reduction of thyroxine

[R7vfmbroadway]

Hello everyone. Would really appreciate your thoughts! I have been taking Thyroxine reduced from 125g to 100g, along with 5g of T3 (twice a day). Because my TSH is still too low, my consultant has advised me to reduce Thyroxine to 75g. I’m a little apprehensive with this, and would really appreciate your comments

Blood results are (taken as suggested)

TSH. 0.03. 2.20-2.60 mmol/L

T4 (MM3130) (still over). 16.9 pmoL/L

10.00-20.00 pmoL/L

T3 5.9. 3.50-6.50pmol/L

[tattybogle]

Just wondered why the 'still over' comment ?

"T4 (MM3130) (still over). 16.9 pmoL/L 10.00-20.00 pmoL/L"

that result is not over range ? lab range is [10-20]

So there doesn't seem to be any need to reduce Levo dose based on the fT4 result .

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and The TSH result of 0.03 is not really low 'enough' to be that much of an issue ( especially since you are taking T3 which we know lowers it more than T4 does)

The NHS warns of risks of 'low' TSH based on this paper looking at long term low TSH in patients taking just levo:

academic.oup.com/jcem/artic...

But the paper actually showed NO increased risks when TSH was 'low but not supressed' 0.04 -0.4

The risks did increase quite sharply when TSH was below 0.04 however ( so unfortunately this paper wont help you with the endo at the moment ... but it would if your TSH was 0.04 or 0.05 )

Basically i would not agree to reduce Levo by as much as 25mcg since your fT4 is not over range it's at 69% .. so not too high . Calculator thyroid.dopiaza.org/ fT3 is 80%

if you can negotiate a smaller reduction of 12.5mcg (to 87.5mcg) you may find it doesn't affect how you feel much , but is just enough to get TSH to come up to 0.04 or above .. (then you can use that paper to tell them to bog of in future)

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'Bone loss'/ osteoporosis is often used to warm patient off having low TSH.. but this paper shows it's a pretty insignificant risk when just TSH is low but fT4 is in range :

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

[R7vfmbroadway in reply to tattybogle]

Thank you for your reply, I’m not sure about the ‘still over’ that’s just what it said on my results.

[tattybogle in reply to R7vfmbroadway]

ah ok~ it probably just relates to the TSH still being under range ,, as in 'still over replaced (with thyroid hormone) '