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
Written by
FLAMB
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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.
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.
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 ;
"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.
"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 '.
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 .
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.
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
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...
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.
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.
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.
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but until we know the sequence of events /dose and the blood results for each dose .. it's hard to give the right answers.
T4 what does it mean? 
In Range of what? What does it mean?
What does it mean to have normal TSH and Free T3, but have high free Thyroxine (T4)?
Does a normal TSH result mean I'm not Hypo?
What does this mean? 
