I’m 26 and I have had my thyroid removed and are taking 125mcg a day of Levothyroxine. My doctor just called and said that my T4 level is low which is my hormone level and automatically being young you think of your fertility. They have said to drop my medication down to 100mcg a day, should I also stop my contraception as at my age I’ll like to keep my hormone level as in tact as I can. Can you recommend how I can increase my hormone level and any other suggestions you may have or any words of reassurance if you’ve been in the same position .
Thank you.
Written by
SJMRx
To view profiles and participate in discussions please or .
If FT4 (free thyroxine) is low you need an increase not decrease
.Doctors often look at TSH thyroid stimulating hormone.
This a pituitary hormone which signals thyroid. If all it working normally when thyroid levels are high it becomes low - but it’s very unreliable.
I’d obtain actual results dr may be going by TSH only, you need FT4 & FT3 (free triiodothyronine) results.
Get a printed copy or set up online access you need results & ranges (ranges vary).Contraception shouldn’t affect thyroid hormones, or fertility once you stop taking it, but thyroid levels do need to be adequate for fertility.
Low FT4 would have a poor affect on fertility - so your doctors comment is inaccurate.
If it’s Low TSH that’s might not be a issue provided FT4 & FT3 is within range. TSH would not cause symptoms or impact fertility. Focus in FT4 & FT3
Thank you for your comment, I’m going to call them back and schedule a call to make sure the information is correct as it was given to me so quickly.
Do you know what levels would need to be out for it to affect my fertility? as I want to assure these levels were in tact. I initally called the doctor as I was having intense sugar cravings and couldn’t settle at night time. I thought it was strange they were being lowered and not increased too
If you were feeling alert at night it could be that your dose did need to be reduced. In this case it would have been your TSH that was low not your fT4. The only way to know is to get a copy or your results. I would get hold of all your results not just the latest ones.
If you are under medicated it would affect your fertility for as long as your thyroid hormones are low.
I am alert at night therefore I believe I have missheard, they are calling me back tomorrow so I would check for definate! What are the negatives or side affects of low TSH does that affect fertility or anything else do you know ?
A low TSH carries long term risks of cardiac events and bone loss. It probably has effects on fertility / baby development but I don't know of any studies and if these effects were substantial we would know about them. A high TSH is not good for pregnancy, it leads to a higher risk of harm to the baby and probably reduces fertility.
Please note these risks although present are not high risks.
All the above assumes the 'axis', the mechanism that controls thyroid hormones is working as it should, this is so in most people. TSH will fall as fT3 or fT4 increase and vice versa. This is why TSH is very informative for most people. However, for some people TSH goes low even though fT3 or fT4 isn't high, the pituitary isn't working as it should. So, it is really useful to measure TSH, fT3 and fT4 at least once. Unfortunately, this is rarely done as GPs are not usually allowed to request fT3 (on cost grounds, it's costs about £1-20 grrrrrrrrrrrr.).
So, get hold of whatever results they have, all of them. If your TSH was low the assay machine will probably automatically run an fT3 test, if TSH is high it usually runs fT4. The machine rules, totally wrong but that's the mess we are in.
Let's wait and see your results. You can get a home kit to measure TSH, fT3, fT4 for less than £30 but you may not need to do this, depends on the result from your GP.
ALWAYS test thyroid levels early morning and last dose levothyroxine 24 hours before test
Is this how you did your test
Which brand of levothyroxine are you currently taking
Do you always get same brand levothyroxine at each prescription
What vitamin supplements are you currently taking
What was reason for thyroidectomy?
You are legally entitled to printed copies of your blood test results and ranges.
The best way to get access to current and historic blood test results is to register for online access to your medical record and blood test results
UK GP practices are supposed to offer everyone online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.
A fully functioning working thyroid would be supporting you on a daily basis with trace elements of T1. T2 and calcitonin + a measure of T3 at around 10 mcg + a measure of T4 at around 100 mcg :
So if your T4 is low, you likely need to be taking more T4 thyroid hormone replacement not less.
We generally feel at our best when our T4 sits in the top quadrant of its range as this should in theory convert to a good level of T3 in it's range - as it is T3 that runs the body which is said to be around 4 x more powerful than T4.
T4 - Levothyroxine is a prohormone and needs to be converted by your body into T3 the active hormone with the average person needing to find and utilise and convert to around 50 T3 daily just to function.
Your ability to convert the T4 into T3 can be compromised by non optimal levels of ferritin, folate, B12 and vitamin D, inflammation, any physiological stress ( emotional or physical ) depression, dieting and ageing so whilst we can't stop the clock we can keep on top of other contributing factors to ensure we keep as well as possible.
Maybe ask your doctor to run a full thyroid blood panel including the vitamins and minerals for you - if you haven't got any recent results to share with forum members - and we can explain any results and readings to you.
If you doctor can't help with the blood tests there are a list of private companies on the Thyroid UK website thyroiduk.org and Thyroid UK is the charity who supports this forum.
For blood tests we generally suggest you arrange an early as possible morning blood test - fast overnight just taking in water and take your daily dose of T4 - Levothyroxine after the blood draw.
If taking any supplements stop them all around a week before the blood test so we can see exactly what your body is holding on to and when your results are back just a new question detailing all the results and ranges and forum members will talk you through what it all means and what your next best steps back to better health are.
P.S. just to add T4 - Levothyroxine should be taken on an empty stomach - hence why most people take it in the morning but you do need then to wait around an hour before you eat or drink anything other than water so to get maximum absorption.
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
Low T4 & more thyroxine 
Is this TSH and T4 too low?
Tgab elevation low t4 
LOW TSH WITH STABLE T4
Low T4 result being on T3 only
