hypothyroid

[minawir]

Hello, i have hypothyroid and currently take 100mg daily of levothyroxin and just got my TSH back that its currently seems like it’s too much . normal range 0.300-4.5

current: 0.032

i haven’t gotten a chance to discuss what i should do as the system here in denmark is for me to await 2 weeks to get a new appointment to discuss my new dosage.

my t3 and t4 levels are in normal range it seems

i feel fine. still a bit tired but i’ve always been and some dry skin + gray hair which has been a curse since day one. would appreciate any insight in what you make of this

[Lalatoot]

Minawir just knowing that ft4 and ft3 are in normal range is not good enough.Imagine you and your friend share a wardrobe full of clothes. You are both normal sizes. Everyday you reach in and pull out something to wear. The clothes are normal so they should fit you but they don't. The jeans are a little too tight and the sweater too baggy. That's because what is normal for one person isn't normal for another

Your results for ft4 and ft3 have ranges which if your result is in that range you are told it's normal. But like the clothes your normal result might not be a good fit for you. You might need to adjust your dose to get that better fit.

TSH is not a good measure for dose adjustment. You need to go by what your ft4 and ft3 results are and where they are in the normal range.

[minawir in reply to Lalatoot]

Hello, thanks for your time. i thought i attached everything for the t3 and t4 whether it’s the free t4 and t3 i have no clue, since this was the only thing the doctor ordered for me to get tested.

let me start by giving the full attachments so it might help you see the results. i’m a bit lost to say the least in what to do and it’s still very new to me

april 2023 T3: 1.4 (normal range according to the test 1.1-2.5)

april 2023 T4: 84 (normal range according to test 60-140) 

to be frank the doctor only looked at the TSH and i asked about t3 and t4 which i was told they don’t really care about and only look at TSH as an indicator. this came from a specialist

t3

[minawir in reply to Lalatoot]

i see i messed up the attachment on my main post. the TSH levels are now attached here too.

my TSH was in may 2022: 1.46 (normal range 0.300-4.5) and the month before (april 2022) 1.59

i wasnt tested for a while since i was traveling aroind rhe world feeling fine. but now ive been back for 1.5 months in Denmark and just got the appointment last week

TSH levesl

[tattybogle]

Hi minawir ,

That looks like a Total T4 test (doesn't tell you how much FreeT4 you have)

April 2022:

TSH ....1.59 [0.3 -4.5]

May 2022:

TSH ...1.46 [0.3 -4.5]

TT4 .....93 ish [60 -130]

T3 ..... 1.2 ish [1.1 -2.5]...... not sure if this is totalT3 of freeT3

April 2023:

TSH ..... 0.032 [0.30 -4.5]

TT4 ..... 84 [60 -130]

T3 .........1.4 [1.1 -2.5]

TSH is below range , but that doesn't necessarily mean you should reduce dose if you feel well:

healthunlocked.com/thyroidu... useful-evidence-that-tsh-between-0.04-0.4-has-no-increased-risk-to-patients-on-levothyroxine-updated-new-study-does-show-small-risk

healthunlocked.com/thyroidu.... tsh-is-just-the-opinion-of-your-pituitary-about-your-dose-but-your-pituitarys-opinion-is-a-bit-warped-once-you-take-thyroid-hormone.

[minawir in reply to tattybogle]

yes i thought i attached everything actually. let me reattach the t3 and t4

april 2023 T3: 1.4 (normal range according to the test 1.1-2.5)

april 2023 T4: 84 (normal range according to test 60-140)

t4

[SlowDragon Administrator]

Always test thyroid levels early morning, ideally just before 9am and last dose levothyroxine 24 hours before test

TSH, Ft4 and Ft3

Plus test TPO and TG thyroid antibodies at least once

You also need to test vitamin D, folate, ferritin and B12 at least annually

[minawir in reply to SlowDragon]

hi, yes i had these levels tested last year, but haven’t had any recent tests done. i hope he’ll agree to test me for these at our walk through.

[SlowDragon Administrator in reply to minawir]

What were vitamin and antibodies results last year?

[minawir in reply to SlowDragon]

thank you for caring. these are from the test i took prior to getting my hypothyroidism treated. i haven’t gotten a follow up sadly.

D vitamin (d2+d3) 73 (normal range 50-160

b12: 473 pmol/l (normal range 200-600)

ferritin: 23 µg/l (normal 15-120)

TPO; 600 (normal <35) (only have one test for this before my tsh got in “control”)

i don’t believe i was tested for folate because i can’t find that number. i don’t seem to have gotten any TG tests either

[SlowDragon Administrator in reply to minawir]

Ferritin is very low. Needs improving to at least around 70. Look at increasing iron rich foods in your diet

Low vitamin levels tend to lower TSH

B12 and folate need testing together

High thyroid antibodies confirms autoimmune thyroid disease also called Hashimoto’s

About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high thyroid antibodies 

Autoimmune thyroid disease with goitre is Hashimoto’s

Autoimmune thyroid disease without goitre is Ord’s thyroiditis. 

Both are autoimmune and generally called Hashimoto’s.

Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease (Hashimoto’s or Ord’s thyroiditis)

Have you had coeliac blood test done yet. Should be tested at diagnosis of autoimmune thyroid disease

Only 5% of Hashimoto’s patients test positive for coeliac, but further 81% find strictly gluten free diet helps or is essential

Get tested BEFORE considering cutting gluten out

How long since these tests were done

Get thyroid and vitamins retested 2-3 months after and significant changes

[mabu2010]

Hi minawir,

I am in a similar positon. I'm currently taking 125ug Levothyroxine and my last results were:

TSH 0.01

fT4 15.9

fT3 3.5

I'm feeling better on this dosage although still not right. My GP wanted to reduce my dosage but was willing to listen. I said my fT3 was still too low. He is letting me continue on this dosage but has referred me to an endocrinologist to let him have the final say. I did get an appointment but it was cancelled due to the strikes. I have no idea if/when I'll get another appointment but I'm happy to keep things as they are for the moment.

Use the useful information in this forum to put your case to your GP. It's all about how you feel rather than absolute numbers. As everyone has said just using TSH is useless.

[minawir in reply to mabu2010]

thank you. it’s very overwhelming. my next appointment is in 3 weeks and he wants to lower my dose.

[G_NorthEast in reply to mabu2010]

I have had similar results to you and My GP talked to him (not me) and he told him to stop my meds for a month as I 'may not be hypothyroid'. It was devastating. I ended up having to do a private test after 5 days to prove to my doctor that my TSH had skyrocketed. I felt chronically ill and took 3 months to recover.

Eventually, I was referred to an endocrinologist and spoke directly to him. He agreed to keep me on 125 Levothyroxine as I felt generally well.

Whatever you do, don't let them stop your meds completely!

[tattybogle]

Ok, i've put them in order to make it easier for people to follow:

April 2022:

TSH ....1.59 [0.3 -4.5]

May 2022:

TSH ...1.46 [0.3 -4.5]

TT4 .....93 ish [60 -130]

T3 ..... 1.2 ish [1.1 -2.5]...... not sure if this is totalT3 of freeT3

April 2023:

TSH ..... 0.032 [0.30 -4.5]

TT4 ..... 84 [60 -130]

T3 .........1.4 [1.1 -2.5]

They want to reduce dose , so i suggest you point out that the T4 is actually lower than it was last year ,, and the T3 which was right at the bottom of the range is only a tiny bit higher ..... both T4 and T3 are low in range.

ask for an explanation why they think your TSH is now so much lower than it was last year with the same T4/T3 hormone levels .. and say you would like to 'watch and wait' for another 3 months to see what TSH is next time before considering lowering your dose , because you currently feel very well/ have important work to be getting on with now you are back home/ and can't risk being unwell .

try saying that you suspect this TSH result may have suffered from some interference from some cause (lab interference / biotin supplement etc )... because it doesn't seem to match the current relatively low T4 /T3 levels, and it doesn't fit with your previous TSH level at those T4/T3 levels .. and you don't want to change dose based on what looks like an questionable TSH result without waiting to see if it;s stil this low in 3 months.

[minawir in reply to tattybogle]

Wow! this is beyond amazing and i thank you so much for this clear explanation. i did wonder about the t3 and t4 being so unchanged whilst the TSH is odd. i know this is far fetched but i didn’t get a reasonable explanation by the doctor, do you know if there’s a reason my skin turned dry the last couple of weeks (started before i traveled back). can this be due to the TSH levels being this low? sorry for the multiple questions