TSH results: could anyone advise on the following... - Thyroid UK

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TSH results

Jack123456 profile image
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could anyone advise on the following

I had my TSH results 6 months ago and it came back 3.7 ( was taking 50mg of Levothyrine) and had been on this dosage for years.

Just had another test and it’s now come down to 1.3 still taking the same Levothyrine 50mg.

the only thing that’s changed in that time is l was started on a 10mg of Atorvastatin for high cholesterol .

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Jack123456
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SlowDragon profile image
SlowDragonAdministrator

Just testing TSH is completely inadequate

Always test thyroid levels early morning, ideally before 9am, only water to drink 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)

High cholesterol is symptom of not being on high enough dose 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)

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

Testing options and includes money off codes for private testing

thyroiduk.org/testing/

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/testing/thyro...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

Symptoms of hypothyroidism

thyroiduk.org/signs-and-sym...

Tips on how to do DIY finger prick test

See detailed reply by SeasideSusie

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

SlowDragon profile image
SlowDragonAdministrator

Levothyroxine doesn’t top up failing thyroid, it replaces it. Important to be on high enough dose. Typically dose is increased slowly upwards in 25mcg steps, retesting 2-3 months after each increase until on full replacement dose

pathlabs.rlbuht.nhs.uk/tft_...

Guiding Treatment with Thyroxine:

In the majority of patients 50-100 μg thyroxine can be used as the starting dose. Alterations in dose are achieved by using 25-50 μg increments and adequacy of the new dose can be confirmed by repeat measurement of TSH after 2-3 months.

The majority of patients will be clinically euthyroid with a ‘normal’ TSH and having thyroxine replacement in the range 75-150 μg/day (1.6ug/Kg on average).

The recommended approach is to titrate thyroxine therapy against the TSH concentration whilst assessing clinical well-being. The target is a serum TSH within the reference range.

……The primary target of thyroxine replacement therapy is to make the patient feel well and to achieve a serum TSH that is within the reference range. The corresponding FT4 will be within or slightly above its reference range.

The minimum period to achieve stable concentrations after a change in dose of thyroxine is two months and thyroid function tests should not normally be requested before this period has elapsed.

When left on inadequate dose levothyroxine, vitamin levels drop, due to lower stomach acid

We need good vitamin vitamin levels for good conversion of Ft4 (levothyroxine) to Ft3 (active hormone) Low vitamin levels tend to lower TSH

Low Ft3 results in high cholesterol

nhs.uk/conditions/statins/c...

If you have an underactive thyroid (hypothyroidism), treatment may be delayed until this problem is treated. This is because having an underactive thyroid can lead to an increased cholesterol level, and treating hypothyroidism may cause your cholesterol level to decrease, without the need for statins. Statins are also more likely to cause muscle damage in people with an underactive thyroid.

greygoose profile image
greygoose

If your TSH - a pituitary hormone - is that high, then your thyroid hormones are too low, and that is what is causing your high cholesterol. You do not need a statin, you need the correct treatment for your hypothyroidism.

Your doctor must be specatularly ignorant about thyroid to have left you on a starter dose for years. It should have been increased six weeks after starting it. You could probably sue him/her for negligence! The result of this negligence is probably more than just high cholesterol, I expect you have a lot of other symptoms, too, don't you?

Statins are not recommended for hypos or for women, even by the NHS. They can cause a lot of muscle damage in hypos. High cholesterol is not even a problem - it doesn't cause heart attacks or strokes - it is a symptom, not a disease. Statins, on the other hand can cause a lot of problems by artificially lowering cholesterol, which the body needs. Without cholesterol the body cannot repair and regenerate itself, nor make sex hormones, putting you at risk of hormone dependant cancers. They can cause diabetes and a lot more.

However, they will not affect your TSH. Were the blood draws for both tests done at the same time of day? Because TSH levels vary throughout the day, something that doctors don't seem to have a clue about!

Jack123456 profile image
Jack123456 in reply to greygoose

Thank you for your reply.

My TSH is now 1.3 taking Levothyrine 50mg which l understand is in the normal range.

greygoose profile image
greygoose in reply to Jack123456

Yes, but that's not the point. TSH is a very poor indicator of thyroid status - especially when it gets down to that level. And you can still be hypo even with a low TSH. And your high cholesterol is telling you that you're still hypo.

Your TSH has come down because you are taking levo, and the pituitary senses that. But that doesn't mean that your thyroid hormone levels have risent to any great degree, nor that they are high enough to make you well.

And you didn't answer my question: were both blood draws, for those two tests, done at the same time of day? If not, you cannot compare them and say, oh well, my TSH is in the normal range now, so everything is alright. Your TSH could be 3.7 at 8.30 am and 1.3 at midday, on the same day. So, you see, it's meaningless. And that is just one of the reasons why dosing by the TSH is 100% wrong.

Jack123456 profile image
Jack123456 in reply to greygoose

No 3.7 result was 6 months ago and 1.3 a few weeks ago.

SlowDragon profile image
SlowDragonAdministrator in reply to Jack123456

But what time of day were 2 tests done

TSH has pronounced diurnal variation

TSH is significantly higher at 8am than 2pm

Jack123456 profile image
Jack123456 in reply to greygoose

I have been diagnosed with FH That’s why l was put on statins as cholesterol apparently high since birth. (Genetic)

I been looking back over few years and my TSH was between 1.1-1.3 but for some reason 6 months ago it jumped to 3.7 it’s now back to 1.3 which l understand is in normal range.

My TSH

greygoose profile image
greygoose in reply to Jack123456

Did they test your cholesterol when you were born? Even if it is FH, statins are not a good idea.

Forget the so-called 'normal' range, it's a nonsense and doesn't mean anything. If you look at statistic, people with not thyroid problems (euthyroid) have a TSH around 1, never over 2 and at three you are hypo. That 'normal range' includes a lot of people that are hypo! And having a TSH in-range doesn't necessarily make you well. People that are hypo need their TSH lower than euthyroid because they need their thyroid hormones higher. Being hypo changes everything.

But, far more important that the TSH is how you feel. How do you feel?

Jack123456 profile image
Jack123456 in reply to greygoose

At the moment l feel fine.

greygoose profile image
greygoose in reply to Jack123456

But, you still haven't answered my question, so I'm guessing you don't really want to know.

Jack123456 profile image
Jack123456 in reply to greygoose

What was the question sorry

greygoose profile image
greygoose in reply to Jack123456

What time of day were the blood draws for each of these blood tests.

Jack123456 profile image
Jack123456 in reply to greygoose

Hi

It was around 9 in the morning it was a fastening blood test for both.

greygoose profile image
greygoose in reply to Jack123456

OK, so there was a sustantial difference.

Do you have Hashi's?

Jack123456 profile image
Jack123456 in reply to greygoose

That’s never been mentioned

greygoose profile image
greygoose in reply to Jack123456

Well, it's the most common cause of hypothyroidism. And the way to find out is to have antibodies tested. Ask your doctor to test them next time you have a blood test.

The point of knowing is that with Hashi's - aka Autoimmune Thyroiditis - levels of TSH and thyroid hormones can fluctuate from one test to another, on the same dose.

Jack123456 profile image
Jack123456 in reply to Jack123456

It was only when l was referred to a Lipid specialist that he thought l was a case for FH that’s why l had the genetic test.

I am 69 now so just been told l have FH.

greygoose profile image
greygoose in reply to Jack123456

Well, if you've had high cholesterol since birth and you're now 69, it just goes to show that high cholesterol isn't a problem, doesn't it. They just want to prescribe as many statins as they possibly can because there's money in it!

Jack123456 profile image
Jack123456 in reply to greygoose

That’s so true I don’t know what to do consultant saying because you had high cholesterol for so long should take a statin to lower the LDL as that’s high, so you tend to listen as they are supposed to be the experts.

I asked the consultant when he was looking at my blood test results is my thyroid blood test ok and he said it was ok that was a few weeks ago.

What l am thinking now about 12 months ago l didn’t feel that well tired and noticed my hair was falling out didn’t link it to anything other then it’s my age, perhaps that may have had something to do with my thyroid at that time being 3.7

greygoose profile image
greygoose in reply to Jack123456

Supposed to be, yes, but they're not. I'm no expert, either, but I've never seen a doctor that knew as much about thyroid as I do.

As for cholesterol, it's a nutrient, and doctors know zilch about nutrients. They get their information from Big Pharma sales reps, who want to seel statins. They didn't learn anything about it in med school.

Jazzw profile image
Jazzw in reply to greygoose

It feels appropriate to link to this Thyroid UK article: thyroiduk.org/related-condi...

Once upon a time, doctors in general practice knew that high cholesterol levels were a strong indicator of hypothyroidism (and indeed, undertreated hypothyroidism).

They don’t seem to be taught this any more.

greygoose profile image
greygoose in reply to Jazzw

Lord knows what they're taught these days. Nothing that is much help to us!

SlowDragon profile image
SlowDragonAdministrator

Request GP test vitamin D, folate, ferritin and B12 now

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