Hi I'm due to go through some fertility treatment and they asked me to have some tests. One of them was tsh which came back as 0.027mIU/L and free thyroxine 31.3pmol/LI think tsh is really low now. Last year it was 30 so I started to take levothyroxine 50mg 1 a day as for fertility it needs to be 2.5 or under.
Can someone help me please x
Well, it is under 2.5. 
Your TSH is low because your FT4 looks very high. Do you have the range for that, please? Also, have you had FT3 and antibodies tested? Having such a high FT4 could indicate Hashi's, because your FT4 is unlikely to get that high on just 50 mcg levo, but antibodies would confirm it.
I only took these tests recommended by fertility.
Yes, I see. But, to get the full thyroid picture of what's going on, you do need full thyroid testing:
TSH
FT4
FT3
TPO antibodies
Tg antiboeis
vit D
vit B12
folate
ferritin
Do you have the range for your FT4?
Just seen what you wrote in reply to @PurpleNails: I did take levothyroxine in the morning as usual. Is this dangerous? I'm very worried
If you took your levo in the morning, what time was the blood draw? Because you have a false FT4 there - the gap should be 24 hours - but we don't know false by how much.
Are you worried about the high FT4 or the low TSH? No, a low TSH is not dangerous in or of itself. It's not a thyroid hormone. And, it's level depends very much on the time of day. High FT4 is not dangerous either. But the important number is the FT3.
The consultant said it is overactive thyroid.
The consultant is wrong. You cannot have an overactive thyroid because your thyroid is underactive, and that's why you're taking levo - a TSH of 30 is very under-active - and the thyroid cannot regenerate and suddenly start producing too much hormone (which is the definition of 'overactive').
You could be over-medicated but that's unlikely if you are still only on 50 mcg levo.
So, your high FT4/low TSH is either due to incorrect testing. Or, it could be due to Hashi's, but to know that, you need your antibodies tested.
Don't worry. Nothing is dangerous in this situation.
Are you currently taking 50mcg levothyoxine?
Can you add lab ranges with your results.
Was FT3 tested?
Recommend tests are taking in morning after fasting and dose delayed until after blood draw. Was test done under these conditions?
Do you take any supplements containing biotin? Biotin needs to be stopped 5 days before test as can skew results.
Hi I only took these tests and nothing else. I did take levothyroxine in the morning as usual. Is this dangerous? I'm very worried
If TSH is low & FT4 over range the dose might need adjusting.
Taking replacement before test show high daily FT4. Is it just above range? It’s likely lower & in range for other times of day.
Most are well with FT4 in top third or range.
You also need to know of your T4 is being converted to T3 the active thyroid hormone in your body. This could be low even if TSH & FT4 indicate otherwise.
Just checking x Was your TSH 30 or your FT4 30 the year before? I assume it was your TSH as levothyoxine wouldn’t be prescribed with such a high FT4.
It was TSH
Recommend you arrange a complete thyroid test including thyroid antibodies FT3 and ideally key nutrients too. Medicheck thyroid advanced is a good option.
List of companies offering different options, some packages include thyroid function, key nutrients and thyroid Antibodies. Others basic function only. some also have discount codes available.
thyroiduk.org/help-and-supp...
You order test online the kits arrives via post sample taken by finger prick (extra fee for private venous draw). Post back and results available online quite quickly.
Ideally test before 09.00. Fast overnight, delay dose until after. Remember to leave off biotin 3-5 days before.
Complete test early in week to post back sample avoiding weekend delays.
Thank you for all this information. I think I should book a gp appt and then a further full blood tests.x
The consultant said it is overactive thyroid.
Not necessarily so
More likely a Hashimoto’s swing
About 90% of primary hypothyroidism is autoimmune thyroid disease also called Hashimoto’s
Hashimoto’s frequently starts with transient hyperthyroid results and symptoms as thyroid breaks down releasing excess thyroid hormones
After each Hashimoto’s flair thyroid becomes a bit more damaged and hypothyroid
Do you always get same brand levothyroxine at each prescription
How long have you been on just 50mcg levothyroxine
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
About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high thyroid antibodies
Autoimmune thyroid disease with goitre is Hashimoto’s
Autoimmune thyroid disease without goitre is Ord’s thyroiditis.
Both are autoimmune and generally called Hashimoto’s.
Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease
20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis
In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)
Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)
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
Your results are skewiff because you took the levo close to the test. Even so, the results are NOT dangerous. Stop worrying. Slowly take in all the info above, take a deep breath and you will be fine.
I bet your Endo is a diabetic specialist! Hug.
Thank you all you lovely ladies for giving me information that I didn't know. Last question should I still continue to take levothyroxine? I'm away at the moment for a few weeks and will book gp appt once I'm back home.x
probably best to carry on with same dose until you can get a blood test sorted out ,test correctly about 24hrs from last dose levo .
..... as long as you are not suffering from any signs / symptoms of overmedication ( fast heart rate / feeling too hot / anxious / jumpy / diarhoea/ fine tremor in fingers ) there's no harm in short term high levels of T4.
because if you lowered the dose now , then you'd need to wait 6 weeks on lower dose before another blood test would be reliable ( it can take TSH 6 weeks to adjust to new dose) .
and your current dose may not really be too high anyway , since we know you took levo shortly before tests.
and if it is a hashimoto's swing causing the high fT4 , they may have gone down again in a few weeks.
So personally i'd carry on with current 50mcg dose unless you get any symptoms of overmedication while you are away ... if you do , just miss a dose to allow T4 levels to fall faster and then resume at a lower dose eg 25mcg /day .
Many thanks for replying x
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