Medics are poorly educated and consequently afraid of matters thyroid. That's why there are over 100,000 people on this site looking for answers that their medics failed to find....in truth, that their medics failed to look for!
You need comprehensive thyroid tests,, the results of which will help members evaluate your thyroid status.
Following a diagnosis TSH is worth diddly squat! It is a pituitary hormone
You need FT3 and FT4 tested but medics rarely test FT3 these days which is why many of us have private tests. Shocking this should be the case but it is our only option, beating down surgery doors doesn't seem very effective either!!
TSH, FT4, FT3, folate, ferritin, vit D, vit B12 and antibodies
Info can be found in the website above
Without numbers it is impossible to even guess what your problem is.....with numbers(including ref ranges in brackets) members can begin to analyse your thyroid health
Unfortunately, even if the doctor orders an FT3 test along with FT4 and TSH, the lab is unlikely to do the FT3. You might have to get blood tests done elsewhere to check FT3 is in range.
Being over medicated doesn't necessarily help weight loss. For me it doesn't help. The best thing I've found is going gluten free, low carb, following the diabetes societies advice for low carb. I'm not diabetic but blood tests have shown an improvement into a lower range for diabetic markers which is more healthy so I'm not worried about weight.
I don't gain or lose weight even with reducing or increasing thyroid meds. My TSH rose to over 11 on one occasion and it made no difference to my weight. So, we're all different and there might be a range of factors influencing weight gain or loss. I wouldn't be in a hurry to reduce thyroid meds if you feel well.
The fact that your hair is falling out suggests low nutrients like iron. Hopefully the blood tests will reveal any deficiencies.
Edited:
One more bit of take it or leave it advice. If you don't want your med dose changed focus on the fact you feel well (if you do) when you speak to the doctor. Don't focus on weight gain or loss. I think Dr's think we're all obsessed with weight so it might not help your argument.
If not feeling well it might be low nutrients common with thyroid disease.
Hi MOtO, in a rush at moment so cant reply properly , but if you can be bothered to wade through it , my profile has all my blood test Tsh results over years. and a sorry tale of allowing GP to reduce dose when feeling well because he as so concerned .
Followed by him letting me put it back up again.
TSH 'risks' dont start till <0.03 , and even then risks for heart dysrythmias are greater with TSH over 4.
You may find your GP talking about risks to your heart and osteoporosis, when you have next appointment . I hope the following is useful to stand your ground with GP.
In your case M0t0 Your TSH of 0.13mUI/L is comfortably within the LOW but not suppressed category ** of this study, showing NO increased risks . This study (below) is accepted by the NHS, in fact they use it as part of the NICE evidence base to show that out of range TSH has risk's, but they cherry pick which parts they mention and so GP's don't know the details unless they do their homework and read the full result's of this study for themselves..
"Serum Thyroid-Stimulating Hormone Concentration and Morbidity from Cardiovascular Disease and fractures in Patients on Long Term Thyroxine Therapy"
Journal of Clinical Endocrinology and Metabolism ,Volume 95 ,Issue 1, 1 January 2010.
'In summary, patients on long term T4 with either an increased serum TSH (>4mu/L) or a suppressed TSH (<0.03mu/L ) have an increased risk of cardiovascular disease , dysrythmia's , and fractures, when compared to patients with a TSH within the laboratory reference range.
**Patients with a LOW but not suppressed TSH (0.04 - 0.4 mu/L ) had NO increased risk of these outcomes in this study"
"All patients in Tayside ,Scotland taking T4 (n=17,684 ) were included ,using data linkage from regional datasets between 1993 and 2001".
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