I went for a check up on yesterday and my GP wasn't there so, I end up seeing a NP . She looked over my lab work from Feb and told me that my t4 level was normal and so was my t3. However, my tsh was low. I have never understood how these level work, I just can't process it for nothing. I learned today that when your tsh levels are low, you're on to high of a dose of levo. I know when I go back for my next visit my GP is going to lower my dose which is scary but for the betterment of my health. My question is this, does it mean I will gain more weight when my dose is lower? It is so strange but the only symptom I have from being hyperactive is a HUGE appettie. I can't control it, and it's making me gain so much weight. Back in Feb, my GP added a small amount of t3 that was suppose to make me feel better and help me to lose some of the weight gain, sadly to say it didn't help in no way. The one thing it did do was made my appetite go over the roof even more. At this point in my life, I really don't know what to do to solve the joint pain, weight gain and soooooo much more . This disease is horrible. But, nevertheless, I try to do my best with the help of the Lord. Any advice you give, will be greatly appreciated.
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By the sound of it, the NP doesn't understand it, either!
Heres a brief explanation of how it works:
The thyroid makes two hormones: T4 and T3.
T4 is basically a storage hormone. T3 is the active hormone that causes symptoms if it is too low or too high.
TSH - Thyroid Stimulating Hormone - is a pituitary hormone.
When the pituitary senses that there isn't enough thyroid hormone in the blood, it increases its output of TSH.
When the pituitary senses there's enough thyroid hormone in the blood, it reduces its output of TSH, because you don't need it.
That's how it works in a euthyroid (normal) person.
The problem with being hypo, though, is that you need more exogenous (coming from the exterior/levo, etc.) hormone than a euthyroid person needs endogenous (coming from the inside, the thyroid) homone. So, the TSH tends to become suppressed although the T4 and T3 levels are still in-range.
The suppressed TSH does not mean you're over-medicated - and certainly does not mean you're hyper, which is a physical impossibility! - by itself it doesn't mean anything at all.
The most important number is the FT3, the active hormone. So, if that is still in-range, you are not over-medicated, and your dose should not be reduced.
TSH is, as I said, not a thyroid hormone. Therefore it should not be used to dose by. It is just a chemical messenger from the pituitary to thyroid, and is only useful for dosing if it is high. Once it gets below 1, it doesn't give any useful information. Not enough to dose by, anyway. It doesn't cause symptoms, and it doesn't have any effect on anything except the thyroid and the convertion of T4 to T3.
Back in Feb, my GP added a small amount of t3 that was suppose to make me feel better and help me to lose some of the weight gain, sadly to say it didn't help in no way.
In that case, he didn't add enough T3. It's not just the act of taking T3 that helps, it's taking enough of it.
Or, perhaps you didn't really need it. Do you have the exact numbers: results and ranges of your blood test? If so, post them here. If not, ask at reception for a print-out - you are legally entitled to one.
At this point in my life, I really don't know what to do to solve the joint pain
Joint pain is very often due to low vit D. Hypos are very often low in vit D - and other nutrients - due to having low stomach acid, which means they cannot digest their food properly, and therefore can't absorb nutrients. Ask your doctor to test for vit d, vit B12, folate and ferritin. He won't understand the results, so get a print-out and post them on here - with the ranges - and people will help you understand and supplement.
A fully functioning working thyroid would be supporting you on a daily basis with approximately 100 T4 + 10 T3 : and it is good that your doctor has introduced T3 into the medication but it probably now needs for the T3 and T4 to be dosed and monitored independently to bring both these vital hormones into balance and to give you an acceptable level of well being.
When on any form of T3 the TSH drops down to a low suppressed number and this doesn't matter - what does matter is where you T3 and T4 are within the ranges and it is T3 that causes the symptoms, too high a T3 gives you symptoms of hyperactivity and too low a T3 gives you symptoms of hypothyroidism.
Levothyroxine - T4 is a storage hormone and needs to be converted by your body into T3 which is the active hormone that the body runs and I read read most people use about 50 T3 daily, just to function.
Your own ability to convert the T4 into T3 can be compromised if you do not maintain ferritin, folate, B12 and vitamin D at optimal levels so this is another area that needs looking into, and though you may be said to be in range, all this means is that the doctor isn't obliged to medicate, but this doesn't mean that you don't need to supplement yourself.
The thyroid is a major gland responsible for full body synchronisation, including your physical, mental, emotional, psychological and spiritual wellbeing, your inner central heating system and your metabolism.
I take it you are not in the uk as currently GP's aren't allowed to initiate prescribing T3 and we need to be referred to endocrinology - resulting in most of us on this platform having to source thyroid hormone replacement ourselves as the price of T3 within the uk has risen exponentially compared to elsewhere in the world.
Important to regularly retest vitamin D, folate, B12 and ferritin too
Come back with new post once you get actual results and ranges
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 as you had Hashimoto’s prior to thyroidectomy
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?
Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins
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