Very low TSH

[Cait23]

Hi folks,I was on NDT and my Tsh went down to less than 0.005 from 3.59

Is this normal? Worrying? My GP told me to come off meds immediately.

[SeasideSusie Remembering]

Cait23

Your TSH reduced because NDT contains T3 and T3 reduces TSH. The most important results of a thyroid panel are first FT3 (if over range we are overmedicated) followed by FT4, these are the thyroid hormones. TSH is a pituitary hormone and although useful for diagnosis once on replacement thyroid hormone it isn't particularly useful, especially when we take NDT or synthetic T3.

Also, it seems that you have Hashi's (raised TPO antibodies shown in your other post). When the immune system attacks the thyroid it releases hormone which causes TSH to go very low and FT4/FT3 go high, so what were the FT4/FT3 results/ranges when the TSH was <0.005?

[Cait23 in reply to SeasideSusie]

FT4 is 19.3 this time and no free T3 result just total T3 which is 3.12. My GP sent to hospital and no free or reverse T3 result.

Is it worrying of antibodies Tpex have been going up consistenly?

[SeasideSusie Remembering in reply to Cait23]

Cait23

Do you have the reference range for your FT4 result? As ranges vary from lab to lab we can't interpret any results with the reference range that comes with it. We have no idea if your FT4 is in range or over range. If it's over range then that might suggest overmedication but it's the FT3 that's more important.

Total T3 isn't a helpful test. It measures the total amount of T3 - that which is bound to proteins and that which is unbound (free) which is available for the cells to use. You could have a good/high Total T3 result but it doesn't necessarily mean that the Free T3 is also good, you could have a very low Free T3.

Thyroid antibodies fluctuate all the time, that's normal, so every test could show a different result and they could be over range one time and in range the next. Your result of 190iu/ml doesn't show a range but the comment says HIGH so it must be over range. The two most common ranges for TPO antibodies we see here are <30 or <60.

[Sparklingsunshine]

Is your NDT prescribed for you or do you self source? Its dangerous telling someone who needs thyroid replacement to suddenly stop taking it. Is your GP going by all your thyroid levels, FT3 and FT4 or just looking at the TSH? Because dosing via TSH is inherently flawed.

[Cait23 in reply to Sparklingsunshine]

It was subscribed by a functional GP. But when my local GP saw my blood the results she said come off meds now. She was alarmed and said I was now gone from hypo to hyper. She doesn't look at Free T3 just total. Mainly looks at TSH and free T4

[Sparklingsunshine in reply to Cait23]

Well it shows how little she knows lol. If you are hypo you cant become hyper, its impossible. You can become over medicated. But unless doctors look at the all important FT3 then they cant know.

[pennyannie]

Hello Cait :

The results you posted a day ago show all your results in range apart from a thyroid antibody reading which means you have a thyroid auto immune disease - commonly referred to as Hashimoto's :

Your TSH was over 3 and your doctor commenced treatment with Natural Desiccated Thyroid which contains a measure of both T3 and T4 thyroid hormones and will have suppressed your TSH and hopefully your symptoms.

What are your T3 and T4 readings this time around ?

Is this the same doctor who prescribed the NDT as once on any form of thyroid hormone replacement we must be dosed and monitored on our Free T3 and Free T4 reading and on NDT we track on the T3 reading -

not a TSH reading which once on any form of thyroid hormone replacement is pretty much meaningless.

thyroidpharmacist.com for all things Hashimoto's AI Disease.

[Jazzw]

How much NDT did the doctor put you on?

For what it’s worth, it sounds like a complete over-reaction. I’m afraid we see it here all the time. T3 tends to suppress TSH but it doesn’t necessarily mean that you’re on too much NDT—and even if it did, a reduction would be a more sensible answer rather than telling you to stop meds altogether.

Some doctors drive me bonkers. 🤦🏼‍♀️

[Cait23 in reply to Jazzw]

She was so alarmed and said omg come off your meds immediately. I am referring you to the hospital endo with urgency. I got another docs opinion and she said listen to your GP so it's impossible. They have no time for NDT.

[Cait23 in reply to Cait23]

She was going on the advice of Professor O'keefe a harvard graduate and endo. One would think a professor would know

[Brightness14]

My TSH was that low for years on NDT. That's often what it does i.e. reduce you TSH to low.

No worries I am still alive and kicking at 77 years old and 8 years later, No heart problems

or bone problems my only problems are the Doctors and their little knowledge of the thyroid.