an update on low tsh

[Salsybar73]

i had a phone call appointment with my doctor yesterday eveing, but told me to come and see him today in surgery. he has ordered a parathyroid blood test has a scan on my neck too , has i have a bit of swelling and the bottom of my thyroid. i feel absolutely awful. jitters,can not sleep, tremors in my hands, the headaches are driving me nuts. i feel wired . and he has kept me on 100mcg levothyroxine , is this possible, with my tsh so low. my free t4 is 19 .. the range is 7 to 21. my free t3 is 5.6 range is 3 to 6. he has also ordered my thyroid antibodies too. my body feels so drained, but my head is in overdrive .

[SlowDragon Ambassador]

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

Low vitamin levels are extremely common and tend to lower TSH.

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)

What vitamin supplements are you currently taking?

Do you have autoimmune thyroid disease- Hashimoto’s, diagnosed by high thyroid antibodies?

[Salsybar73 in reply to SlowDragon]

i have rung up to order my bloods. and my appointment is next monday 9am. i am on foreval vitamins and minerals , thankyou for the advice. doctor has nor reduced my levothyroxine is that wise with tsh low.

[SlowDragon Ambassador in reply to Salsybar73]

You don’t want levothyroxine reduced

Does your vitamin supplement contain biotin?

If so you need to stop it now

If it contains iodine you don’t want to be taking it at all. Extra iodine is not good with Hashimoto’s

[Salsybar73 in reply to SlowDragon]

no has no biotin in, or iodine . i can not understand has in 8 weeks mt tsh has gone from 7.2 to 0.02 is this even possible

[SlowDragon Ambassador in reply to Salsybar73]

How long have you been on levothyroxine?

What dose did you start on

How long have you been on 100mcg levothyroxine

Do you always get same brand of levothyroxine?

[Salsybar73 in reply to SlowDragon]

i have been on levothyroxine 7 years, started at 25mcg , then on 50mcg been on 100mcg 2 years . it is always the same brand.

[SlowDragon Ambassador in reply to Salsybar73]

How long have you been taking Forceval vitamin supplement?

[Salsybar73 in reply to SlowDragon]

2 years

[SlowDragon Ambassador in reply to Salsybar73]

So nothing has changed recently

Getting bloods tested on Monday BEFORE changing anything other than stopping your vitamin supplement

[SlowDragon Ambassador in reply to Salsybar73]

Looks like Forceval contains both biotin and iodine

medicines.org.uk/emc/produc...

Suggest you consider looking at only supplementing vitamins that you need depending on what blood tests show

drknews.com/iodine-and-hash...

[Salsybar73 in reply to SlowDragon]

no way omg so its that, that has supressed my tsh .?

[Salsybar73 in reply to SlowDragon]

the doctor put me on forceval

[LECJ in reply to Salsybar73]

Forceval capsules aren’t very high unfortunately in the essential vitamins Mentioned previously

Amongst other supplements I’ve recently been using a vitamin d spray which I find really easy Better than chewable tablets

[Salsybar73 in reply to SlowDragon]

the doctor has ordered the full panel, which i was very shocked because not many doctors do it. plus the parathyroid blood test . my b12 is low, my seum folate is low and so is vitamin d and my ferritin. even though i am on good vitamins and minerals .but why?

[SlowDragon Ambassador in reply to Salsybar73]

GP’s don’t understand vitamins

When hypothyroid low vitamin levels are EXTREMELY common. When hypothyroid we frequently have LOW stomach acid and this results in low vitamin levels

But generally multivitamins are bad idea for anyone with Hashimoto’s

Better to supplement individual vitamins

If vitamin D is low - supplement vitamin D

If folate and B12 are low supplement a vitamin B complex (but still need to stop this a week before ALL BLOOD TESTS as biotin in vitamin B complex can falsely affect test results)

[Salsybar73 in reply to SlowDragon]

thankyou for the information, i will have the forceval taken off my prescriptions asap .and supplement in singulars

[jimh111]

Has he not ordered a calcium level test with the PTH (and ideally vit D)? I would be inclined to skip my levothyroxine for a couple of days and then switch to 50 mcg (half a tablet) just to see if it works. You may be on too much levothyroxine.

(I'm a patient not a doctor).

[Salsybar73 in reply to jimh111]

i had my serum adjusted calcium done and its 2.67 that is why he is doing the full panel and my parathyroid. so i do not know if i am hyper or hypo now. i am certainly in overdrive my brain hurts

[jimh111 in reply to Salsybar73]

I think this calcium level is a little high, hence the PTH test. High calcium can cause symptoms also.

[Salsybar73 in reply to jimh111]

yeah, got told today off my doctor that it can cause havoc in my body, can too much calcium

[Partner20 in reply to Salsybar73]

I haven't got the range for serum adjusted calcium to hand, but this is the reading that is taken note of, and can flag up parathyroid issues, which are, of course, not the same as thyroid conditions. Calcium supplementation can be damaging for anyone if not needed, as can iodine for people with thyroid conditions. Biotin in supplements will not affect your thyroid, but can skew the blood tests done. You seem to be getting a wide range of testing done, and your GP appears quite thorough, so hopefully you will be getting some answers soon.

[Pippah45 in reply to Salsybar73]

You are not Hyper as long as your T4 and T3 are in range. Your Vit and Min levels need to be optimal for you to feel well.

[Sammie48]

You really need to see an endocrinologist as your gp is not qualified to determine what your condition is

[Teras]

A Parathyroid test is completely different test from a thyroid test. Misfiring parathyroids can make you feel pretty badly. I know, I had hyperparathyroidism. Is it parathyroid he tested you for? You have 4 parathyroid glands that are attached to your thyroid.

[Sewit1]

Go by how you feel too. If you feel wired and are not sleeping it’s possible you’re over medicated. Without sleep you cannot think straight.

[LittleHil]

I had very similar symptoms to you in May of this year and ended up in A&E with palpitations. The upshot of this was my thyroxine dose was reduced as the TSH had become suppressed. Since then, I am much better. I'm not a doctor but agree with several others posting here that maybe your dose of thyroxine should be reduced initially. Hope you feel better soon.

[Batty1]

Are you taking Any new medication thats not thyroid related?

[msb44]

At the moment you may have two separate problems. With hyperparathyroidism your calcium may be high, and your Vitamin D low. You may have even more fatigue than usual, and bone pains. The mantra is "stones and bones, groans and moans." For more info, check parathyroid.com, an American site.

For thyroid issues, this forum (I believe, in my humble opinion) gives you more detailed information than one gets from most doctors.

Should you need parathyroid surgery, once done properly, it's done, and doesn't repeat.

Thyroid issues need to be dealt with the rest of one's life.

[vocalEK]

Several people have suggested lowering your levothyroxine dose. I disagree. A low TSH does NOT necessarily prove hyperthyroidism. Your doctor is already suspicious of the parathyroid glands as the potential cause of your symptoms. You also have low levels of important vitamins. Lowering your dose of medication will lower your thyroid hormone levels. The odds are you will become much more ill, and it will be difficult to get doctors to put your thyroid medication dosage back up where you need it to be.