Recent test results; TSH below range

[Macp17]

Hello, am recently diagnosed and have been gradually having Levothyroxine increases and tested 3 monthly. Was on 50mg (TSH wa 2; range (0.35-4.94) and felt better than on 25, but still not great so was increased to 75mg 10 weeks ago. Had blood test yesterday (followed all advice on this very knowledgable site; fasted, no morning dose levo and done 830am same as others tests). Results have come back as TSH 0.11 (same range as before so out of their range). Just noticed this morning they have also tested Free T4 (presumably as out of range as this hasn’t normally been done); this is upper end (16.3; range 9-19). I had assumed when I got TSH result I need to go back to 50mg, but if Free T4 is within range is that the case? (Never been sure about the correlation if these 2!) All results were on the NHS app so assume I will get a phone call in next few days but just wondering what anyone’s thoughts were on next steps. I’m happy to reduce if advised; felt great on higher dose initially but have been really tired last few weeks (which I had put down to being busy at work but may be related?)

Thank you in advance 😊

[PurpleNails Administrator]

How do you feel? 

Doctor will likely suggest reduction based on TSH low. 

If you feel “well” and lowering dose may make you feel less well, tell doctor you want to stay on current dose or compromise by lowering by half a 25mcg dose. 

FT4 is not over range and FT3 hasn’t been tested.  FT3 could be low.  

Resist saying “great” as Doctor will assume your are energetic & over replaced “hyper”.  Doctors are looking to improve numbers.  You want to be well. 

Say you functioning better / fewer symptoms.

You can test privately to see if FT3 level is good.

Have key nutrients been tested?

[Macp17 in reply to PurpleNails]

I have been more tired but thought that was work. I’m 55kg so 75mg Levo should be just under (I think!) what is generally recommended. Perhaps I could try 50mg and 75mg on alternate days (my wockhardt pills are tiny so don’t want to start cutting them!) 😂

[Gingernut44 in reply to Macp17]

I have successfully halved Wockhardt 25s with a pill cutter. They cut nicely and don’t crumble so, if needs be, buy a pill cutter.

[Macp17 in reply to Gingernut44]

thanks for your reply. I heard back from Dr (via text) yesterday late afternoon stating I should alternate 50 & 75mg each day and retest in 8 weeks. Assuming there’s not much difference in doing this to cutting them in half each time so will see how I go.

[SlowDragon Administrator]

suggest you remain on current dose and retest again in another 6-8 weeks

Have you had vitamin D, folate B12 and ferritin levels tested

What vitamin supplements are you taking

Do you have high thyroid antibodies

[Macp17]

Hi, thanks for your reply. Ferritin and Vitamin D were both below range last year when I first went to GP re potentially having thyroid issue so was prescribed supplements from Gp for 8 weeks and then advised to take multi Vit. Asked about retesting but was told they don’t normally do that. Am taking multivitamin and Vit D 3000+K2 spray.

Not heard from GP yet so may just alternate 50 & 75mg and then ask to be retested in a couple of months (or do the monitor my health test which I had early last year and picked up the thyroid issue in the first place; I’d been putting all my symptoms down to menopause!).

As I say, felt better initially going from 50 to 75mg (started on 25mg whic made my TSH come down a little but no improvement in symptoms) However, last 2/3 weeks not feeling so great so maybe in between 50&75 is my sweet spot?! Very new to all of this though so any advice appreciated. ( And yes, I did have raised antibodies when the did the initial full blood tests)