Advice again please? Which would be better to try to keep TSH as high as possible? Add 5 T3 to 75 or 87.5 levothyroxine?
Results on 75 levothyroxine
TSH 0.84(0.4-3.7)
Ft3 3.6 (3.5-6.5)
Ft4 14 (12-22)
On 87.5 t4
TSH 0.23(0.4-4.2)
Ft3 4.2 (3.5-6.5)
Ft4 15 (12-23)
In short you can’t.
I suspect it’s your doctor that wants a higher TSH.
If you want a higher TSH you need to reduce replacement (which you don’t want to do). This will allow the FT4 & FT3 lower (likely below range) then IF the Pituitary responds, the TSH will eventually rise. (It take time even in healthy individuals)
Keep your FT4 & FT3 so low / under range you will make you feel very unwell & hypothyroid. BUT your doctor will be “happy” because your TSH will be in range & you can be marked “job done”.
However The TSH can be very unreliable so it may not rise in which case all will remain low, (neither you or your doctor will be happy).
Unfortunately you can only adjust replacement which affects FT4 & FT3. The TSH response can’t be controlled it has a “mind” of it own & lots of factors affect it.
I understand that it might not be achievable but I would like to try to at least keep it as it is now. So would it be best to increase liothyronine or levaxine a tad since I need it as I'm feeling symptoms now. 75+10 or 87,5+5 wich would get TSH highest do you think?
levo.
Lio tend to have more affect on TSH as even small amounts tend to lower (suppress TSH), levo will too but usually by less. Levo isn't as strong, that why levo is given in higher quantities compared to lio.
Both will have an affect.
Why would you WANT to focus on TSH? You are feeling symptoms because your actual thyroid hormones T4 and T3 are too low to resolve your symptoms.As has been said many times on this forum, TSH is not a thyroid hormone, it is a signal from the pituitary for your body "T3/T4 thyroid hormones too low, please make more T4 and T3".
Your doctor SHOULD know - but probably doesn't- that as soon as you start taking T3, the TSH signal drops and even stops (they call it suppression). Which is logical and normal - why send a TSH signal for "need T3" when you are now getting T3 . Whoever has prescribed you T3 ought to know this.
I have read through your previous posts, and you seem to be very worried and preoccupied about keeping TSH low. It is not a helpful preoccupation, and I see you also have long Covid to deal with. Please do not let the TSH number be a worry for you - concentrate on getting your symptoms improved.
If you have a doctor pushing you on the TSH number tell them 'from the information given by Thyroid UK, once T3 is being supplied, the TSH levels are not satisfactory or reliable for assessing the T3 and T4 dose. '
In your case, as experts on the forum have already said, you look to be undermedicated, even on Levo 87.5. T4 (27.27% ) T3 (23.33%) - both of them very low in range. Most people don't get their symptoms reduced until they are AT LEAST over 50% in range, usually more.
I can't tell whether you have actually started taking the dose ofT3 Lio 5mcg. Please do what's necessary to get your T3 and T4 higher in range, and forget about TSH. Sometimes we have to get ourselves well and then "confess" later on to our doctors that we've taken matters into our own hands and feel better.
Good luck.
Its your body and your GP does not live in it. Do what is best for you and your health.
Did you know how they came by the TSH range? By testing 29 people in 1970's.
ncbi.nlm.nih.gov/pmc/articl...
You are unique, you are not a set of numbers. Do what is right for you.
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