Tsh results

[Joad467]

Hi had this result from recent blood test,doctor has now dropped levo to 75mcg a day,I did complain but they insist I am overmedicated.

[Buddy195 Administrator]

Do ask your GP for a print out of your thyroid blood test results and share these with us (with ranges- as these can vary between laboratories).

What time of day was your blood draw?

[Joad467 in reply to Buddy195]

Thank you have managed to do it

[Joad467]

Results

Colour

[Joad467 in reply to Joad467]

Thank you 9.50 am

[SlowDragon Administrator]

Looking at previous posts

You were taking 12.5mcg T3

Are you still doing so

Taking almost any dose of T3 will significantly lower or suppress TSH

It’s then ESSENTIAL to dose by Ft3 and Ft4 levels

And retest vitamin D, folate, ferritin and B12 at least annually

You will need to test full thyroid and vitamin levels privately

Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine

Low vitamin levels are extremely common when hypothyroid, especially if dose too low

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

Post all about what time of day to test

healthunlocked.com/thyroidu...

Testing options and includes money off codes for private testing

thyroiduk.org/testing/

Medichecks Thyroid plus BOTH TPO and TG antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes BOTH TPO and TG antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

Only do private testing early Monday or Tuesday morning.

Link about thyroid blood tests

thyroiduk.org/testing/thyro...

Symptoms of hypothyroidism

thyroiduk.org/signs-and-sym...

Tips on how to do DIY finger prick test

support.medichecks.com/hc/e...

Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee

[Joad467 in reply to SlowDragon]

Thanks SlowDragon,wasn't able to get/afford T3 for over a year,so been on 100mcg levo,I have noticed from being exhausted lately to suddenly being highly energetic and hot,just today really

[SlowDragon Administrator in reply to Joad467]

Really recommend never reducing dose without getting full thyroid and vitamin testing done first

What vitamin supplements do you take

When were vitamin D, folate, ferritin and B12 last tested

which brand levothyroxine is your 100mcg

Do you always get same brand at each prescription

[Joad467 in reply to SlowDragon]

Higher nature support,allways get same brand not sure what it is as don't them on me,will check when I get home,will look at doctors records re vit results,thank you

[greygoose in reply to Joad467]

Higher nature support

Is that a multi-vit?

[helvella Administrator Thyroid UK in reply to greygoose]

I think this might be it:

Thyroid Support Formula

Nutritional supplement for thyroid health

One capsule typically provides

Ingredients

Vitamin C 25mg, Niacin (vitamin B3) 30mg NE, Vitamin B6 6.6mg, Folic acid 120µg, Vitamin B12 10µg, Magnesium 57mg, Iron 2.5mg, Zinc 5mg, Copper 500µg, Manganese 2.5mg, Selenium 60µg, Iodine 60µg, Tyrosine 900mg

INGREDIENTS: Tyrosine, magnesium citrate, capsule: hydroxypropyl methylcellulose, kelp†, nicotinamide (vitamin B3), anti-caking agent: magnesium stearate, ascorbic acid (vitamin C), ferrous gluconate, zinc citrate, manganese citrate, l-selenomethionine, anti-caking agent: silicon dioxide, pyridoxine HCl (vitamin B6), copper gluconate, pteroylglutamic acid (folic acid), cyanocobalamin (vitamin B12). †May not be suitable for people with a fish or crustacean allergy.

Daily Intake

Suggested intake

Adults take 2-3 capsules a day at least 30 minutes before meals. Do not exceed recommended daily intake. Food supplements should not be used as a substitute for a varied and balanced diet and healthy lifestyle.

highernature.com/healthy-li...

[greygoose in reply to helvella]

Ugh!

Joad467 There are all sorts of things wrong with this multi, but mainly the iron and the iodine.

The iron will block absorption of most things but mainly the vitamins. Iron should be taken at least two hours away from everything else, except vit C, and four hours away from thyroid hormone.

Iodine should not be taken at all. It could make everything ten times worse. If you suspect that you are iodine deficient you should get tested for it, and the supplement under the supervision of an experienced practitioner. But it's rather doubtful that you would be deficient because you will be getting 65 mcg iodine from your levo every day, which is recycled in your body. And that at a time when your thyroid is not making thyroid hormone, so you need less, not more. More is never better.

[Joad467 in reply to greygoose]

Thanks GreyGoose I didn't realise that 😃

[greygoose in reply to Joad467]

You're welcome.

[SlowDragon Administrator]

Request GP test vitamin D, folate, ferritin and B12

Before you will reduce dose Levo

Ft4 is only 57% through range

Free T4 (fT4) 17.7 pmol/L (12 - 22) 

[Joad467 in reply to SlowDragon]

Thank you

[Joad467]

OK thankyou,was worried they were right re overmedicated as feel very hyper today

[tattybogle in reply to Joad467]

well to be fair those symptoms do sound like overmedication, so i wouldn't rule it out. We are all individual when it comes to 'how much is too much for us'.

How do these latest TSH / fT4 results compare to previous results when you felt more ok on levo ? .... is the current TSH significantly lower? ... is the current fT4 significantly higher ?

if the current TSH is lower than when you have felt well , then trying a small dose reduction is a reasonable experiment . But i would suggest reducing by 12.5mcg rather than 25mcg ... 25mcg can often be more than is needed if the overmedication is only slight .

yes, it is a good idea to get other the things checked too ... ideally you want a fuller picture than just an isolated TSH / FT4 before fiddling with Levo dose. ie: fT3 level / vitamin levels / comparison to previous results .

Personally when i feel i may be overmedicated, i will try a very small reduction of 12.5mcg for 6 wks to see how it feels .... (by cutting 25mcg tablet in half , i don't ask the doctor or get my prescription changed in case i want to go back up again later ~ they may not increase my prescription again without a load of hassle)

If/when you do try a reduction, don't pay too much attention to how you feel until you get to at least 5/6 wks ...in my experience any adjustment in dose can cause all sorts of odd/ fluctuating symptom changes for the first few weeks ... it may feel undermedicated for a while and then slowly improve as the body acclimatises to new levels .

[Joad467 in reply to tattybogle]

Thank you for answer will take a look when I get home

[DippyDame]

To confirm overmedication/ thyroid function you need a full thyroid test to include TSH, FT4, FT3, vit D, vit B12, folate, ferritin and thyroid antibodies TPO and Tg.

Following diagnosis and medication TSH is not a reliable marker

But because your TSH is low they are concluding that you are overmedicated...not necessarily!

So why is your TSH low?

Your FT4 isn't high enough to cause such a low TSH, At your TSH level, your thyroid would be producing considerably more hormone. Your FT4 is only 57% through the ref range.... but we have no idea what your FT3 is doing!

Have you ever taken T3? If so it lowers both TSH and FT4 and these numbers can take some time to re-set if T3 is stopped? Your pituitary may not be sending the correct signals to th thyroid

FT3 is the most important result ( T3 is the active thyroid hormone) so without knowing it's level we are missing a huge clue.

I'm not convinced you are overmedicated but only a full thyroid test will show that

Personally I would never adjust the dose based on TSH!

thyroidpatients.ca/2021/07/...

I also suspect you may have Hashi's.....sudden increased energy and overheating may indicate a flare causing the thyroid gland to temporarily increase hormone production causing overmedication/ feeling hypo

SlowDragon as already explained the testing protocol....follow that.

I would test again after you have been on a steady dose for 6 weeks......then consider changing dose according to results

[Joad467 in reply to DippyDame]

Great thank you will do that

[SlowDragon Administrator in reply to DippyDame]

DippyDame

Yes she was previously on T3, so TSH may still be low as legacy to that

[DippyDame in reply to SlowDragon]

Ah....thank you....I suspected that.

I can't see any antibody labs either.....from being exhausted lately to suddenly being highly energetic and hot.....thinking maybe Hashi's

What do you think?

[Joad467 in reply to DippyDame]

If its hashis what is best

[DippyDame in reply to Joad467]

You need to test first!

A gluten free diet helps many with Hashi's.

Monitor your hormone levels.

A flare is transient

[Joad467 in reply to DippyDame]

Thank you😁

[DippyDame in reply to Joad467]

You're welcome......take care!

[Joad467 in reply to DippyDame]

Thank you DippyDame 😊

[SlowDragon Administrator in reply to Joad467]

Looking at previous posts found a Medichecks test where both thyroid antibodies were negative but test was many years after initial diagnosis of hypothyroidism

If thyroid antibodies were ever high in past, even if now negative, cause is still autoimmune thyroid disease (hashimoto’s)

…..your hypothyroidism diagnosed after pregnancy….suggests autoimmune

ever had ultrasound scan of thyroid

20% of Hashimoto's patients never have raised antibodies

healthunlocked.com/thyroidu...

Paul Robson on atrophied thyroid - especially if no TPO antibodies

paulrobinsonthyroid.com/cou...

Are you on gluten free/dairy free diet

[Joad467 in reply to SlowDragon]

Thank you it was after pregnancy 😄

[Joad467 in reply to SlowDragon]

Yes gluten free thank you

[Joad467 in reply to SlowDragon]

No ultrasound on thyroid