Confused about recent TSH readings

[Sailing14]

I am confused about a recent TSH reading.

Today it is 0.1 (below lab ref range of 0.4 to 4.9).

Is this a higher or lower reading than 0.03 that was taken at the end of Nov 22 when I was told it was suppressed?

I am currently reducing the dose at present.

Thank you for you help.

[SlowDragon Administrator]

it’s higher than 0.03

Most important results are always Ft3 followed by Ft4

And all four vitamins at optimal levels

[Sailing14 in reply to SlowDragon]

Thank you. I am going to check the vitamin results from Nov 22.

What is the scale for TSH in figures? Sorry, I don’t understand the exact way it works.

T4 and T3 results were:

T4 15.8 (9 to 19) T3 4.2 (2.4 to 6).

I have been reducing for 4 weeks due to hyper symptoms.

[SlowDragon Administrator in reply to Sailing14]

What is the scale for TSH in figures? Sorry, I don’t understand the exact way it works.

0.03 is smaller/lower number that 0.1

Too soon to retest really

Test at 8-10 weeks after reducing dose

Test early morning and last dose levothyroxine 24 hours before test

currently

FT4: 15.8 pmol/l (Range 9 - 19) 68.00%

FT3: 4.2 pmol/l (Range 2.4 - 6) 50.00%

[Sailing14 in reply to SlowDragon]

Thank you for your response and help. I will wait for at least 8 weeks before retest. However, could you explain if 0.1 is classed as suppressed and where 0.01 and 0.03 is on this scale?

Colour

[SlowDragon Administrator in reply to Sailing14]

More important than TSH are Ft3 and Ft4 and symptoms

But far too many endocrinologists and GP’s are TSH obsessed

You will see many hundreds of members on here who are well, on stable dose and have very low or suppressed TSH…..especially if on levothyroxine plus T3, or NDT

T4 therapy

ncbi.nlm.nih.gov/labs/pmc/a...

In a study evaluating tissue function tests before total thyroidectomy and at 1 year postoperatively when using LT4, it was found that peripheral tissue function tests indicated mild hyperthyroidism at TSH <0.03 mU/L and mild hypothyroidism at TSH 0.3 to 5.0 mU/L; the tissues were closest to euthyroidism at TSH 0.03 to 0.3 mU/L [48]. A normal serum TSH level consequently does not necessarily indicate a euthyroid state at the tissue level.

[SlowDragon Administrator in reply to Sailing14]

This table is referring to TSH of someone NOT on replacement thyroid hormones

Taking levothyroxine as single dose once a day is not how your own thyroid would work

Increasing number of members find it better to split levothyroxine dose ……taking half in morning and half at bedtime

Something to consider in a few months

[Sailing14]

Thank you for your helpful response. At the moment, I am feeling more unwell and I am approaching 5 weeks. Is it better to wait until 6 weeks at least to see if things improve?

I have trialled 75 daily last year and felt very undermedicated in the second month and increased back to 100 daily but became over medicated. I am trialling 75/100 now but I was hoping for improvement by now. When I first reduced, I had slight bursts of energy after a few weeks but this has not happened since.

I wondered if maybe you could advise on this?

[tattybogle in reply to Sailing14]

I've reduced by 12.5mcg on 2 occasions in the last 3 years , both times the first 5 weeks felt rubbish /undermedicated/ all over the place to be honest ... but things gradually settled by about week 5/6 and improved from then on ...i've now made myself a rule to just make a note of how i feel at the end of each week for the first 5 weeks after any dose change, but other than that , try to ignore how i feel for those weeks ...and start paying more attention to how i feel from week 5 / 6 onwards .

If i'd been asked if it was an improvement at 5/6 weeks, i would have been absolutely adamant that the dose was too low , and would have insisted on putting it back up .... i'm glad i waited longer to see what it would be like once my body properly settled into the new dose ,, a couple of months later i was sleeping much better than i had for a few years , my head was much calmer, and a few random aches and pains had also dissipated .

I see it a bit like a pendulum swings a bit too far in the opposite direction before settling in the middle again if you see what i mean

6 weeks is the absolute earliest to do a blood tests .

[Sailing14 in reply to tattybogle]

Thank you. That is good to know as I feel the same and could easily increase. I have underlying long covid so it could be making symptoms worse (or the thyroid could be adding to the slow recovery) I am not sure, but I will wait to see how the next two weeks go.