Just received online results of my recent annual blood test. I have Hashimoto's (16 years) and on levothyroxine.
Serum Free T4 14pmol/L [9-23]
Serum Free T3 4.3pmol/L [2.4-6]
TSH 0.18 [0.3 - 4.2] - with a note of 'abnormal - need to speak to doctor.
I know they will be pressing for me to lower my dose of levo (75mcg), when, if anything, I think a rise would help! I weigh 62kg which according to NICE guidelines of 1.6mcg per kg body weight would be 100mcg. I cannot lose weight despite a very healthy low carb diet and good level of exercise. I feel well enough now (though have suffered other hypo symptoms in the past including severe depression when I was on a lower dose). A previous doctor at the Practice allowed my TSH to be this low - and actually took into account how I was feeling - but unfortunately she has since left.
Can anyone advise me what to say other than T3 and T4 are normal (if anything, T4 on the lowish side)?
Written by
Kacey12
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If GP says " I have to reduce your dose because the guidelines say i can't let you have a below range TSH" .....
The first paragraph in the NICE (NHS) Thyroid Disease, Assessment and Management guidelines says :
nice.org.uk/guidance/ng145
"Your responsibility
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian. "
Thank you for your swift and useful response. I am on Teva 75mcg. The blood test was done with perfect timing (thanks to info on this site!). I have not had coeliac test but do not have any symptoms and eat a pretty much gf diet (low carb). Vit D was tested (63.6) and ferritin was low in range 33ng/ml [20-300] but I have recently donated blood.
I have just been watching a very good youtube video by Dr Toft in which he goes into the history of how the TSH range came about, and dismissing it's impotance if T3 and T4 are okay - which is what I've read on here many times. I'll have to show that to the GP!
recent consensus statement ... written by some of the most influential endocrinologists in the country... says the following ( i relation to making sure the patient has been tried on the optimal dose of levothyroxine before considering a trial of T3):
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