Sub-clinical Hypothyroidism

[rachelleigh73]

Hi - I'm curious about the implications of treating subclinical hypothyroidism. The NHS diagnosed this for me some years ago, and since then I have been treated privately with ndt. I'd assumed the ndt was 'topping up' my low thyroid hormones, but now understand that the ndt acts as a 'replacement'. What are the implications for my thyroid? If I stop taking ndt will my thyroid resume its own production of thyroid hormones as it did before, or will it struggle more than before. Does taking ndt/levo etc damage our own ability to produce thyroid hormone? Does anyone successfully improve 'lifestyle' to the point where they no longer need the hormone replacement treatment? Many thanks!

[SlowDragon Administrator]

Taking levothyroxine or any replacement thyroid hormone will reduce/stop your own thyroid hormone output

Taking any T3 (and there’s T3 in NDT) will usually significantly lower or suppress TSH

If your hypothyroidism is autoimmune, many find it best to suppress (shut down) own thyroid output, otherwise levels are hoping up and down madly

If TSH is very low or suppressed it may take many months for TSH to respond to drop in thyroid hormone levels if replacement thyroid hormone dose is reduced

Why there’s a time lag on TSH changing….and might not ever change if been suppressed long time

healthunlocked.com/thyroidu...

Why TSH is sluggish - mechanism called 'Hysteresis'.

healthunlocked.com/thyroidu....

starts at the end of the first reply from Tattybogle : " To understand why TSH stays suppressed for a long time after an episode of hyperthyroidism/ overmedication, (or ANY T3 use) has finished... "

and is continued in detail much further down in another reply from me : " CONTINUED HYSTERESIS ~ Why TSH remains lower for quite along while following episodes of hyperthyroidism / overmedication .... (or any T3 use) , it is due (at least partly) to a mechanism called 'Hysteresis'.

[tattybogle]

The thyroid's production of T4 and T3 is stimulated by TSH ( Thyroid Stimulating Hormone) .

So when TSH rises the thyroid is asked to make more T4/T3.

How much T4/T3 it can actually make in response to higher TSH will depend on whether it is already damaged by eg. autoimmune thyroid disease.

Also how long it takes TSH to rise will depend on various factors .... if it's been very low for a long time it may take a very long time ( many months) to rise . ( for detail of why this delay can happen ~ healthunlocked.com/thyroidu... ~ go to the end of the first reply to this post : "To understand why TSH stays supressed for a long time after an episode of hyperthyroidism/ overmedication, (or ANY T3 use) has finished , you need to look up 'Hysteresis' ..... CONTINUED ~ in my reply a LONG way further down this post" )

Stopping / reducing your dose of thyroid hormone replacement would normally be expected to lower T4/T3 levels , and should cause the TSH to rise (eventually) UNLESS central / secondary hypothyroidism is the problem, which your previous posts have mentioned.

Did your TSH ever rise over-range ? I ask because "sub-clinical" hypothyroidism means over range TSH with T4 still in range.

but basically IF your TSH rises enough , and IF your thyroid is not too damaged , then yes , the thyroid should EVENTUALLY go back to making as much T4/T3 as it can if you stop taking thyroid hormone replacement .... BUT you may suffer problems from lack of T4/T3 while you are waiting for the TSH to wake up and stimulate thyroid , so it would NOT be advisable to stop cold turkey, it would be safer to slowly reduce dose over many months and allow TSH to rise gradually if it's going to .....

as you can see there are a lot of unknowns here , and a lot of "if" s.

the only way to know for certain what would happen to you if you stop taking thyroid hormone replacement is to try it cautiously and see what happens.

to be sensible , a thyroid ultrasound scan would provide some basic reassurance that your thyroid is at least still there and largely undamaged before you try coming off ...obviously not much point trying to come off if a scan shows it's a shrivelled up little raisin , or shows a lot of autoimmune damage. ... if that is the case then no amount of TSH is going to make it produce enough T4/T3.

[greygoose]

If I stop taking ndt will my thyroid resume its own production of thyroid hormones as it did before, or will it struggle more than before.

Speaking from personal experience - I stopped my T3 mono-therapy and took nothing for six months - if you stop your thyroid hormone replacement your thyroid will eventually go back to making as much as it can. Whatever that is.

My TSH had been suppressed for years but it did rise to around 48 - which was a lot higher than the 11 I was diagnosed with. I can only assume that the Hashi's continued to destroy my thyroid during the years I was on thyroid hormone replacement.

Does taking ndt/levo etc damage our own ability to produce thyroid hormone?

The gland may atrophy somewhat due to lack of function - although if you have Hashi's/Ord's it would be difficult to know if it was lack of use or the continued autoimmune damage to the thyroid. But in any case, I wouldn't call that damage.

Does anyone successfully improve 'lifestyle' to the point where they no longer need the hormone replacement treatment?

A lot of people think they do, but I've yet to see the proof of that, and usually, in my experience they end up crashing and having to go back onto thyroid hormone replacement.

With Hashi's you can have quite long periods of euthyroidism after a 'hyper' swing. That is usually when people think they've cured it by whatever they've been taking or doing. But sooner or later they all end up hypo again as the disease continues its course.