T4 only, TSH suppressed

[Kriticat]

Thanks to advice here I ditched my previous endo, and gradually increased my 25mcg T4 dose to 50, then 75/50. My latest results from March 9th were

TSH: 0.02 mU/l (Range 0.3 - 4.5) -6.67%

FT4: 1.4 ng/dl (Range 0.8 - 1.8) 60.00%

FT3: 4.89 pmol/l (Range 3 - 6.5) 54.00%

B12 633 pg/ml (200 - 1050) 50.9%

Vit D 41 ng/ml (30 - 100) 15.7%

Ferritin 99.4 ng/ml (15 - 195) 46.9%

For reference, folate was tested last October and was 

10 ng/ml (3 - 19.9) 41.4%

The thyroid hormones were not much higher than after 12 weeks on 50mcg, and although I felt much better, I wasn't 100% better, so I felt there was room to up the dose to 75mcg daily.

There was a definite improvement at first but now, 4 weeks in, I'm feeling quite sluggish again, either sleeping like I'm drugged or not sleeping at all.

My weight is now going up again, not entirely surprising as I am permanently hungry... eating healthy stuff, but too much of it! (Still gluten-free, thinking of cutting out my daily live sheep yoghurt, which is my only real dairy, but reluctant as it's a good probiotic and helps keep my protein intake up. )

My joints also feel achy and stiff again (but i ran out of glucosamine 3 days ago, so could be from that) and my digestion is playing up again, despite consumption of chia and flax seeds, prunes and magnesium, which had been working wonders!

Perhaps more worryingly given how low the TSH is, my resting heart rate has increased, it has always been around 62/3, but is now around 80.

My core temperature has remained around 35.8, even 36 occasionally, having risen from 34.8 last August.

Anyway, waffle waffle, I have 2 questions.

Firstly, should I back off and drop down to 75/50 again, stick it out at 75 until getting tested in the next 2 weeks, or get tested now... (in 5 days, as I have to quit the b complex)?

And secondly, just how dangerous is suppressed TSH? I waited 3 months and travelled to the next city to see a new endo whose listing claimed she was a hashimoto's specialist first. She seemed to think my TSH level was life threatening and I was being stupid... but she also said she would only test FT3 if I was pregnant or trying to get pregnant, and otherwise it's irrelevant! Obviously I left and haven't been back!!! But when I can't sleep and feel my heart racing I can't help worrying...

[Jaydee1507 Administrator]

When was your last dose of Levo before this test? What dose of levo were you on for this test?

A heart rate of 62 is not that healthy unless you're an athlete. may have been due to low thyroid hormones. 80 is an OK heart rate and its likely the Levo has raised that to a more healthy level.

Your FT4 is still only 60% of its range and I think you have room for an increase there. You do also seem to be converting well so you will be fine on Levo. Just a matter of getting dose right + vitamin levels OPTIMAL.

Vitamin wise you would benefit from a good B complex. Look for one with methyl or active type vitamins that contains 400mcgs methylfolate. That would bring that level up & B12 too + keep all the B's in balance. Folate sorted out my gut btw.

I wouldnt change your dose, get tested in 2 weeks and remember to stop the biotin supplement 4-7 days before.

But when I can't sleep and feel my heart racing I can't help worrying...

This is more likely undermedication at this point. Your FT3 is only just 50% and both free hormones are well within reference range. I'm happy you ran from this Endo.

Doctors over and over stress about TSH but its a really bad guide in many people for many reasons. Its perfectly safe to have a suppressed TSH. Mine is.

Also, coconut yoghurt is pretty good probiotic wise. So many dairy alternatives now.

[Kriticat in reply to Jaydee1507]

Thanks Jaydee1507 , that's really reassuring, hopefully I'll sleep better tonight. Yes, my RHR and BP have always been very low, and I'm definitely not an athletic type! It just feels a bit racy sometimes, and I'm finding myself out of breath easily too. I think all the endos (I've seen a few!) are worried because I also tested positive for TSI antibodies, which apparently means I 'could ' also have Graves. But nothing has ever been said about blocking my thyroid, so I assume no one thinks it's a real possibility, but they all want my TSH at about 2... when it was I could barely get out of bed!

I'm currently taking a good liposomal B complex (yipmai, recommended here). My calcium and phosphorus are top of range so my second endo took me off vitamin D, but it has dropped quite a lot so will try some with K2. My zinc and copper are both at the low end of range, despite taking a high zinc dose for months now, have ordered some picolinate to see if that is absorbed better.

I also take high dose magnesium, a glucosamine and chondroitin joint complex and an omega 3 supplement. Plus I make my own turmeric ginger and black pepper shots. So doing my best to get all vits and mins optimal.

I love coconut yoghurt but I live in Crete and have never seen it here... we are deep in sheep and goat country!

Anyway, thanks again for the reassurance and encouragement, I will get tested in a couple of weeks and see where I am then.