What TSH level is considered optimum for Hypo on Levothyroxine?
My GP has altered my Levo after a recent blood test and I am unsure that he genuinely understands Hypothyroid.
So my TSH was 20 in March on 150mg. Dropped to 9 in April - this was a blood test done in Resus whilst I was being cardioverted for 200 heart rate (7th event in 4 years) and this result was only known to GP when I referred to it last Friday In a telephone consult.
Another GP increased Levo from 150 to 175 in May using March result of 20.
Latest bloods showed TSH was 0.9.
I have asked for wider thyroid tests to be done for last 4 years. always refused either by GP or lab technician on 1 occasion.
So they just test TSH.
Can anyone enlighten me as to best levels for hypo on Levo? I am sure I read somewhere that being on Levo there is a certain level considered optimum but I can't find that reference now.
Thank you
Molly
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MollyMoo53
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Which brand of levothyroxine are you currently taking
Many people find different brands are not interchangeable
Do you always get same brand at each prescription
What vitamin supplements are you currently taking
What’s reason for your hypothyroidism. Thyroidectomy, RAI or Autoimmune hypothyroid
Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine
For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested.
Very important to test vitamin D, folate, ferritin and B12
Low vitamin levels are extremely common, especially with autoimmune thyroid disease (Hashimoto’s or Ord’s thyroiditis)
Low vitamin levels common as we get older too
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 and last dose levothyroxine 24 hours before test
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)
Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins
If TPO or TG thyroid antibodies are high this is usually due to Hashimoto’s (commonly known in UK as autoimmune thyroid disease). Ord’s is autoimmune without goitre.
About 90% of all primary hypothyroidism in Uk is due to Hashimoto’s. Low vitamin levels are particularly common with Hashimoto’s. Gluten intolerance is often a hidden issue too
TSH needs to be around 1.00 ish. It should never be above 2.5.
A healthy persons thyroid is normally around 1.00. This was explained to me by my private only Endocrinologist. TSH of 1.00 is what to aim for or thereabouts.
You are right though and need your TSH, T4 and T3 tested at the same time. Levothyroxine T4 sits in your body waiting to be converted to the most important hormone T3. Some people are poor converters to T3. I’m one of them. It’s extremely important to have a good level
of T3. NHS don’t want to test T3 as they might have to prescribe Liothyronine T3 which was put on a drop list due to price hikes of 6000% by the manufacturer to the NHS. Anywhere else in the world it is affordable, only the U.K is a problem. Privately you can get it cheaply though in the U.K. anyways I digress. Sorry!
I'd say TSH of 1.00 is a maximum - many of us, especially those who need to take T3 meds as well as levo becayse we are poor converters, will only be happy with TSH much lower than this.
I agree with SlowDragon : TSH is pretty well irrelevant once you are on thyroid meds - it's a useful initial diagnosis tool but has no real function beyond this. It's far more important to have free T4 and free T3 nice and high in range.
MollyMoo it's also worth remembering that you are not over-medicated unless free T3 is over-range, so you should never agree to reducing meds on the basis of TSH alone - especially if you feel well on your current level of meds.
My latest TSH was 0.64 again hovering around 1.00. For myself if it goes suppressed I don’t feel as good. I slightly reduce my liquid Levothyroxine dose if I go suppressed and never alter my T3 dose. My T4 and T3 are midway in the range prior to taking medications in regular blood tests. Obviously those levels will jump once I’ve taken my medications Liothyronine and Levothyroxine. I try to aim for a healthy persons thyroid range of 1.00. But I do have to adjust medications if my energy output drops over a period of time or increases over a period of time It’s all about energy expenditure and balancing your Liothyronine and Levothyroxine to coincide.
I’ve never felt so energised or well and happy in many many years
My TSH is 0.03 and free t4 is midrange and free t3 is approaching the top third.
I personally have more problem in the summer as we do have poor thermostats and dont sweat much to cool the body down for hypothyroid souls.
As Dr Skinner said to me. TSH after treatment has started (and even before) doesnt matter a hoot. He actually never read blood test seriously full stop just the patients symptoms, basal temps thing like that.
He could not think of any good reason to keep a patient clinically hypothyroid based on a TSH level.
I have always stuck to that principle and still to this day self regulate with ndt.
3 grains on winter and two in the summer as hopefully get more time outside so reduce vit d over summer and take 4000iu with vitamin k2 mk7 over the winter.
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