Blood Results TSH Low need your help with adjusting Dosage

[Anic]

Hi everyone

I need some help again with my blood test results please.

Ive been to the Endocronologist recently and based on my blood tests TSH too low she has decreased my Thyroxine by 1 tablet a week ie 75mg. (I was taking 75mg/day 7 days). I also take this 2hours before breakfast to help absorption)

I was hoping you good people who have given me your kind advice in the past could take a look at my results please. I would like to know whether i should drop by 75mg or not or drop less ?? Half that ???

Thank you in advance🙏

Ive had Thyroid Cancer (2015) with RAI

Psoriatic Arthritis Dec 2020 on Prednisone , now down to 1.5mg but CRP crept up to 16🙄 and ESR 21

Also on ACTONEL for osteoporosis

and i take supplements

Vit D; Vit C; Curcumin; B Complex; Magnesium; Quercetin; Lipoic Acid;

Bloods done early morning fasting and before taking thyroid meds and other meds and supplements

Thyroid

TSH 0.46 (0.5-4.0)

FT4. 17 (10.-20)

FT3. 4.2 (3.5-6.5)

Thyroglobulin. <1.0

(<55.0 healthy subjects)

(<1.0 - athyroid subjects)

Anti-Thyroglobulin Abs. <1.3

(aTGII (<4.5)

Parathyroid. 6.2 (1.5-9.9)

Vitamin B12 371pmol/L (156-740)

Serum Folate 50.0 nmol/L (>9.0)

Iron 16 (10-30)

T’ferretin 24 (32-38)

T.Sat 34 (13-45)

Ferretin 53 (30-400)

Vitamin D

Haemolysis. Nil

Serum 25(OH) Vitamin D. 72 nmol/L

Sufficiency 51-200 nmol/L

Mild defficiency 25-50 nmol/L

[Sparklingsunshine]

Sounds like your Endo doses by TSH only. Your FT4 and FT3 are not over range and in fact your FT3 looks a little low. If you drop your Levo then its possible your thyroid hormones will drop further. Your TSH isnt suppressed and is only just slightly below the reference range. The important question is how you feel on your current dose?

[Anic in reply to Sparklingsunshine]

Sparklingsunshine thank you for your prompt reply. I feel OK on the dose Im on, maybe a little shaky but hard to know cos Prednisone does that too.

It seems Doctors like to reduce also because of age, Im 66 and been on this for 8 years now, after thyroidectomy.

[Hylda2 in reply to Anic]

I’m 80 and operate best at 0.001-0.005. I stand my ground but think it might be time to come clean on T3!

[Anic in reply to Hylda2]

Thank you Hylda2

[Brightness14]

When having your thyroid removed due to Cancer most patients need to have their TSH supressed. Mine was also removed in 2015. My surgeon who is a top professor in his field in France, sent me home with two letters one for my GP and the others my own copy. These clearly state that my TSH should always be suppressed because of the cancer. Below 1.

[Anic in reply to Brightness14]

Thank you Brightness14. I was also told that but it applies for the first 5 years…then they let it go. Anyway, i learned through this forum and reading other material on internet that low TSH is fine. Because mine was on lower limit i got a bit worked up.

[Brightness14]

Mine is always very low indeed that's eight years after the Thyroidectomy and I am 77 years old.

[Charlie-Farley]

Hi Anic

If the lab work doesn’t ‘look right’ to them, medical ‘professionals’ will adjust medication down on people who are feeling perfectly well. Ultimately the decision is yours you can say you will take responsibility for the consequences. I found with a good steady read up, I was able to amass enough references and knowledge to ask them the questions they can’t answer. Much more effective than trying to wow them with my knowledge. 😉

[Anic in reply to Charlie-Farley]

Thank you Charlie-Fry. I will take supporting info. Im usually pretty good at printing stuff from reliable sites.

[SlowDragon Administrator]

FT4: 17 pmol/l (Range 10 - 20)

Ft4 only 70.00% through range

FT3: 4.2 pmol/l (Range 3.5 - 6.5)

Ft3 only 23.33% through range

So not over medicated at all

You probably have room for small dose INCREASE…..perhaps an extra 12.5mcg 3 days a week

75mcg is low dose, especially for a bloke

How much do you weigh in kilo

Was test done early morning, ideally before 9am, only drinking water between waking and test and last dose levothyroxine 24 hours before test

prednisone will tend to lower TSH

ncbi.nlm.nih.gov/pmc/articl...

Currently poor conversion of Ft4 to Ft3

improving low vitamin levels next step

Vitamin B12 371pmol/L (156-740)

Optimal B12 at least over 500

Ferretin 53 (30-400)

Ferritin is terrible

Are you vegetarian or vegan

Serum 25(OH) Vitamin D. 72 nmol/L

Might be better nearer 100nmol

[Anic in reply to SlowDragon]

Thank you SlowDragon.

Im female and weigh 54kg and i live in Australia

Im gluten free and dairy free and mostly sugar free as ive been told by Integrative GP that will help with inflammation.

will work on increasing Ferritin and my Vit D

From info on internet my is too high at -Serum Folate 50.0 nmol/L (>9.0)

How do i tackle that?

[SlowDragon Administrator in reply to Anic]

ok

Assumed you were male due to ferritin range

So 54 kilo x 1.6mcg Levo per kilo of your weight per day suggests possibly slightly higher dose might be needed

high folate

what vitamin supplements are you taking

[Anic]

PS. Im 150cm and shrinking🥺

[Anic in reply to Anic]

Oh does Ferritin range differ for females and males?? That range was on results

[Anic]

Vit D; Vit C; Curcumin; B Complex; Magnesium; Quercetin; Lipoic Acid;