How much reduction in dose to lower TSH to please the specialist???

[RockyPath]

In July I saw an endocrinologist who found my TSH of 0.025 alarming. He wanted to lower the dose because "Low TSH can cause heart complications." (Eye roll) As many of you pointed out, it's not the TSH that's the problem. Is there sufficient, but not excessive, thyroid hormone to support cellular energy?

I had hoped that when I began the HRT last summer, it would absorb a bit of the thyroid hormone and move my TSH closer to the number he finds soothing. Perhaps 0.2. But the subsequent test remained glued at 0.025.

"But inadequate thyroid hormone can trigger hyperlipidemia," I replied this morning in the clinic visit.

"I'll order a lipid panel," he responded.

"Medicare will only pay for lipid panels every five years," I retorted. "My last one was in 2021."

He could see it in my EMR.

"No. I've never seen them not pay."

"No, they won't," I replied with an elevated tone of 'I should know.'

"The lab told me this the last time I tried to get one."

I tried to maintain my calm but now he really had me on edge.

My free T3 and free T4 are in the bottom quartile. I have no symptoms of being oversupplied with hormone. I have decent energy for exercise. I always have the blood drawn first thing in the morning, 24 hours after the last dose. I never take Biotin.

Now he wants fresh blood work before he decides if he needs to reduce my dose to raise my TSH. I'm thinking of next Tuesday, and perhaps making an adjustment to my intake between now and then. Maybe skip a day? Or two? Or three? Does anybody have any ideas on how slowly TSH will rise if I go cold turkey until the test? My suspicion is that it would be a slow change. I still have my full thyroid gland. No Hashimoto's markers. The gland just seems to be impaired by ubiquitous environmental pollutants from where I've lived.

He might be intelligent enough to think something amiss if my TSH shows up at 13 next week.

Any thoughts would be appreciated. I value the depth of experience and wisdom I find here.

RockyPath, the brain-injured, genetically unique human on the autism spectrum

[greygoose]

Now he wants fresh blood work before he decides if he needs to reduce my dose to raise my TSH. I'm thinking of next Tuesday, and perhaps making an adjustment to my intake between now and then. Maybe skip a day? Or two? Or three? Does anybody have any ideas on how slowly TSH will rise if I go cold turkey until the test?

No, no, no, no, no. That's not something he gets to decide unilaterally. Your changes in dose should be a joint decision. He's there to advise you, not dictate to you. If you don't want to reduce your dose, just say no.

Your plan won't work, anyway. The TSH could take weeks to rise - it certainly won't get to 13 by next week! lol And, if it's been that low for a long time, it might never rise.

No, don't play into his power game. Stand your ground. Tell him you don't care about your TSH because you know what it does - and, more importantly, what it doesn't do. But, should there be any risks, you will take them for the sake of your well-being. Your life, your health, your TSH.

[Sparklingsunshine]

I'm in the UK, our doctors are similarly obsessed with TSH levels. I privately tested my bloods in October and saw my TSH was very low, even though my frees were in range. So when I got notified my annual NHS thyroid bloods were due I was dreading it.

I decided between end of October and beginning of December to drastically lower my dose of Levo in an attempt to tweak my TSH, I dropped to 50mcg in the last 3 weeks from 100mcg ( I was taking 175/ 200mcg before).

My TSH did rise, to 0.33, so just in range, however my FT4 dropped to 7 (12-22) and my FT3 was 2.7 (3.1-6.8). I felt extremely tired and feel like I harmed my health for a very measley rise in TSH. I dont think I'd do it again or recommend it lol.

[Anthea55]

Go to this page on the Thyroid UK website for 'Myths of Hypothyroidism'

thyroiduk.org/further-readi...

Then go down to a heading which says

"The myth that a suppressed TSH leads to Osteoporosis"

My TSH has been suppressed for years, so don't worry.

More interesting reading on that page.

[blondpalomino]

My TSH is 0.004 and has been like that since I had my thyroid removed 23 years ago. The thing is that even Endos don't understand the thyroid, let alone your doctor. I said TSH - "thyroid stimulating hormone", If I don't have a thyroid there is nothing to be stimulated! They kept saying it was the T3 that reduced it, and made me go on just Thyroxine for a while, but the TSH stayed the same and it made me ill in the process, so there is no changing it. Also that I would get osteoporosis, but it is in the family, my Mum had it and my Sister has it, and neither had/has thyroid problems. When I get my annual blood test, I usually stop the T3 for a couple of days before and just take the thyroxine,otherwise my doctor wants to reduce the T3 again, saying I will get atrial fibrilllation if the reading is too high. I know my own body. If I reduce it anymore I am so tired and can't do anything. I take my own blood pressure regularly, which is fine, and my temperature.