Hello,
Are these results ok? I am on T3 (10 morning and 10 afternoon) and T4 100 ( morning). My TSH is constantly suppressed do you think it is fine? Some docs say it is better not suppressed, below 1 but not suppressed. Thinking of further lowering T3 . I already reduced it from 20 to 10 in the morning 6 weeks ago... THANK YOU.
TSH 0.01 0.27 - 4.2
FT3 5,9 3.1 - 6.8
FT4 17.6 12 - 22
So many of us who are on combination treatment have suppressed TSH; it’s part of the course so I wouldn’t worry about it. Your FT3 and FT4 are well within range, so if you feel well on your current dose, I’d stay as you are.
Clara62
It's how you feel that's important. When taking T3 it's almost inevitable that TSH will be very low or suppressed (suppressed is below 0.1). It's just what happens.
When doing thyroid tests, to get a measure of your normal circulating hormone then you should take last dose of Levo 24 hours before the test and last dose of T3 8-12 hours before test, adjusting the time of the second dose the day before if necessary. Taking your doses longer than those times gives false low results, taking doses before the test gives false high results.
So if you took your doses as described then your results for FT4 and FT3 as accurate as they can be and they are good results. So if you feel well with those levels you don't need to change anything. Please don't lower your dose of T3 just because of your TSH, look at the FT3 and how you feel.
Thank you SeasideSusie,I did take my last T4 dosage 24h before and T3 dosage 13 h before.
The one thing that I am noticing is the thinning and loss of my hair. Since I lowered T3 from 20 to 10 in the morning is a little better... I won't lower the t3 dose for now. Thank you
Taking T3 suppresses TSH, and that's fine. It's suppressed because you don't need it anymore.
The TSH has only two jobs:
1. It stimulates the thyroid to make more hormone when the pituitary senses that there is not enough thyroid hormone in the blood. If you are hypo, then that is not going to work, anyway. And, if you are taking thyroid hormone replacement of any kind, the thyroid doesn't even need to make hormone, so the TSH is not necessary for that.
2. It stimulates conversion of T4 to T3. But, if you're taking T3, you don't need it for that, either. So, why would the pituitary - TSH is a pituitary hormone - waste its time making you hormone for which you have no need?
The most important number is alway the FT3, not the TSH - although doctors have learnt the opposite in med school, unfortunately. If your FT3 is still in-range, you are not over-medicated, no matter what the level of the TSH.
Have you tried asking these doctors why it shouldn't be suppressed? I bet that if you did, they would either say because it causes heart attacks or osteoporosis - which is rubbish - or they won't know. Never be afraid to question doctors. That how you learn how little they actually know. 
Thank you greygoose. I will reply later with what the doc said yesterday.
Hi greygoose, yes he said that in some patients, not all, a suppressed TSH for a long time can have some risks ( atrial fibrillation and osteoporosis), especially those with a hereditary predisposition. He also said that it might not be the case for me. I see that I feel better with less T3 when I was taking 20 morning and 10 afternoon I was more tired...
It's what makes you feel good that is important, not the level of your TSH.
Yes, there have been some studies done that report finding increased risk with long-term suppressed TSH. But, there are two problems with those studies:
1. They do not take into account FT3 levels. Long-term high FT3 - and I mean well over-range - might increase the risk of heart problems and osteoporosis. And, if your FT3 is high your TSH will be low. But, it is the excess T3 that causes the problems, not the lack of TSH.
2. The risk is very small. So, even if it were the TSH causing the problems, you have to ask yourself is it worth sacrificing your present quality of life by reducing your dose to bring up your TSH. Or would you rather be well now and let the future take care of itself. I
know which I would chose - have chosen. My TSH has been suppressed for many years.
It is impossible to have ALL THREE (ft4, Ft3 and TSH) at the same previous levels you had before becoming hypothyroid.You have to decide what's best for you. Low- normal T3 or suppressed TSH.
I personally prefer the first choice.
Thank you Alejandrita, you are right, it's impossible, I have noticed... Can I ask you why you prefer the first choice ( low-normal T3)? I would like to know. Also, what dosage are you having?
I only take t4 (75 x6 and 50x1). My Ft3 is low-normal:Ft3: 2,56 (2-4,2).
TSH: 1,25
Ft4: 1,2 (0,7-1,7).
I have some issues like tinnitus and some neuromuscular discomfort, but overall I feel fine.
Taking t3 come with RISKS such as insuline resistance, and heart and bone issues. I suppose low-normal t3 can also come with RISKS.
But so far, I can live without taking t3.
In that sense, t4 is just a stick you can use to walk, and t3 is a whole wheelchair. I prefer the stick.
I hadn’t heart that T3 causes issues with insulin etc, some on here are only on that does that mean you can end up being diabetic if you jus5 take T3?
I think it is even mentioned in the leaflet. The risk of insuline resistance is real. Does that mean it Will inevitably happen to You? No. It means your risk of having sugar issues is higher.
.." It means your risk of having sugar issues is higher".
Hi Alejandrita, I might have misunderstood the paper below (i don't really know anything about diabetes and blood sugar) ... but i think it says other changes in thyroid hormone levels also increase the risk of sugar issues too , meaning it's not just T3 use that has an increased risk .
Sub clinical hypothyroidism , and increasing TSH / decreasing fT4 /fT3 levels (even within range) also seem to show an increased risk for developing sugar issues ( i think ) It looks interesting anyway... so i've put it here for anyone who can get their head round it .
ncbi.nlm.nih.gov/pmc/articl...
" ........Changes in TSH and/or TH in longitudinal studies and incidence of diabetes .....
The same group of authors reported that individual changes in TSH and THs, even within the normal reference range, were an additional risk factor of incident T2DM during a 7-year longitudinal study on 6235 euthyroid subjects without T2D (117). A progressive increase in TSH with a decrease in T3 and FT4, suggesting the development of a more severe form of hypothyroidism, was independently associated with the risk of developing T2D regardless of sex and thyroid autoimmunity. An increase in TSH from baseline (range, –4.1 mU/L to +12.3 mU/L) was associated with a higher risk of T2D (HR, 1.27; 95% CI, 1.14 to 1.40 per SD). An increase in FT4 (range, –0.60 to +1.60 ng/dL) or T3 (range, –76.5 to +223 ng/dL) was associated with a lower risk of incidence of T2D. T3 directly increases islet β cell mass pathways (118) and controls insulin secretion (119) and intracellular glucose availability. These results suggest that subtle changes in the levels of serum TSH and THs, even within the physiological range, can induce insulin resistance or diabetes (120, 121) "
Read the leaflet of the meds.
This one ?
medicines.org.uk/emc/produc...
Warnings and precautions
Talk to your doctor or pharmacist before
taking Levothyroxine tablets if you:
• are suffering from an underactive adrenal
gland (adrenal insufficiency)
• suffer from heart problems including
angina, coronary artery disease or high
blood pressure
• are being treated for diabetes. The dose
of your anti-diabetic medicine may need
to be changed as levothyroxine can raise
blood sugar levels
It doesn't make you diabetic necessarily , but T3 can increase blood sugar levels in some people , but not in others .... (? presumably blood sugar returns to normal if T3 dose is reduced or stopped, i don't know that for certain though )
High T4 and /or T3 levels are known to do it to , as seen in hyperthyroidism.
However low (below range) fT3 and low (below range )TT3 are also associated with insulin resistance ... or at least i think that is what this says ncbi.nlm.nih.gov/pmc/articl... Low total and free triiodothyronine levels are associated with insulin resistance in non-diabetic individuals
not quite sure what HOMA-IR means. and haven't read it in much detail.
But we are not talking about below range T3, it's low-normal t3. For example, mine is 2,56 (2-4,2). I read the leaflet of the t3 meds and it clearly states that there's an increased risk of blood sugar issues. Nothing is mentioned in t4 leaflet.
I think t3 is the last choice, once your life is completely wrecked. Not before.
Alejandrita "I read the leaflet of the t3 meds and it clearly states that there's an increased risk of blood sugar issues. Nothing is mentioned in t4 leaflet." ........ levothyroxine can also raise blood sugar in some people , and the risk of this is mentioned in the P.I.L.s
My 'below range fT3' reply was to Lilylui who has a below range fT3 , and has developed problems taking Levo now ,... after being ok on it for many years.
I realise your fT3 is in-range and that it's ok for you because you are feeling reasonably ok and are able to take levo without difficulty . You are new to thyroid hormone replacement , but don't forget that some people on here are already at the point of 'life completely wrecked'. I hope you continue to do well on levo, and never need to bother with taking anything else ..it makes life a lot easier.
The relationship between thyroid hormone levels and blood sugar is complicated , so yes , taking T3 can increase the risk of blood sugar problems for some people , but that risk / benefit equation is different for someone who has below range T3.
Thank you Alejandrita. It's good to know different choices!
Query about suppressed TSH
Should I worry about suppressed t3
Bit worried about recent bloods. My TSH 0.014 and I'm 10 weeks pregnant. Have I done any harm? 
Well guys my tsh is going back up… again. 
My little moan about so called \"specialists\"
