Doc rang with recent blood test results, which included TSH, said to be on the low side of normal at 0.29. My TSH reading has therefore steadily reduced over the past 12 months. I didn’t have the wit to ask the doc at the time about will it stop reducing or will it tip over into hyper at some stage. Doc said it was ‘very high’ when first diagnosed - it wasn’t, it was borderline then tipped over to about 5. Last few tests have been 2ish then 1ish. I have been more inclined to drop off to sleep during the day recently, been a bit more irritable and worry-ish.
T3/4 not tested.
I take levothyroxine at 75mcgs daily.
I followed the recommended protocols before test.
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will it stop reducing or will it tip over into hyper at some stage.
A low - or even suppressed - TSH does not, by itself, make you hyper. In any case, you cannot become hyper because you are hypo, and the thyroid cannot suddenly regenerate and start making excess hormone.
You could become over-medicated but the TSH alone will not tell you that. Your TSH will continue dropping the higher your FT4/3 levels rise - i.e. the higher your dose rises. But, you are only over-medicated if your FT3 is well over-range. So, never agree to reduce your dose on the basis of TSH only.
75 mcg levo is not much more than a starter dose, so you are probably under-medicated, despite your low TSH, and that is probably why you fall asleep during the day. TSH is a pituitary hormone, not a thyroid hormone, and is a very bad indicator of thyroid status.
Of course just testing TSH is completely inadequate. You need to know your FT4 & FT3 at the same time for a complete picture.
Have you retested vitamin levels and been supplementing? What are you supplementing with?
Suggest you get some private bloods done to see whats really happening. See link for companies offering private blood tests & discount codes, some offer a blood draw service at an extra cost. thyroiduk.org/help-and-supp...
There is also a new company offering walk in & mail order blood tests in London, Surrey, Sussex, Kent areas. No charge for blood draw in clinic. Check to see if there is a blood test company near you. onedaytests.com/products/ul...
Only do private postal testing early Monday or Tuesday morning.
My TSH always hovers around the low end and is frequently flagged as below normal, however my GP has never reduced my dose (100micrograms) and I feel well. Unless the doctor is wanting to reduce your dose, I wouldn’t worry.
TSH is the worst way to gauge hyperthyroidism, despite what your doctor thinks. Do you have any hyperthyroid symptoms? Diarrhea, feeling hot, irregular heartbeat?
My TSH has been undetectable for months and I have none of these things, but I went from being obese to being a healthy weight, with full eyebrows, shiny hair, and soft skin. I no longer even need coffee.
I randomly became 'hypo' from normal hormone levels, with T4 & T4 declining. But then my TSH which was always on the low end anyway slowly declined even more! I added T4 and felt nothing for 7 months. Added T3 and began to feel a bit better. But my TSH has now gone below the red zone and is undetectable. Not good. T3 has helped enormously though. But I still have many symptoms. Endo worried that such a low TSH will rapidly cause osteoporosis. He is right to worry.
That said, another Endo said if after adding Levo/Lio your T4 & T3 level look really good on a test result but TSH is below normal and you are still symptomatic - It not your Thyroid thats the root cause. Could be pituitary. There are tests for Pituitary. Had my bloods done yesterday for that. Recent MRI and Cat scan showed no adenoma though.
My suspicion is low copper. My copper and ceruloplasmin are low and have been for over a year - Very bad news! We need Copper for just about everything in our bodies. Deficiency Copper and Ceruloplasmin will cause 24/7 heart palpitations, anxiety, paresthesias, massive brain for and memory loss, cognitive dysfunction and even confusion which I'm starting to experience, issues with balance and being clumsy, eye sight suddenly getting worse, stiff muscles and degeneration of myelin sheath between bone in places like spine, neck, hips and guess what, the brain and it shows up like white matter lesions. But back to the Thyroid, Copper is needed to carry instructions to the Hypothalamus. No copper or Ceruloplasmin (the copper and iron transporter to get the minerals where they're supposed to go to get into you organs for energy and function) then no Hypothalamus instructing the Pituitary to make TSH, thus starts the low hormone cascade.. But thats not all. The Pituitary will also not be able to produce adrenal hormones or pancreatic hormones etc etc either so low cortisol and aldosterone will make you so irritable even the tiniest noise or delay or if you drop your pen on the ground will set off hellfire. Crowds, bright light and the ability to 'deal' with anything will become impossible. Its beyond horrible. Pancreas stops its excretion of digestive enzymes so you'll get malabsorption and leaky gut and allow SIBO to grown to make things worse. You'll feel hypoglycaemic at times but its not diabetes, but could become diabetes if not corrected. Copper and Ceruloplasmin if deficient can't transport oxygen or iron ion the blood to your bones to creat new blood cells so your WBC and RBC and eventually Haemoglobin with starts to hover right around the bottom. But its not true anemia bc other markers won't fit the picture. But if your bones stop making adequate blood cells, immune systems disappears, and RBC will be immature and unable to carry oxygen or iron and you'll fall into chronic fatigue or fibromyalgia-myalgia. This just happened to me. I now have dysautonomia, orthostatic hypotension, am losing sodium and electrolytes at a pace I can't keep up with so its now affecting kidney function, i cannot keep my eyes open and I am so weak and light headed I drop myself to the ground on a daily basis now so I don'y hurt myself. Its not fainting, you're totally alert but you don't even have the energy to speak or blink.
I am sharing this to all you who have low T4, T3 AND low TSH. Get a copper test and a ceruloplasmin test. GPs will give them but they're not on your typical FBC or liver panel. Get your iron and Ferriting tested too at the same time. Iron and copper work symbiotically and their balance ratio is delicate. So if one is high or low, it can send the body into a tails spin like it did me, the copper and iron will get stuck in the liver causing liver damage (liver enzymes ALT and AST will go up bc of inflammation and inability to detox) and the liver will literally eject nutrients (B12, Folate, Vitamin E etc) normally synthesised in the liver for uptake, energy & detox bc the liver is unable to process them. So you're B12 will look really high on a blood test and your GP will tell you to lay off the supplements, meanwhile you're not taking any, but won't be able to tell you why on earth your B12 is so elevated yet you have every symptom of deficiency. I finally read in my research that its called Paradoxical B12 Deficiency. I asked my Endo about that phenomenon yesterday and she confirmed that the liver does indeed do that, causing malnutrition despite a super healthy diet.
I'm gutted that these useless doctors never caught any of this. The anxiety from no thyroids, no cortisol or aldosterone, no B12 & Folate and the lot is unbearable. And then the GP shows a Benzo at you and label you a hypochondriac with an anxiety disorder. Anybody experienced this medical gaslighting?So you don't want to get hooked on Benzos so you ask for something else for the racing heart and they give you an beta blocker with lowers your heart rate more getting even less oxygen to your muscles and brain and you can do nothing but let yourself fall to the ground. I mean honestly! GP school is kindergarten! I have run into this with GPs in the UK and US alike. Shocking. I've been almost bedridden for 2 years and only thanks to my own obsessive research and instigation I'm pushed for the right tests. and am getting to the bottom of this sh*1 show.
I'm typing this in really bad shape. Thanks for listening/reading. I should really be getting all my medical printouts organised to bring to the doctor today. Another new one. God help me! A while ago I committed to go on these chat rooms and help at least one person a day. I have learned so much from you all and try to return some knowledge that just should not be this insanely difficult to fine and treat.
Have a good day all and wish me luck. Hope you all get to feeling better soon too.
I take T3 only but my TSH and T4 levels are v low, and have been for years. MY GP usualIy report, abnormal result but expected. I am fine with a high in range T3 level and low TSH and T4. I was never well on T4, for 20 years. It is worth reading around the topic.
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