Hi- been under active for years and been on 100 micrograms of Levo for years as well. Feeling ok and levels always normal since.
Had my annual check up last week and results just come back abnormal and too low (never had that before!)
Serum TSH level 0.074 U/mL |0.38 - 5.33];
Below low reference limit
any idea what has happened , do I need to reduce my dose? Not changed brand and took test before taking usual early morning meds.
says to see doctor but through I check here first - thank you!
They have only TSH so its not possible to assess if your free hormones FT4 & FT3 are within range.
TSH is not the only factor to consider when deciding if you have too much or not enough thyroid hormone.
What time of day was this test taken and did you fast before the test?
Recommended blood test protocol: Test at 9am (or as close as possible), fasting, last levo dose 24hrs before the blood draw, no biotin containing supplements for 3-7 days (Biotin can interfere with thyroid blood results as it is used in the testing process).
Testing like this gives consistency in your results and will show stable blood levels of hormone and highest TSH which varies throughout the day. Taking Levo/T3 just prior to blood draw can show a falsely elevated result and your GP/Endo might change your dose incorrectly as a result.
Suggest you run your own private test, possibly with Monitor My Health as they are an NHS lab and GPs accept their reults usually. You need TSH, FT4 & FT3.
What are your latest vitamin results?
What supplements are you taking?
When hypo we get low stomach acid which means we cannot absorb vitamins well from our food, regardless of a great diet. For thyroid hormone to work well we need OPTIMAL levels of vitamins.
Have you recently or could you ask your GP to test levels of ferritin, folate, B12 & D3? 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.
Thank you- they never test for anything else.
I had the test at 11am and had a smoothie that morning. I did not take my Levo so had been over 24 hours. I am already vitamin D deficient and take prescribed tablets for that (have done for years). I recently had normal ferritin levels I know that.
The only thing that has changed is that I have started taking Magnesium at night (away from Levo) so not sure if would affect.
Testing at 9am or earlier is recommended for highestTSH. Your TSH would have been higher if you had tested earlier. Some foods can affect TSH so suggest you fast in future for tests.
Prescribed vit D is likely not enough to get your level to OPTIMAL which is where we need it for best use of thyroid hormone.
'Normal' range ferritin is often far too low. What was your result?
Suggest you get B12 & folate tested. See link in my first reply for private testing companies of GP wont test.
Refuse to reduce dose if GP suggests that. Show them NICE guidelines and accept responsibility for your results.
The first paragraph in the NICE (NHS) Thyroid Disease, Assessment and Management guidelines says :
nice.org.uk/guidance/ng145
"Your responsibility”
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian. “
Likely you have low vitamin levels lowing your TSH.
If magnesium is taken 2-4 hrs away from Levo it wont be affecting your results.
Thank you- it was actually in June last year so coming up to a year. Dr thought I would be anaemic and had been quite unwell, but results were Serum ferritin level 36 ug/L [11.0 - 307.0]
Which other vitamins should I test for? (Or just B)
36 is only 6 points above deficient. Your ferritin is actually quite low.
Can you ask your GP for an iron panel?
Ferritin should be around 90 - 100 for best use of thyroid hormone. Suggest increasing iron rich foods in diet and eating them often. Chicken livers, pate, red meat etc
Link with ideas for dietary iron:
dailyiron.net/https://three...
Suggest you test vit D, B12 & folate.
Typo alert Jaydee "Your TSH would have been lower if you had tested earlier"
i suspect you meant to write higher .
I'll edit it. Blame brain fog.
TSH is not affected by when you took your last dose. It doesn't move that fast. It is affected by the time of day. And, at 11 am it will be approaching it's lowest point. Do you always have the blood draw at the same time every test? If not, you can't compare them.
Your profile doesn't list your age. Another thing could be esteogen levels. But as above you probably need a wider range of tests to figure this out.
I have been on 100 mcg of thyroxine for around 16 years and my TSH has always been very low (0.01). I feel absolutely fine on this dose with no problems. As others have suggested, as they only test TSH, you have no idea what your T4 or T3 levels are, so I would strongly suggest to tell your GP that without a test for the free hormones, you would not agree to any dose changes. Only of you assess these hormones, you can really see what's going on.
The TSH test is a good tool to diagnose hypothyroidism, but once a patient is on treatment, the free hormones should really guide decisions. Besides, in a patient with thyroid disease, who can guarantee that the TSH feedback loop works in the same way than it does in a healthy person?!
Just wondering when they reccomend refusing to lower your dose how would you continue high dose without without a prescription? Guess you would need a second opinion. Here in the states your doctor makes the rules.
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