My TSH varies considerably: 1.5 to 3.1 in a number of NHS test but my T4 has been more consistent between 17.4 to 19.1.
In two Blue Horizon tests:TSH 1.29 and 4.7 with T4 15 and 14.5 and T3 4.2 and 4.21.
So fairly constant T3 and T4 but wildly varying TSH.
These results all for 75mcg dose over almost 4 years (I am now on 100mcg).
Everything I read, research papers etc., argues that TSH is the best guide for diagnosis and for determining levothyroxine dosage. But, on the basis of my results, this is unworkable.
Can anyone point to any relevant papers please?
Written by
Jasper79
To view profiles and participate in discussions please or .
Are the blood draws for all these tests done at the same time of day? Because TSH varies throughout the day, being higher before 9 am and at it's lowest around midday.
TSH is actually a terrible indicator of thyroid status - we patients know this - and should never be used to dose by. Have a look at some of the papers linked to on diogenes profile:
TSH is highly unreliable on replacement thyroid hormones
It also has pronounced circadian variation so it’s important to always test 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)
You need to retest thyroid and vitamin levels 8-10 weeks after increase in dose (or after any change in brand of levothyroxine)
is your hypothyroidism autoimmune
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)
Testing options and includes money off codes for private testing
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
Is TSH relevant when taking T3?
normal TSH and T3 but Low T4
Low TSH with normal T3, T4. 
Levo t4 vs t4 and t3 treatment 
