TSH 1.71 - what does this mean?: Hi My thyroid... - Thyroid UK

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TSH 1.71 - what does this mean?

FLAMB profile image
21 Replies

Hi

My thyroid result came in at TSH 1.71 back in January and the doctor said I was in range & to retest in a year.

I am not sure what the range is? Is this a good result?

I am feeling very tired again and have brain fog. Just wondering if I should go back and have my bloods re-taken.

I have been on a journey of taking 25mg, 50mg, 75mg and now 100mg. It would seem that when I take 100mg I then go from underactive to overactive thyroid.... the doctor said I am sensitive to the medication.

Thanks in advance

Leanne

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FLAMB profile image
FLAMB
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21 Replies
tattybogle profile image
tattybogle

Hi FLAMB . First , just to clear up some 'terminology' so we all know what we mean .. 'hyperthyroid' is when your own thyroid is making too much hormone by itself .

If we mean taking too high a dose of Levo we are 'overmedicated ' which is not quite the same as hyperthyroid. (but the symptoms can be the same)

Why do you say you went hyperthyroid (overmedicated ?) on 100mcg ? . was it because you had symptoms that suggested 'too much thyroid hormone' ...... or did the GP say you were 'hyperthyroid' because of a blood test result ?

When did you increase to 100mcg ?

What dose were you taking for that January blood test ?

What dose are you taking now ?

Sorry for all the questions :) but until we know the sequence of events /dose and the blood results for each dose .. it's hard to give the right answers.

FLAMB profile image
FLAMB in reply totattybogle

I was on 75mg end last year, felt terrible and I was going bald. Which is what always happens when I am under medicated.

I took 100mg Dec & Jan (8 weeks total).

Bloods taken with me taking 100mg, and I am still on the same does.

My doctor told me when my dose went to 100mg (in 2021) my blood test results showed I was now hyper. However, because I felt crap on 75mg she increased my dose.

My doctor has changed since then and now they say TSH 1.71 is within range and essential said re-test in 1 year.Hope this helps.

tattybogle profile image
tattybogle in reply toFLAMB

So you've been on 100mcg before ?

FLAMB profile image
FLAMB in reply totattybogle

Yes, and my TSH results went under 0.

Reading online I am within range, so there should be no issue with my thyroid.

But appreciate that slow dragon below is saying my ft4 and 3 is important in a whole result. Maybe I'll get a private test to be absolutely sure!

tattybogle profile image
tattybogle in reply toFLAMB

Being 'within range' for TSH has very little to do with feeling well or being optimally treated on Levothyroxine.

Being 'in range' for TSH doesn't mean there is no issue with your thyroid.. there is .. you no longer make enough of your own thyroid hormone... you take T4 only (levo) so you no longer have the same proportions of T4 /T3 that you had when your thyroid was making you some T3.

Being 'in range' for TSH does not mean you are on the right dose of Levo.

TSH of 1.71 is actually a little high , indicating you might benefit from a slight increase in dose , perhaps to 112.5mcg ... an awful lot of 'healthy people have TSH around 1 and very often , people on Levo need a TSH a bit lower than when they were healthy .

Consider asking the GP to give you a 'trial' increase of either 12.5mcg or 25mcg for 6 months to see if getting your TSH below 1 will improve your symptoms.

References written for GP's advising on lower TSH levels to improve patient wellbeing and symptoms .... This one ;

gp-update.co.uk/files/docs/...

"The goal of treatment is to make the patient feel better and this tends to correspond with a TSH in the lower half of the reference range (0.4–2.5 mU/l).

If a patient feels perfectly well with TSH between 2.5 and 5 mU/l there is no need to adjust the dosage" .

and This one ........ found in GPonline.com 15th April 2010.

gponline.com/endocrinology-...

"Replacement therapy with levothyroxine should be initiated in all patients to achieve a TSH level of 0.5-2.0pmol/L." Written for GP's by "Dr Iqbal is a specialist registrar in endocrinology and Dr Krishnan is a specialist registrar in cardiology, Liverpool".

The TSH 'range' is only really useful for diagnosing hypothyroidism .. it is much less use for accurately deciding what dose of Levo we need to be on . For that we need to consider the TSH TOGETHER WITH at symptoms AND fT4 and preferably fT3 levels if you can get a GP to test it... they are often not allowed to because the lab / budget says 'no'.

We are all very different and we need our own individual levels of Ft4/ fT3 an TSH to feel well.

And taking Levo means our TSH doesn't 'read' quite the same way as it did when we were making our 'own' thyroid hormones . (TSH is just a signal asking for more or less thyroid hormone the actual Hormones are T4 and T3)

It matters a great deal exactly where in the range you personally feel best .. if you feel best on enough Levo that your fT4 and fT3 are near the top of their range and your TSH consequently goes a bit below the bottom end of the range... then that is just the way it is. It doesn't mean you are hyperthyroid ,and it doesn't automatically mean you need to lower the dose.

It is possible to feel utterly dreadful and be very under medicated while your TSH is perfectly 'in range '.

tattybogle profile image
tattybogle in reply totattybogle

p.s the NHS lab won't usually agree to do a repeat thyroid blood test for 3 months if the last one was 'in range' .. but your GP doesn't need another blood test to give you a dose increase.. she already knows there is room for a slight increase in dose by looking at you recent TSH test on 100mcg .

FLAMB profile image
FLAMB in reply totattybogle

Thank you for so much feedback. This is slowly piecing together. I’m going to buy a test and at least get all the results I need I.e. TSH/FT4/FT3 and antibodies.

I’ll be back with results soon ☺️

tattybogle profile image
tattybogle in reply toFLAMB

Good plan, Getting the full information for yourself is always useful in guiding dose decisions . Yes ..it's a lot to get your head round all at once .. it will eventually seem quite simple.. honest.

The more you read old posts on here ,and follow other peoples histories, the more it will make sense :)

SlowDragon profile image
SlowDragonAdministrator in reply toFLAMB

Make sure either to include testing vitamin D, folate, ferritin and B12 pri

Or get GP to test vitamin levels, vitamin D, folate, ferritin and B12

(they rarely want to test vitamin D)

Always get actual results and ranges on all results

FLAMB profile image
FLAMB in reply toSlowDragon

I am taking Vit D, Iron and Vit B12 should I not take them the day of testing to get a true result?

SlowDragon profile image
SlowDragonAdministrator in reply toFLAMB

If testing iron levels you should stop iron supplements a week before test

Do fasting test early morning

Don’t eat steak the night before test!

Stop any supplements that contain biotin a week before as biotin can falsely affect test results

B12 and vitamin D just don’t take on morning of test

B12 you would have to stop for several months to get a true base result

Lulu2607 profile image
Lulu2607 in reply totattybogle

Brilliant advice.and information Tattybogle. It should be printed and provided to all Thyroid patients..... and the Drs!

SlowDragon profile image
SlowDragonAdministrator

As per my reply in previous post 3 months ago

healthunlocked.com/thyroidu...

Just testing TSH is completely inadequate

You need TSH, Ft4 and ft3 tested

Have you had thyroid antibodies tested…if not these need testing

90% of primary hypothyroidism is autoimmune thyroid disease also called Hashimoto’s usually diagnosed by high thyroid antibodies

Do you have Hashimoto’s

ESSENTIAL to test vitamin D, folate, ferritin and B12 at least annually

Request GP test vitamin levels (and antibodies) now

Low ferritin often linked to hairloss

Or get full thyroid and vitamin testing done privately

Always test thyroid levels early morning, ideally before 9am and last dose levothyroxine 24 hours before test

Come back with new post once you get results

Thousands upon thousands of U.K. Thyroid patients forced to test privately to make progress

FLAMB profile image
FLAMB in reply toSlowDragon

Appreciate that you have replied already with the same information, however I still find this all a bit of a mind field & my doctor wont do any other tests i.e. ft4 & ft3.

Had my antibodies tested back in 2020 and it would suggest no other autoimmune disease. The doctor will not retest.

Do the private paid tests offer TSH, ft4 and ft3 results? Not sure what I would do with the results once I got them...

SlowDragon profile image
SlowDragonAdministrator in reply toFLAMB

NHS only tests TG antibodies if TPO antibodies are high

Many autoimmune thyroid patients only have high TG antibodies

Low vitamin levels are extremely common with hypothyroidism, especially autoimmune

Only test early Monday or Tuesday morning, last Dose levothyroxine 24 hours before test

Come back with new post once you get results

Medichecks or Blue horizon are most popular options

List of private testing options and money off codes

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...

Examples of private test results

Medichecks

healthunlocked.com/search/p...

Blue horizon

healthunlocked.com/search/p...

Thriva

healthunlocked.com/search/p...

FLAMB profile image
FLAMB

Ah okay... I did not know this! That is ridiculous that they don't do a thorough test of auto immune diseases!

I'll buy a test and post my results.

Sparklingsunshine profile image
Sparklingsunshine in reply toFLAMB

Hi

I had to push to get my antibodies checked I've got pernicious anaemia, another AI disease. I reckon that's the only reason they tested me for Hashis. As it happens my antibodies were negative.

Doctors treat autoimmune hypo and plain old hypo the same way, ie normally with Levo so they probably don't see the need to test for antibodies. Not defending it BTW, just assuming this is why they don't test for it routinely.

SlowDragon profile image
SlowDragonAdministrator in reply toSparklingsunshine

Sparklingsunshine

Were both TPO and TG antibodies tested

healthline.com/health/antit...

If you do have small amounts in your blood, it may be a sign of certain health problems, such as:

type 1 diabetes

pernicious anemia, a drop in red blood cells caused by a vitamin B-12 deficiency

collagen vascular diseases, such as rheumatoid arthritis and scleroderma

thyroid cancer

If you have high levels of antithyroglobulin antibodies in your blood, it may be a sign of serious autoimmune disorder, such as Graves’ disease or Hashimoto thyroiditis.

Sparklingsunshine profile image
Sparklingsunshine in reply toSlowDragon

Hi

The NHS one was negative but I know they only test one type. My Blue Horizon one in 2016 was also negative for both. I've also been tested for Lupus and Sjogrens antibodies, the test took ages as it has to go to a specialist centre somewhere. Thankfully negative although the initial blood sample showed speckled patterning, hence the need for further testing.

FLAMB profile image
FLAMB in reply toSparklingsunshine

Which test did you take to find out you had pernicious anaemia?

Sparklingsunshine profile image
Sparklingsunshine in reply toFLAMB

Hi

I got tested years ago by GP. Not sure what test was performed. I've been having 3 monthly B12 jabs ever since.

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