Blood Results

[Odinil]

I need help with my blood test results please.

I have attached the results.

my consultant has reduced my T4 dosage because my TSH is too low.

I am on liquid levothyroxine. My consultant has reduced my dosage from 6.5mcg daily to 5mcg five days and 3.5mcg two days. I am also on T3 5 mcg x 2 daily but she said no increase there. Since the reduction i feel weak, body aches, brain fog, i have like a shin splint in one leg my gp sent me to a and e to rule out a blood clot. Thank goodness it wasnt.

I have such painful joint pain in my hands and fingers all this since the reduction of T4.

my consultant said i have adequate vitamin B12 vitamin D and folate levels and no edvidence of iron deficiency.

Any advice will be appreciated thank you.

[SlowDragon Administrator]

Well your results suggest you are probably under medicated

TSH is almost always low or suppressed when taking T3

Was test done early morning, last dose levothyroxine 24 hours before test

Last 1/2 or 1/3rd T3 approx 8-12 hours before test

Ferritin, folate, B12 and vitamin D all too low

What vitamin supplements are you currently taking

[Odinil in reply to SlowDragon]

Thank you that's what i thought too but should i worry about my TSH being so low. She seems very concerned about it. I asked her if T3 can make my TSH low, no she said it doesnt have any affect on it. Don't most people feel better when their TSH is between 1.0 - 2.0?

I thought i heard her mention that low TSH can affect the heart. Ive just found out i have a heart murmur and ive got to have an echo heart scan on the 26th. I dont want it to interfere with my heart and give me any problems if what she says is true.

I worry that if i increase my dosage i will be going against her advice and run the risk of being discharged from Addensbrooke for going against her advice. I'll be scared if that happened as my gp has no idea. At least i can get my blood tests done including T3 by the hospital.

To be honest i have been neglecting taking vitamins. I have been grieving the lost of my mother and im now getting dad through chemo and a major op on friday. I havent had time to think about myself. Like i said i was doing ok before she reduced my levothyroxine.

What do you think about my TSH result. On 6.5 liquid daily was 0.06 how much lower can it go!!!

Why would my consultant say my vitamin results are adequate.

Is it something else they dont know much about. I also asked my gp she too said they were fine.

It's all a worry.

I had the blood test done at 9am.

and no medication for 24 hours.

[SlowDragon Administrator in reply to Odinil]

You will see many people on here on T3 with TSH at 0.01

In an ideal world….taking T3 wouldn’t suppress/lower TSH and for a very few people it doesn’t

But the vast majority of people on almost any dose of T3 find TSH immediately nose dives to near 0

The most important results are always Ft3 and Ft4

I can get my TSH to reach the dizzy heights of 0.02 …..but only if reduce levothyroxine dose so that Ft4 is 12 (12-22) and then there’s the downside…..I can’t function

Best thing for strong bones is being active

Heart murmur

Is it Mitral valve?

Mitral valve prolapse is fairly common with autoimmune thyroid disease …..research suggests it could also be autoimmune

[Odinil in reply to SlowDragon]

Ive had a 24 hour heart monitor recently and have an Echo Heart Monitor scan on the 26th July so i wont know until i get the results. What does such a low tsh do to the body. What effects does it have?

[shaws Administrator in reply to Odinil]

First, I am very sorry that you've lost your mother recently, that in itself will have had a huge effect on you and it will take some time just to comes to terms with your loss.

Look after yourself now and take things easy and try not to worry.

[SlowDragon Administrator]

FT4: 13.2 pmol/l (Range 10.5 - 21)

Ft4 only 25.71% through range

FT3: 4.2 pmol/l (Range 3.5 - 6.5)

Ft3 only 23.33% through range

Most people when adequately treated will have both Ft4 and Ft3 at least 50% through range

Suggest you increase levothyroxine first

Perhaps back to 6.5mcg daily

Retest in 6-8 weeks

Meanwhile working on improving low vitamin levels

[Odinil in reply to SlowDragon]

If i go back on 6.5mcg daily my tsh will go back down to 0.07 again. I wondered if i go back on 6.5mcg and take just 5mcg T3 daily instead of 10mcg. My T3 wont keep my tsh down as much. I never noticed a hugh improvement when i first took T3.

Im totally confused

[SlowDragon Administrator in reply to Odinil]

Well you’re probably not on high enough dose T3

Likely to need increase…not decrease

[Odinil in reply to SlowDragon]

Will an increase in T3 just make my tsh go even lower. That will make my consultant reduce my levo again. Also why do consultants say that T3 affects your heart. Maybe not short term but in the long term.

[SlowDragon Administrator in reply to Odinil]

Yes increase in T3 could make TSH drop lower

Heart needs good levels of T3

Many members find palpitations improve dramatically with addition of T3

Endocrinologist this low TSH = hyperthyroid…..but that’s only true if it’s your own thyroid making TSH low

On replacement thyroid hormones, especially any medication that contains T3 it’s almost inevitable that TSH will be low. You’re only over medicated if Ft3 is over range

healthunlocked.com/search/p...

restartmed.com/suppressed-tsh/

endocrine-abstracts.org/ea/...

[Odinil in reply to SlowDragon]

My nhs consultant said she will not increase my T3 5mcg x 2 while my TSH is low 0.35.My next appointment is December 2022. I had to go private to get my T3 prescription looks like i'll have to make an appointment to speak to him. Trouble is i'll be in the middle of both of them who do i listen to.

[SlowDragon Administrator in reply to Odinil]

All life is a risk

I had interesting conversation with endo….re low TSH and “the risks involved”

I explain my mother, her mother, and all my aunts had dementia and that dementia was clearly affecting they’re lives by age of 75

…..I would say being well enough to enjoy life while brain is working is “worth the risk” of some hypothetical risk of osteoporosis in future

Personally if my TSH is where the medics like it ….within range….I would be bedbound and immobile….

For good bones health we need lots of physical activity to keep bones strong

If your endocrinologist is worried about osteoporosis….they should do a Dexa scan

Some members on T3 have seen bone health IMPROVE with addition of T3

Osteoporosis can be linked to LOW Ft3 …..not just high Ft3

Osteoporosis

thyroidpatients.ca/2018/07/...

[Jazzw]

Bet your consultant is a diabetes specialist. We see this so much.

my consultant has reduced my T4 dosage because my TSH is too low.

I asked her if T3 can make my TSH low, no she said it doesnt have any affect on it.

Sadly your consultant doesn’t seem to understand what taking T3 does to TSH levels. And I’d agree with SlowDragon that you actually appear undermedicated, not overmedicated.

Poor you, you’re not getting the right advice from the very person you should be able to rely upon.

SlowDragon: You will see many people on here on T3 with TSH at 0.01

Yep! I’m one of them! And I know from experience that I have to reduce my dose to almost nothing to get TSH to rise again. Which leaves me feeling very ill. No one should make themselves ill to meet someone’s misinformed expectation that TSH should be in range. It doesn’t work like that for many of us.

[Odinil in reply to Jazzw]

I just dont know what to do. I want to increase my levo back to where it was but then i run the risk that my nhs consultant will refuse to monitor me on T3 with regular blood tests and i'll end up with being left to go it alone and revert back to my yearly routine appointment to check on my thyroid cancer marker. My gp has not idea regarding medication even though he is a trained endocrine doctor but again a diabetic doctor.What are the dangers of having very low tsh results?

[tattybogle in reply to Odinil]

evidence to use with Endo's / Gp's to keep the 'risks' of low TSH in proportion and help you understand what those 'risks' are ... :

please see my reply to this post ( 3rd reply down) :

healthunlocked.com/thyroidu... feeling-fine-but-TSH-is-low .

It contains links to a large long term study showing that TSH 0.04 -0.4 had no greater risks than TSH 0.4 to 4.

Also has links to several other posts which contain useful discussions on the subject of low TSH / Risk / Quality of life.

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See diogenes reply to this post :

healthunlocked.com/thyroidu... endos-only-care-about-tsh

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healthunlocked.com/thyroidu... longterm-subclinical-hyperthyroidism-does-not-affect-bone-density-in-patients-having-had-thyroid-ablation-for-cancer

diogenes introduction to this post says "They term the state subclinical hyperthyroidism - ie low TSH but normal FT4. So it shows that doctors need not get worried about OP(osteoporosis) effects over a long term TSH- supressive dose of T4.

A minority may be affected but it is individual not widespread. I don't think FT3 was included. This finding can obviously apply to patients on T4 or T4/T3 who have low or no TSH, with normal FT4/3