Worried about TSH levels :( 0.04mlU/L

[LittleMissTeapot]

I am taking a small 3mg of T3 with a private prescription and my NHS endo has said, this prescription is causing my lower TSH - but that feels like I'm being gaslight again. I'm feeling soo fatigued and stressed trying to get it sorted. I know I need to my levels on the lower side due to previous thyroid cancer. any help would be weclome: )

thank you to this amazing community.

My TSH is 0.04mlU/L - (0.3-5.5 range)

( it was 0.35 in late Nov)

T4 15.7 pmol/L ( 10.0-22.0 range)

previous private testing T3 level 5.4

B12 527ng/l - 197.0-771.0)

ferritin level seems a bit low but in range - 60ug/L (13-150)

serum folate 3.9ug/L - (2.1-26.8)

[Buddy195 Administrator]

Liothyronine lowers TSH & knowledgable medics know this and should only look to FT3 and FT4 results when suggesting changes in medication. You don’t need to worry about being over medicated unless FT3 or FT4 are over range.

Do you have a FT3 test result or was just FT4 and TSH tested in the latest bloods?

I managed to improve my folate with Thorne Basic B & found this site useful for improving ferritin

dailyiron.net/

[LittleMissTeapot in reply to Buddy195]

Thanks Buddy 195, no I haven't FT3 in the latest test, as they were completed at GPs, so just TSH and T4.

Ok, will have a look at the folate - thanks for the link.

[SlowDragon Administrator]

How much levothyroxine are you taking

How much T3

Low TSH is typical when taking almost any dose of T3

Recommended that all thyroid blood tests 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)

T3 ….day before test split T3 as 2 or 3 smaller doses spread through the day, with last dose approximately 8-12 hours before test

is this how you do your tests

No vitamin D

NHS easy postal kit vitamin D test £31 via

vitamindtest.org.uk

Folate is very very low ….too low

Ferritin slightly low as well

[LittleMissTeapot in reply to SlowDragon]

I am taking 100mcg levo / liothyronine 5mcg 3 tablets a day, first thing am, 3 o clock / 6 o clock by roseway labs. I have been recommended B12 injections by private functional doc. mainly for a bit of nerve pain too. seems a bit much?

I have your words ingrained about taking tablets / timings and only water before every blood test, so they are all based on the same info

Vit D levels - 73.2 nmol/L - but have just started taking the spray, so might not show in results.

abit thank you

[SlowDragon Administrator in reply to LittleMissTeapot]

I am taking a small 3mg of T3 with a private prescription

So you need to correct that opening statement

You’re taking 5mcg x 3 per day = 15mcg per day T3

obviously you need to test TSH, Ft4 and Ft3 together

Work on improving low folate and improve vitamin D level too

Increase iron rich foods in your diet too

thyroid levels

See what next results are

Ft4 might be a bit low if still similar to these results

Free T4 (fT4) 15.7 pmol/L (10 - 22) 47.5%

Many people on levo plus T3 find they need both Ft4 and Ft3 at least 60-70% through range

[LittleMissTeapot in reply to SlowDragon]

opps, completely missed your message, just checked in this evening and saw it

thank you and noted- I have started the folate supplement you mentioned this week, some vit D spray, I have thyroid cancer bloods next week, but not F3 levels, so will order a private test too. okay, will look out for the percentage to go up.

thanks for your help.

[SlowDragon Administrator]

what vitamin supplements are you taking

Low folate

supplementing a good quality daily vitamin B complex, one with folate in (not folic acid)

This can help keep all B vitamins in balance and will help improve B12 levels too

Difference between folate and folic acid

healthline.com/nutrition/fo...

B vitamins best taken after breakfast

Thorne Basic B recommended vitamin B complex that contains folate, but they are large capsules. (You can tip powder out if can’t swallow capsule)

Thorne currently difficult to find at reasonable price, should be around £20-£25. iherb.com often have in stock. Or try ebay

Igennus B complex popular option too. Nice small tablets. Most people only find they need one per day. But a few people find it’s not high enough dose

Post discussing different B complex

healthunlocked.com/thyroidu...

IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg)

Post discussing how biotin can affect test results

healthunlocked.com/thyroidu...

helvella.blogspot.com/p/hel...

[LittleMissTeapot in reply to SlowDragon]

thank you, just seen this will have a look at it all.

[Huskyy in reply to SlowDragon]

A bit related:How soon does supplementing with B12 has an affect on the test result? (= Is it quick to rise with supplementing)

Can prior daily supplementing with B12 and B complex, (for a month or so) falsify the B12 test result; to appear too good?

- AND should there be a specific pause (after supplementing with B12), before testing it..?

Thanks.

[Alex_p]

I had my thyroid removed due to thyroid cancer. I was told to keep the TSH suppressed for at least 5 years, to make sure cancer isn’t coming back. But after 5 years we would discuss about the possibility of keeping the TSH suppressed - this was said to me by an endo in Romania. I see that endos here are more concerned about low TSH, but mine has been at <0.01 even 6 years after the thyrodectomy and I don’t have any issues with that. The only issues I’ve seen were when my FT3 was close to the lower range. So I’m not so much concerned about low TSH, but by the overall image that the thyroid tests offer.

[LittleMissTeapot in reply to Alex_p]

okay, thanks for that.

[Brightness14]

After I left hospital in 2015 having my thyroid removed due to thyroid cancer. The professor surgeon who had removed it, gave me a letter, it stated that my TSH level should always be suppressed in the future, my GP also received a copy from the hospital. I live in France the trouble is the Endos and most GP know nothing about the thyroid. The only trouble I have is when my FT3 is below 6.

[LittleMissTeapot in reply to Brightness14]

yes, I agree, by GP doesn't know the details of the thyroid care.

[Picketywitch]

hi all endocrinologist say that they want to rethink. I’m on T3 & was told that it permanently suppresses TSH, even if you reduce the T3 or stop it, we need a club for everyone that feels as we do. Good luck

[LittleMissTeapot in reply to Picketywitch]

yes, a club for sure.

[Otto11]

Hi I’m new to starting T3 but my TSH is now only 0.04 & the Endocrine nurse said not to worry as they don’t look at TSH once on T3. They are only concerned about T3 & T4.

[LittleMissTeapot in reply to Otto11]

thanks, my endo nurse isn't taking too me, ignoring my calls and is all a bit rubbish; no follow up apts.

[Otto11 in reply to LittleMissTeapot]

Oh I’m so sorry. I’m new to all this & would be lost without mine. I’ve never met any of them as it’s always been phone calls. I don’t know what to suggest. It’s a huge issue getting through to various departments these days. 🙁

[humanbean]

Just being nitpicky, but Levo and T3 doses are both measured in mcg (micrograms) rather than mg (milligrams).

[LittleMissTeapot in reply to humanbean]

got it, I normally look up the proper letters, but missed it this time!!