I have taken Levothyroxine for over 20yrs for hypothyroidism. For the last year I have been having lots of symptoms ? due to my thyroid or medication. Had my bloods checked and they came back. TSH <0.05 T4 21.2 T3 5.2 . Does anyone know why the TSH is so low ? Is it because my dose is too high Levothyroxine 125 mcg I am 74. Should I stop taking my tablets? Only advice i got from receptionist was to ring for appointment to see gp in 2 week.
Thank you
I wouldn’t stop taking them. The t4 and t3 look ok but you haven’t put the range (number in brackets) perhaps the dose just needs tweaking and don’t agree to a reduction greater than 25mcg.
Thank for replying, I was surprised at low TSH but normal T3 (5.2) T4 (21.2) Thought I knew about hypothyroid but not sure why my TSH is so low as this ?? would Indicate hyper-thyroid. Just wanted to know if the reason was that my dose was too high
I guess the only way to know is to reduce the dose and see what happens.
previous post from year ago with loads of suggestions
healthunlocked.com/thyroidu...
Have you had vitamin D, folate, ferritin and B12 levels tested
Do you have Hashimoto’s (high thyroid antibodies)
Are you still taking PPI
Thank for replying, yes I had all my bloods taken and they were within range apart from TSH. At the moment I have stopped PPIs as need to have h-pylori test. Because of medication I was on I took ( and still do) them between 3 and 4 am.
last dose levothyroxine should be 24 hours before test
Always test early morning for highest TSH
If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test
If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal
Please add actual results and ranges for Ft4 and Ft3 plus vitamin D, folate, ferritin and B12
What vitamin supplements are you taking
Low vitamin levels are extremely common when on levothyroxine, and especially as we get older and especially if been on PPI
PPI will lower vitamin levels
See links
gov.uk/drug-safety-update/p...
webmd.com/heartburn-gerd/ne...
pharmacytimes.com/publicati...
PPI and increased risk T2 diabetes
gut.bmj.com/content/early/2...
Important to test vitamin levels at least annually
H Pylori common when hypothyroid/on levothyroxine due to lower stomach acid
drhedberg.com/hashimotos-th....
drhagmeyer.com/h-pylori-and...
Thank you so much for the helpful advice, obviously I don't know as much as I thought, I do know about drug interactions though hence reason for taking thyroxine hours apart from other drugs. I did have problems Initially with taking PPI too close to thyroxine. All the bloods I had taken were within range and Doctor commented no further action needed !
You’re legally entitled to copies of vitamin results and ranges ……assuming GP did them
If not taking any vitamin supplements it’s quite likely you have low vitamin D, folate, B12 and magnesium
On levothyroxine we MUST have GOOD vitamin levels for good conversion of Ft4 (levothyroxine) to Ft3 (active hormone)
Test vitamin levels at least annually
List of private testing options and money off codes
thyroiduk.org/getting-a-dia...
Medichecks Thyroid plus antibodies and vitamins
medichecks.com/products/adv...
Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins
bluehorizonbloodtests.co.uk...
Only do private testing early Monday or Tuesday morning.
Link about thyroid blood tests
thyroiduk.org/getting-a-dia...
Link about Hashimoto’s
thyroiduk.org/hypothyroid-b...
Symptoms of hypothyroidism
thyroiduk.org/wp-content/up...
Tips on how to do DIY finger prick test
My TSH is 0.02. I’d think 0.5 was perfect. Studies show there’s no risk to bones or heart if TSH is above 0.4. Lots of us on this forum have very low TSH .
Do you have any symptoms of over medication?
just checking you decimal points bearo ....
Hollyminou' s TSH is <0.05 not 0.5, that's quite a big difference
the "<" means her result was lower than 0.05 and that particular test method can't measure accurately below 0.05 .. so <0.05 could be 0 or 0.04... but since it is unmeasurable it would be termed 'totally supressed'
(0.4 ish is the bottom end of the normal reference range ... 0.04 is significantly lower than the ref range )
Hollyminou , if this TSH is lower than your 'usual' on that dose , then it may be that your dose has become a bit too much and this could be responsible for symptoms ( this happened to me.... following menopause my needs changed and my previous dose of 150mcg became a bit too much and i felt really terrible.. dose was reduced and symptoms of overmedication gradually improved .. (note symptoms of sight overmedication that have crept up gradually can be very hard to recognise if you are not used to them ...eg my GP's thought i had kidney stones , or cancer, for a while. and i thought i had interstitial cystitis ....)
For your information , there are studies showing no risk to bones heart when TSH is over 0.04 and lots of other information/ discussion on the subject of Low TSH / Risk vs Quality of Life here : 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
Basically yes, the usual reason TSH goes so low is due to the dose of levo being 'high'..
whether you want/ need to reduce the dose a little to get TSH back into range depends on:
How well you feel .
Whether this is a significant drop in TSH from your 'usual 'TSH on this dose.
ideally we would all like to keep TSH in range or failing that, we would like to keep it at least 'measurable' rather than totally supressed. ... but not everyone can manage this and still feel well.
Some people do need a dose that results in a low TSH in order to to feel well and would feel unwell if dose was reduced.
But for others , a low TSH with symptoms of overmedication indicate that a slightly lower dose may be needed.
What are the symptoms you have been having this last year ?
Oops - thanks for correcting me! I think I started reading, got halfway through the replies, got distracted to some household stuff for a few hours then came back to it!
Thank you so much for the advice. In my opinion I have both hypo and hyperthyroidism, over the years I have lost a loss of weight and gained lots, over the last three years I have list over two stones this is despite eating lots if sweet stuff.I have extreme tiredness a pulse as low as 45bpm dry cough, difficulty swallowing, have Gerd and continous heart burn despite ppis. Had a gastriscope which didn't show anything, last scope I had showed I had sliding hiatus hernia
My TST is: <0.05. I have symptomso of both hypo/hyperthyroidism. Vit D and full blood profile she values within normal range.
Than for replying.
hashimoto's will cause fluctuations in ths just get another test like gp sead
Very low TSH and low T4
Low TSH and menstrual cycle 
Low TSH - is that bad?
low tsh but still hypothyroid 
Is this TSH and T4 too low?
