please help me with this wretched problem we have with doctors and medical specialists regarding low TSH.
I am having some help from a medical herbalist who, on seeing my thyroid blood test results, has got quite stroppy and insisting my TSH should be higher , and I should lower my thyroid medication! .
I don’t want to loose the help of my herbalist, so could someone please give me one or two links that prove that it is ok (if being treated) that our TSH be lower.
In someone with no thyroid issues at all, their thyroid produces some T4 and some T3.
The pituitary, which produces TSH, adjusts its output on the basis of the combined effect of the T4 and T3 inside the pituitary.
If you are on levothyroxine only (L-T4), then you would need your FT4 level to be higher than in someone with no thyroid issues. This is because you are not getting T3 from anywhere else. Your only source is from converting T4.
Your body had been getting both the converted T4 AND some direct T3 from the thyroid. Now it is relying on the T3 from converted T4 only. If that T4 is at the same level it always used to be, and the amount converted is the same as it always used to be, your T3 will be low.
But by increasing the T4 level a bit, that can increase the amount of T4 converted and, to some extent, make up for the lack of direct T3.
However, the pituitary will be reacting to the combination of this higher T4 level AND the converted T3. This pushes TSH down.
(The pituitary effectively converts T4 into T3, and adds this to the direct T3. Whereas in the rest of the body, the conversion of T4 is by a different process and does not convert the T4 as effectively.)
In someone taking T3 as well, the TSH is pushed down by this as well as converted T4.
There is much discussion about how far TSH is pushed down whether on T4 only or combined T4 and T3. Your 0.01 is very low and that makes it somewhat more difficult to argue.
Thank you so much for coming back to me with such a lot of information.
One thing I would like to say is that over the last three years my TSH has been at 0.01 at every blood test, but with a higher T3 figure of 5.2 or thereabouts. It confuses me , because if the TSH is static does that mean that my thyroid gland is dead, with my body consequently serviced only by my thyroid medication, which is Armour Thyroid. ….surely therefore I can’t afford to take medication down in order to push up my TSH?
I would just say that over the past seven months I have been through a large amount of stress, including three operations and my husband’s stroke, hence my T3 is now only 4.6
My herbalist who has helped me lift up my adrenals is insistent that I get my TSH UP.
TSH being that low is a common issue. It means that your pituitary is not making TSH, at least, not more than a tiny amount. Your thyroid could be able to make thyroid hormones but a very low TSH will not be stimulating your thyroid to make and release thyroid hormones.
One problem is that is TSH has been low (or extremely low) for a long time, then it can take a very long time for the TSH to rise. Indeed, it might never rise enough to be effective. This is often observed in Graves Disease - for example after a total thyroidectomy.
It might mean that your thyroid is not making and releasing any thyroid hormone.
No, it is inappropriate to reduce Armour Thyroid (or whatever you are taking) solely to get TSH to rise. At least, that is how I see it.
I think your reply should be to ask for a full and detailed explanation as to WHY your TSH needs to rise.
The usual responses are related to your heart and bones. But if the thyroid hormone levels are appropriate, I don't see TSH alone being an issue. If anything, yours seem to be a touch low.
I have read that it is the liver that is the main site for converting T4 to T3. This was also stated in a an article in the new Thyroid UK newsletter. Is this the latest result of new research?
The pituitary gets blood containing T4 and T3. And converts the T4 to T3. And reacts to the total T3 within the pituitary gland itself.
But it is the size of a pea (that is the most common comparison used!). And the volume of blood that goes through it is tiny, and the amount T4 it receives is incredibly much smaller than that. Therefore it has absolutely no effect on the T3 level in the rest of the body.
The importance is that it is this that controls the amount of TSH the pituitary produces and releases.
Like taking a pint of water from a lake or reservoir and boiling it in a kettle. You can see the kettle boiling and the clouds coming out of it. But it is a tiny amount compared to the lake.
thank you very much Anthea55 , but this medical gentleman that is being so strident with me is more concerned with the TSH. …….He gets his information from the American Thyroid Association !
Strident with you and you're paying him!! No thanks! If I'm paying then courteous should be at least how he behaves! Sorry, can't print what I think or would be banned! I am so tired of bossy+ belligerent people telling me what the should do! Sorry for the rant but this is how I feel when reading so many people's situations!
You could point out to your herbalist that healthy people with healthy thyroids on average have a Free T4 roughly 50% of the way through the range. Free T3 might be a little higher than that or a little lower than that in healthy people with healthy thyroid. It wouldn't usually be vastly different to their level of Free T4 in percentage terms.
When people have a poorly functioning thyroid or no thyroid at all those percentages will be much lower, and it is that that makes people feel ill, not the low TSH. Anyone in control of someone's thyroid hormone levels who controls that person using their TSH will inevitably reduce their Free T4 and Free T3 to much lower than that of a healthy person with healthy thyroid. And that is, frankly, torture and is sadistic.
Yay she shouted weakly. The sadism and torture rings true. I just stumble from one day to the next. Feelings of wishing this would all end is a daily occurrence. But I am trying to get out and if I find an hour of energy I try to use it wisely
or this one ( this is mostly useful if TSH is conveniently 0.04 or above which yours unfortunately isn't, but it's still worth a read as some of the other links may be helpful) : 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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