went from under to overactive? Or just over medicated?

[BPVSCF]

hi all, first time posting. These are my thyroid function results over the last two tests.

I did a private test in June - and got these results :

TSH: 3.9 (range 0.27-4.2)

Free T3: 4.4 (range 3.1-6.8)

Free Thyroxine 22 (range 12-22)

I was on 150 Levo at that time. I was feeling a bit off and tried and having read that TSH needs to be under 2 ideally I discussed with my GP to perhaps increase Levo but they suggested against it as it’s within the normal range.

I started losing weight in June and July and went from 103 in beginning of June to 95kg now. I am 192cm.

because I’ve been feeling off (tired, unfocused, irritable and anxious - my symptoms are usually psychosocial and not physical) I requested another blood test and the results just came through, this is NHS so no T3 unfortunately:

TSH: 0.91 (range .27-4.2)

Free T4: 25 (range 11.9-21.6)

My GP has advised to reduce Levo to 125 daily and then check again in 4 weeks.

they’ve not said anything about over medication but could this be the case? My heart rate is normal, even a bit low (60bpm average) Happy for any other advise from this community. thank you for reading.

[TiggerMe]

Welcome aboard

Results from last year show that you are a poor converter with your fT4 top of range and fT3 still low...

TSH 3.9 mIU/L (0.27 - 4.2) 92.4%

Free T4 (fT4) 22 pmol/L (12 - 22) 100.0%

Free T3 (fT3) 4.4 pmol/L (3.1 - 6.8) 35.1%

T4:T3 Ratio 5.000 

Latest result shows you are over replaced, do you test before 9am, 24 hours after last dose, water only before?

Do you have any results for folate, ferritin, Vit D and B12? All essential for conversion, above range fT4 can also inhibit conversion

[BPVSCF in reply to TiggerMe]

thanks for your response. To be clear the June result was also from this year.

On the last test it was taken after I took my Levo in the morning (every morning at 7am well before I have any coffee or breakfast).

On the private one in June it was actually ~24 hours after last dose (this was advised by medichecks).

They didn’t get a proper sample on the folate test, so will need to be redone. I did get the following back on this test in June

Ferritin: 213 (range 30-518)

Vitamin b12 active: 65.2 (range 37.5-188

Vitamin D: 54.9 (range 50-250)

Medicehcks doc suggested I take Vit D supplement but have been outside a lot these last months so don’t think I need it. Others seem to be in range

Last time I tested for folate was in August last year and it ws 9.2 (range 3-20) this was when they found out about my underactive thyroid and possible hashimotos - my tsh was 30 at that time

[TiggerMe in reply to BPVSCF]

Sorry my mistake, so the June result is the more useful as gives your baseline assuming it was taken before 9am (when TSH is at its peak) and shows your fT3 trailing behind your fT4, As GG suggests a small reduction might actually improve this maybe alternate dose 125 -150, yes you do have Hashimoto's with those antibody results which can mean some fluctuation is more likely if your thyroid is still having moments of activity

Your folate could do with being in double figures and active B12 much nearer top of range most of us rely on a good B complex... healthunlocked.com/thyroidu...

Also most of us still need to supplement Vit D even when out and about a lot, I still need 3000iu in the summer and 4000iu in the winter to stay within 100-150nmol/L, it seems to be another thing hypo's aren't great at producing and getting levels up makes a big difference... grassrootshealth.net/projec...

[greygoose]

HI BPVSCF, welcome to the forum.

Well, first off, it's impossible to go from under-active to over-active because thyroids cannot regenerate.

You could be taking too much levo, but it would be strange for your FT4 to go up that much whilst still on the same dose.

So, third possibility: do you have Hashi's? Have you had your antibodies tested?

Your TSH is high for someone on thyroid hormone replacment - it should actually come down to 1 or under - but that is probably because your FT3 is so low. You are a poor converter and that is why you are feeling off. Reduce your levo and your conversion could improve a little. So, worth a try.

[BPVSCF in reply to greygoose]

Thanks for your reply. Yes I possibly have hashimotos. The results in the private test:

thyroglobulin: 150 (range 0-115)

thyroid peroxidase antibody: 99.1 ( range 0-34).

My tsh isn’t high though at 0.91, right? It’s under 1 as you recommend but feeling worse than before - hopefully reducing will help because I feel like *#%^.

[greygoose in reply to BPVSCF]

Oh, yes, you definitely have Hashi's with those antibodies. But, there is no direct link between TSH and antibody levels. A TSH of 0.91 just means that you're probably not hypo at this moment - although on its own it doesn't mean much at all, because your thyroid hormone levels could still be low.

But, as you have Hashi's, your levels are a likely to jump around a lot. And that's probably what happened to your FT4 and has nothing to do with your dose. So, reduce it if you feel the need, but do it on your own, don't get your doctor involved. They do not understand Hashi's, and once they have reduced a dose it's the devil's own job to get them to put it ur again! If you do it yourself you can just go back to your original dose once you feel hypo again. Because the high levels are only temporary, they will go down again by themselves, eventually.

It's time to start ignoring the TSH. Once it gets below 1 it is a very poor guide to thyroid status, and really doesn't mean much at all. It's the FT3 the most important number because T3 is the active hormone, needed by every single cell in your body to function correctly;