Tsh levels

[meggie67]

Hi have had total throid removal 15 years ago my latesr tsh levels are 0.19 is this ok?

[PurpleNails Administrator]

TSH is low so a Dr might assume you must be over medicated and reduce replacement hormone. What dose are you currently taking & do you feel well on it?

First you need to know what level your FT4 & FT3 have you had them tested? Provided they are good, usually top 3rd of range people feel well reducing might not be necessary.

[SlowDragon Administrator]

Just testing TSH is completely inadequate

Essential to also regularly test vitamin D, folate, ferritin and B12 at least annually

Low vitamin levels are extremely common on levothyroxine, especially if dose was reduced

Lower vitamin levels are more common as we get older too

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.

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

List of private testing options

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins by DIY fingerprick test

bluehorizonbloodtests.co.uk...

If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off down to £26.10 if go on thyroid uk for code

thyroiduk.org/getting-a-dia...

monitormyhealth.org.uk/

NHS easy postal kit vitamin D test £29 via

vitamindtest.org.uk

Link about thyroid blood tests

thyroiduk.org/getting-a-dia...

[pennyannie]

Hello Meggie:

A TSH result seen in isolation means absolutely nothing and is a waste of time and money in processing the bloods.

The TSH test was originally introduced as a diagnostic tool to help identify a patient suffering with hypothyroidism and it was never intended to be used once on any form of thyroid hormone replacement, as then, you need to measure both Free T3 and the Free T4 thyroid hormones circulating in the blood.

Once on any form of thyroid hormone replacement you need to be dosed and monitored on your Free T3 and Free T4 blood test results.

We generally feel at our best when our FT4 is in the top quadrant of its range as this should in theory convert, in our body, into a decent level of FT3 which is the active hormone that runs the body.

Both FT3 and FT4 need to be balanced within the ranges, at around a 1/4 ratio T3 / T4 and also high enough in the ranges to give you a good high level of T3 - as it is T3 that runs the body and if it is at too low a level for you, this will leave you suffering with symptoms of hypothyroidism.

I too am without a thyroid, and I too was dosed and monitored on just a TSH result and made very unwell by my doctor, who was likely, just following guidelines and reading the computer dogma, that likely hasn't been programmed to know anything about any patient.

When I questioned my doctor it was eventually agreed that I could pay the local laboratory direct and get a T3 and T4 if I wished - which I did and then I saw the disparity between my T3 and T4 and a referral to endocrinology was processed.

If you go on the Thyroid UK website who is the charity who support this amazing forum, there is a list of private companies who will run the full blood tests for you, with some offering a nurse home visit to draw your blood for you.

This is where I started off several years ago now, as the effort it took me to get anywhere within the NHS system simply exacerbated my symptoms.

We need a full thyroid bundle which is around 10/11 analysis of your blood - a TSH, FT3, FT4, antibodies, inflammation, and ferritin, folate, B12 and vitamin D.

Once you have the results simply post then back on here with the ranges and you will then be talked through your next best steps back to better health.

[McPammy]

Was it removed due to cancer. If so, it is advised to keep your TSH suppressed or very low normal to keep any cancer returning. My sister had thyroid cancer and her thyroid removed. Her TSH is constantly suppressed. It’s been 8 years now and recently her Endocrinologist has agreed she can have her TSH very low normal. Doing this she feels better and has lost some weight. She is only on Levothyroxine as her endocrinologist refuses to trial her on T3 even though her T4 is sky high, she obviously not converting to T3 very well. That’s the NHS for you though. They only check TSH and T4. She had to check T3 privately.

[meggie67 in reply to McPammy]

Sorry to hear u sister has gone through this all trial and error with very little support x

[meggie67]

No non cancerous growth/groiter is 0.19 normal range?

[tattybogle in reply to meggie67]

You can find the ranges for your tests on your screenshot (underneath the test names TSH/Free T4 ).

Your TSH of 0.19 is just under the range for that test which is [0.35 -5.5] .

But if you feel well it's not low enough to indicate any sort of a problem.

The range for your fT4 test is [10.5 -21] so your fT4 of 17 is well within range.

Presumably your dose was reduced from 250mcg to 225mcg after the November results where fT4 was over range at 25 , and TSH was to low to measure ( less than 0.03)

Out of interest .. what was your dose earlier in the year when your TSH was 6 and 14 ?

[meggie67 in reply to tattybogle]

Been on 225 for years

[tattybogle in reply to meggie67]

do you have any idea what made your TSH go up to 6 and then 14 ? (i'm assuming it is normally much lower than that on 225 ) Presumably the '14' in September was why they increased dose to 250mcg.

[Batty1]

How do you feel? Whats your latest results? How much medication are you on?

[meggie67 in reply to Batty1]

Fine was on 250 levothroxine now 225 attached my results

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[meggie67 in reply to Batty1]

Graph of results

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[Batty1 in reply to meggie67]

Add these graph to your original post above

[meggie67]

After rescent blood tests dr suggested i come feom 225 to 200 levothroxine i was on 250 before xmas and felt fantastic. Now i have such bad anxiety very emtional and feel like i cant function. Am still taking 225 but dr is saying it will be bad for my bone density as have been on this medication for 15 years. Please need some advice as i dont know which way to turn. 🙄🤞