Is tsh level 0.04 normal?

[RomyJean]

Hi everyone,

Thanks for all of your great advice, you always know more then anyone I speak to.

The Doctors said tsh is now 0.04 it was 0.22 a couple of weeks ago. She didn’t really tell me what was going on, just referred me to the hospital.

I just can’t quite understand where that is on the scale it’s confusing me. Is that too low or is that in the range?

Thanks again for all your previous answers.

[greygoose]

Is the TSH all that was tested? Because a TSH result on its own doesn't mean much. It has to be looked at in conjunction with the FT4, FT3 and possibly antibodies.

[RomyJean in reply to greygoose]

I think she said t4 was 21?

[greygoose in reply to RomyJean]

OK, so you don't know the ranges, then. Always best to get a print-out of the results of any blood test you have done. It's important to know exactly what was tested and exactly what the results were.

If the top of the range was 22, as is often the case, then you're not over-medicated. In which case, one wonders why she thinks it necessary to refer you to the hospital.

[RomyJean in reply to greygoose]

I think they changed quite quickly tsh from 48 to 0.04 in 8 weeks, but that’s why I was confused, that surely is a good thing. The meds are working

[greygoose in reply to RomyJean]

No, not necessarily good. Not if you have Hashi's. Because the TSH can jump around a lot. And, the aim of taking levo is not just to reduce the TSH, but to raise the FT4 AND the FT3.

Levo is not a medication in the normal sense of the word. It's not a drug. It is the thyroid hormone T4. So, it can't not work. It will always do what it can. The problem arises when your body can't handle it very well, and can't convert it to the active hormone T3. T4 is basically just a storage hormone and doesn't do much until it is converted. But, just testing TSH and FT4 will not tell you if your FT3 is good, nor how well you convert. The TSH could be zero, and the FT3 still too low to make you well.

[RomyJean in reply to greygoose]

I always feel like I’m troubling them it took them 2 weeks to tell me the bloods. I rang up 5 times to get them as feeling unwell. You are right I should of just asked for a print out. It would of been easier. Thanks for your answer very helpful.

[greygoose in reply to RomyJean]

You're welcome.

[tattybogle]

it is a bit low, which suggests you now have 'a bit too much' thyroid hormone (fT4)

1ish is about right for TSH

at diagnosis was too high at 43 , which showed you had 'not enough' thyroid hormone (fT4)

TSH is a signal from the pituitary(brain) to the thyroid gland asking it to make more (or less) thyroid hormone

As T4 goes low the TSH rises (asking thyroid to make more T4)

and as T4 goes higher TSH lowers.

When TSH goes very low it is asking the thyroid to stop making more T4 (because there is a bit too much T4)

The low TSH of 0.04 may just mean your dose of levo is a little bit too high.

You were started on 50mcg ?

and now you're on 100mcg ?

how many weeks had you been taking 100mcg for when this latest GP test was taken ?

Some cases of post partum thyroiditis are not permanent, so some people who are given levo after a pregnancy don't need to stay on levo forever .... so this may be why the doctor has referred you to endo ......however, your positive TPOab showing damage from autoimmune thyroid disease, does make it more likely that you will need to keep taking it .

With autoimmune hypothyroidism , the thyroid hormone levels can sometimes wobble around unexpectedly ,because when the immune system attacks the thyroid, it sometimes chucks out a lot of thyroid hormone all at once.

[RomyJean in reply to tattybogle]

Great that makes a lot of sense thanks

[RomyJean in reply to RomyJean]

I was taking 50 and they changed in within 2 weeks so I was on 100 about 6 weeks ago. She said to take 50 for 5 days of the week and 100 on the weekends.

She made out as if it was quite bad, but I thought it was in range.

[tattybogle in reply to RomyJean]

no , it's not that bad . in fact it might not be 'bad' at all. you need the lab ranges to know exactly what's what , but most TSH ranges are usually about 0.4 - 4.5 ish ... so 0.04 is a bit lower than ideal, but honestly it's nothing to panic about .The real information is in the fT4 result. (and the fT3 result if they did it )

it depends on the lab range that came with that fT4 test .

~ if it's eg [12-22] then 21 is more or less fine , but due to the low TSH it would be reasonable to try reducing the dose by a small amount.

~ if the fT4 range was eg [7-14] then 21 is quite a lot over range ,, and the dose should be reduced by a bit more.

your dose has now been reduced to effectively 65mcg / day ... personally i wouldn't have thought it needed reducing by quite that much .

i'd have said:

~ reduce to 87.5mcg / day if the T4 was in range . (alternate 100 / mcg one day 75mcg the next)

~ or reduce to 75mcg/ day if the T4 was over range.

..... but see how you feel for a few weeks on the 65mcg the GP has suggested .

note * most people won't be able to feel any difference between the 50 mcg days and the 100mcg days .. but some of us would find that big a difference in dose from one day to the next a bit unsettling. ... again, see how you go with what GP has suggested .. you might be fine.

(T4 in levo is basically a 'long life store' that lasts about a week in your blood , so in theory there's nothing wrong with taking different dose on different days ,it evens out in your blood ,

but personally i'd want to spread it our more evenly over the week rather than having two day of 100 next to each other at the weekends and then just 50 again)

hope that makes some sense, and isn't too confusing , my brain has 'left the building' for the day

x

[RomyJean in reply to tattybogle]

Yes that makes more sense then the dr. Than you