Hi Everyone,
I just had my latest blood results which again show that my TSH levels are low. I am currently on 125mg of levothyroxine.
I have been recording my results and I really don't understand what I need to do as my next step.
Here is a snapshot of my results for last few years for better understanding.
I followed the guidelines with respect to not taking my meds 24 hours before my blood test.
Your advice is very much appreciated.
You seem to be converting well but could do with an increase if you are still symptomatic, perhaps add 12.5mcg, you need to sneak up on your sweet spot... perhaps adding 12.5mcg on alternate days and see how it feels or even just an extra 25mcg per week
Free T4 (fT4) 15.3 pmol/L (9 - 19.1) 62.4%
Free T3 (fT3) 4.4 pmol/L (2.4 - 6) 55.6%
T4:T3 Ratio 3.477
Nothing...unless you feel you unwell!
Are you unwell?
Basically...all the TSH is indicating is that the thyroid gland doesn't need to produce more hormone because the pituitary senses there is sufficient in the serum ...so the thyroid doesn't need to be stimulated by TSH to produce more.
TSH is not a reliable marker after replacement hormone is initiated....it's use for monitoring the dose is causing untold misery for many, but the medics refuse to understand, or choose to ignore, how it works.
FT3 followed by FT4 are the important numbers and yours look fine. 125mcg is likely your therapeutic dose.
How do you feel on these results? You aren't over medicated as both your frees are well in range. Clearly your pituitary gland isnt signalling to your thyroid to produce any thyroid hormone of its own as it detects there's enough in your blood.
Sometimes the feedback loop doesn't work properly and TSH becomes extremely low or even suppressed but the frees, which are the important bit, sit in low to mid range. This is the experience of many hypo patients.
Was this an NHS test or private?
This was an NHS test which was delayed from December. To be honest, recently I've been feeling tired and nod off while watching TV. Nothing too alarming but I'm also conscious that I'm no spring chicken either!
I have been experiencing chest pains, which after visiting A&E they confirmed it was not heart related, not sure if this is relevant but thought I'd mention it. I still get them but they said it's probably more muscular and am waiting for clinic appointment.
You'll probably have a "conversation" about GP wanting to reduce dose as your TSH is obviously very low. However if you dont want to reduce then stand your ground.
Your frees are both well in range, so much so an increase wouldn't be ill advised. Many doctors dose by TSH which might satisfy them, but rarely satisfies the patient 😁
In that case, your FT3 may be lower than what is optimal for you as an individual....you will likely benefit from more T4/levo which, if conversion is ok, will raise the FT3.....say up to 150mcg.
So long as FT3 remains in range you will not be overmedicated....your recent FT3 result is well within range
Test again after 6 weeks and importantly, record all symptoms
thyroiduk.org/signs-and-sym...
For good health every cell /T3receptor in the body must be flooded with T3 by way of an adequate and constant supply.
Low cellular T3 = health problems.
You may have a problem convincing a GP to increase your levo dose if they can't see past TSH...point out that your pituitary gland is not responding normally (secondary hypothyroidism) resulting in low TSH... despite FT4 and FT3 being at a reasonable level
Do not agree to reduce your dose based on TSH alone....your symptoms will most likely increase
uclahealth.org/medical-serv...
The heart needs a great deal of T3....good it has been tested/ scanned with a satisfactory result
Have you optimised vit D, vit B12, folate and ferritin to support thyroid function/ conversion
Vit D: 100-150nmol/L
Total B12....top of range
Active vit B12.....100+
Folate: at least half way through range
Optimal ferritin level for thyroid function is 90-110ug/L
Tweaking your levo dose should help
Good luck!
Just wondering what your vitamin levels are like? We cannot use our thyroid hormone well until all key vitamins are at OPTIMAL levels - ferritin, folate, B12 & D3.
What are you supplementing with?
Suggest you either ask GP or buy private vitamin test. Post results in a new post when you get them.
Private tests are available, see link for companies offering private blood tests & discount codes, some offer a blood draw service at an extra cost.thyroiduk.org/testing/priva...
There is also a new company offering walk in& mail order blood tests in London, Kent, Sussex & Surrey areas. Check to see if there is a blood test company near you. onedaytests.com/products/ul...
Only do private tests on a Monday or Tuesday to avoid postal delays.
These have been ok and have been making sure I take supplements.
So what were your last results?
What supplements are you taking?
previous post
healthunlocked.com/thyroidu...
please add most recent vitamin D, folate, ferritin and B12 results
exactly what vitamin supplements are you taking
It's strange, I cannot find my old results for Vit D, folate, ferritin and B12. I can confirm that I'm taking all of these supplements.
I guess I should have a fresh test for these?
Yes
Test at least annually
Test vitamin D twice year
Exactly what vitamin supplements are you taking
What were results BEFORE starting supplements
I remember this great forum advised me to take Vit D, Folate, Ferritin and B12. So that's what I have been doing ever since.
No we didn’t
We advised you get vitamin levels tested
Never start any supplements without testing first - ESPECIALLY iron
You could have high iron/ferritin
Hello, you mention that you left 24 hours between your hormone doses & the blood test. That’s too long to leave between a dose of T3 & a blood test so it’s likely that your t3 level is usually much higher & that would give you a low TSH. Advice re testing T3 is to split your dose & take the last part of your daily dose 8 to 12 hours before test.
oops! Sorry I misread your post, should have had a cup of tea before answering questions.
Undetectable TSH and my results 
TSH over 100, undetectable T4 & T3
Does anyone have 'Central Hypothyroidism'? Where your TSH is undetectable? 
Advice please - T3 trial, TSH undetectable, feeling awful!
Tsh
