It's been a while since had to battle with GP after they reduced Thyroxine to 75 resulting in a return to many of the old symptoms over 6 month period. Your help and advice at that time was invaluable. Resolved after full blood screen confirmed no other issues and speaking with senior GP who was happy to put me back to 100, sensibly acknowledging that 'normal' is a wide band and that if I was feeling well on 100 then that was what I needed. Every year following the results have prompted attempts to reduce the dose again to which my stock reply became " It's not going to happen - speak to Dr Firth" (who seems to be the only one there to have an understanding of Hypothyroidism and maintains the status quo).
Just had a call from the surgery to arrange a further blood test in 6 weeks after current annual results again showed a low TSH (0.17) - Free T4 was (13.6). I've successfully managed the condition since 2007 and last time I had need to visit the GP (other than for above thyroid issue and bloods) was in November 2018. I feel great both physically and mentally despite what the test results might indicate. - but should I be concerned?
Many thanks
Susan
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Tiller-girl
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No, your tsh is not completely suppressed so that is not a concern. Its still being picked up on the blood test ok. Your ft4 is pretty low though! You definitely don't need a dose reduction (more like an increase) but as long as you feel ok on that dose, keep on fighting!
If symptoms of hypothyroidism persist despite normalisation of TSH, the dose of levothyroxine can be titrated further to place the TSH in the lower part of the reference range or even slightly below (i.e., TSH: 0.1–2.0 mU/L), but avoiding TSH < 0.1 mU/L. Use of alternate day dosing of different levothyroxine strengths may be needed to achieve this (e.g., 100 mcg for 4 days; 125 mcg for 3 days weekly).
The test was done at 11am, it was 24 hrs after last dose of Levothyroxine . I also avoid drinking tea or coffee for at least an hour after taking Levo. Question of Hashimotos has never ever been raised in 17 years. I will ask in 6 weeks if they can do the vitamin D, folate, ferritin and B12 as well as it's not done automatically.
I do wonder if taking multivitamins etc effects how Levo works. I am not a meat eater so supplement my diet. I try to keep soy products to a minimum but include a lot of eggs, fruit, nuts and fibre in my diet.
It's worth knowing about the Biotin, thank you. I always take anything other than thyroxine in the evening. I asked about the supplements in case they might interfere with absorption. Egg yolks, nuts and mushrooms are all sources of Biotin too (and all key to my diet) should I cut or reduce them a week before the test?
Just a 'thank you' for the advice offered re knocking off my dietary supplements a week before blood test. It has made a difference and the re-test results have come back satisfactory. Next year I will be prepared!
I feel really good - as I always do when medics don't interfere so asked them to look at my history which confirms that the last time I actively sought attention from them was in November 2018 and for a non-thyroid related issue. One thing I didn't realise until very recently was the potential of Amitriptyline to suppress absorption. I've been on it since 2011 for the relief of joint pain, only20mg which I managed to reduce down to 10mg myself in 2019 with doctor's approval to increase up to 30mg should circumstances dictate (which it never has - so far). 10mg is not a high dose but is it likely to make a difference and if so why didn't GP cotton on?
TSH between 0.04 and 0.4 is not really a big problem/ risk,.. and if fT4 is well within range then i personally wouldn't worry about TSH of 0.1 at all as long as you feel well .
~ what's the lab range for the fT4 result you gave ? just asking because ... 13.6 could be quite low if it's [12-22] or quite high if it's [7-14]
here are links to research clarifying that TSH 0.04 or above is not actually a big risk ... you can put under GP's noses if they give you grief about your TSH of 0.1 : healthunlocked.com/thyroidu... useful-evidence-that-tsh-between-0.04-0.4-has-no-increased-risk-to-patients-on-levothyroxine-updated-new-study-does-show-small-risk
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THYROID TEST AT LAST 
New blood test results
So, this is crazy!
ReBlood Test
Test results confusing
