Low TSH... Doctor says its good

[lilkitty]

Hi all,

My latest thyroid function test is showing a low TSH, my doctor says this is a good thing, is this correct? I've been feeling very unwell for a few weeks now, fatigue, pain and weakness at worst end. I do have fibromyalgia also, so I could well be having a flare up.

TSH 0.14 0.27 -4.20mu/L

T4 17.6 11.30 -21.60pmol/L

There is no T3 result.

Thanks in advance.

[SlowDragon Administrator]

Just testing TSH and Ft4 is completely inadequate

How much levothyroxine are you currently taking

Do you always get same brand levothyroxine at each prescription

Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine

For full Thyroid evaluation you need TSH, FT4 and FT3 tested

Also both TPO and TG thyroid antibodies tested at least once

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

Do you know if your hypothyroidism is autoimmune thyroid disease, also called Hashimoto’s

Was this test done early morning, ideally just before 9am, only drinking water between waking and test and last dose levothyroxine 24 hours before test

What vitamin supplements are you currently taking

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

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

healthunlocked.com/thyroidu...

Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee

[lilkitty in reply to SlowDragon]

Thanks SlowDragon, This is all coming back to me now. I've posted in the past, but I always forget all I've been told.

I'm currently taking 125 Levothyroxine. I usually take in the morning, but I don't always leave a 30 - 1 hour gap before having caffeine, so I decided to try taking at night, but my doctor told me earlier not to do this. I should of, but I did not ask why. I do take other meds (antidepressants) early evening, this could be the reason.

I'm not sure if the brand of Levothyroxine is the same brand with every prescription, although the box always looks the same, I think I would notice if it was different.

None of the above things you have mentioned were tested. This is all coming back to me now, and going off my doctors attitude on the phone earlier, which was very much "listen to me, I am right" I think I will go down the private testing route.

My test was early morning, I fasted, and did not take levo until after test.

I am currently taking a good Q10 supplement which I started taking for my gums and teeth as I have gum disease. It has actually helped with my fatigue also. But as I mentioned earlier, fatigue is quite bad at the moment, which with other symptoms such as muscle weakness and puffy eye lids, in the past has always been a thyroid issue. I am also taking Evening Primrose Oil for the Menopause. I have in the past taken other supplements... Vit D3, B-complex, cod liver oil, but I no longer take due to financial reasons.

[SlowDragon Administrator in reply to lilkitty]

My test was early morning, I fasted, and did not take levo until after test.

I usually take in the morning, but I don't always leave a 30 - 1 hour gap before having caffeine, so I decided to try taking at night, but my doctor told me earlier not to do this. I should of, but I did not ask why. I do take other meds (antidepressants) early evening, this could be the reason.

it’s fine to take levothyroxine at bedtime (on empty stomach) but any other medication should be at least 2 hours beforehand

But if currently still taking in morning, test now

So if you did decide eventually decide to take levothyroxine at bedtime/in night then ideally you would retest 6-8 weeks after changing

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

[greygoose]

It's neither good nor bad. It's irrelevant. The important number is the FT3, but doctors don't know that.

But, whether it's high or low, the TSH itself doesn't cause symptoms. It's a simple messenger telling the thyroid to make more or less thyroid hormone. Or, to initiate conversion.

Fibromyalgia often turns out to be un/under-treated hypo. And, I would say you are under-treated, despite your low TSH. Because your FT4 is not that high - most hypos need it highter, and as your TSH is low, your conversion probably isn't very good. And, it's low FT3 that causes symptoms. Which is why it's so important to test FT3. We can't really know what's going on without it.

[buddy99 in reply to greygoose]

As always, greygoose, you are right on with the fibro. My gp reduced levo, then diagnosed me with fibro and sent me to the rheumatologist. He diagnosed me as hypo, not fibro, which really upset the gp. For some reason that really makes me laugh out loud every time I think of it. Since I am on T3 my "fibro" has completely disappeared. Who would have thunk?

[RandiMG in reply to greygoose]

Greygoose,

You’re 100% right!

FT3 is most important

I don’t understand why doctors don’t prescribe NDTs and only T4. It is a THEORY that T4 converts to T3. I’m on an NDT and a T3. These doctors think one size fits all. Morons!

[greygoose in reply to RandiMG]

They just don't have the education to understand how it all works, and don't have the interest to find out for themselves. They have been taught that thyroid problems are no big deal, and that's what they believe. And, they deny the evidence of their own eyes, dismissing us all as hypochondriacal whingers because what they learn is med school is sacred and they never question it.

I am grossly generalising, of course. There are always exceptions, but finding them is like looking for the holy grail!

[Morning_gl0ry]

hi lilkitty,

Have you considered hrt? It’s been a game changer for me (56) and banished fibromyalgia symptoms. I recently read the thyroid is considered to be the third ovary! So a balance of related hormones makes sense.

[lilkitty in reply to Morning_gl0ry]

Hi Morning-gl0ry,

Thanks for the tip, I will consider this.