Suppressed TSH on medication

[ukap]

I am on Armour 60 and latest blood results still show low free T3 and low free T4 & I would like an increase however my TSH is suppressed at 0.03 (Range 0.40-4.50) My Doctor said she would prefer me to slightly lower armour to try & get TSH in range.

I have read much info here on suppressed TSH but my question is - if you are on NDT will you always have suppressed TSH? - is that just part of the territory?

Some people appear to have TSH in range while on medication so I wondered why do some of us get suppression? Does it mean our dose is too high.

Mr original doctor (a different one to my current Dr.) started me off from the get-go on Armour so I have never taken anyT4 alone such as levothyroxine. I wonder if it is worth giving that a try.

TBH I would prefer my TSH to not be suppressed. Do you have suggestions or has anyone experience adjusting from NDT to T4 only & finding they felt better.

[greygoose]

if you are on NDT will you always have suppressed TSH? - is that just part of the territory?

Yes. And, it's suppressed for a good reason: you don't need it anymore.

TSH is a pituitary hormone, not a thyroid hormone. When the pituitary senses that there's enough thyroid hormone in the blood - T4+T3 - it reduces the TSH because it no-longer needs to stimulate the thyroid to make hormone.

Problem is, when it comes to T3, the pituitary gets served first. So, the pituitary might be well satisfied with the hormone it's getting, even though the rest of the cells aren't getting enough. Which is just one of the reasons TSH levels aren't very good indicators of thyroid status, and shouldn't be used to dose by. Especially not when you're taking T3, then it's the FT3 the most important number.

TBH I would prefer my TSH to not be suppressed.

Why?

If your Frees are both still low, then you are probably under-medicated. And, you say you'd like to increase your dose. You will only get your TSH to rise if you reduce your dose even further, which will probably make you feel even worse. Is that really what you want, for the sake of increased TSH, which doesn't serve any useful purpose?

Whether or not you would feel better on T4 only, is a very personal matter. I felt awful on NDT - went up to six grains and never, ever felt well. But, I felt almost as bad on T4 only. I can only feel well on T3 only. And, quite a high dose, at that. We're all different, and can only find out what suits us best by trial and error. But, it's a risk going from NDT to T4 only. And, if I were you, I'd only take that risk if I was certain I would be able to go back on NDT if the T4 experiment failed.

[pennyannie]

Hello ukcap :

I have switched from T4 to NDT and feel so much better it seems strange I've had to do this myself as I'm unable to access anything other than T4 through the NHS - despite that fact that I have been treated with RAI thyroid ablation and now thyroid less.

In a nutshell - a fully functioning working thyroid would be supporting you on a daily basis with trace elements of T1. T2 and calcitonin plus a measure of T3 said to be at about 10mcg a day and a measure of T4 said to be at about 100 mcg a day.

So without a thyroid I've chosen to replace like with like : NDT contains all the same known thyroid hormones as that of a human gland and is pig thyroid, dried and ground down into tablets, referred to as grains with each grain containing a measure of T3 and T4 :

With NDT you dose to relief of symptoms and not a blood test and certainly not a TSH as it most likely will be low suppressed but this doesn't matter. What matters is getting our T3 to a high enough level in the range for you to feel some relief of symptoms and to restore your health and well being.

Synthetetic T4 - levothyroxine is a prohormone and needs to be converted by your body into T3 the active hormone and just one of the two thyroid hormones that support us daily.

No matter what thyroid hormone replacement you choose it is essential that your strength vitamins and minerals, ferritin, folate, B12 and vitamin D are at good high levels for optimal conversion as your body needs to be able to convert the T4 into T3 which is the active hormone that the body runs on, with the average person said to utilise around 50 mcg T3 daily just to function.

Some people can get by on T4 only, some people take a T3/ T4 synthetic combo ; some people take T3 only : and some people take NDT :

All that really matters is having the options and medical support, if so desired, of finding which thyroid hormone replacement suits you best :