I'd really appreciate any help please. I started having symptoms of underactive thyroid after my first and only covid vaccine 3 years ago. My GP said my tsh was borderline but eventually prescribed 25mg eltroxin. I haven't started taking it yet but have been doing private thyroid blood tests for a few years. The results have varied but mostly tsh has been slightly over normal, between 4.2 and more recently 5.37 (range 02 - 4.2). I decided to have one last blood test before starting to take the eltroxin. I got the result today and am dismayed to find tsh was 3.27 - this has varied in less than two months from 5.37. I really don't know what to do now as it seems my tsh is now "normal". Can anyone explain why my tsh is fluctuating so much. All the tests were taken in the early morning at the same time. T3 , T4 and antibodies have all been well into normal throughout. I feel dreadful most of the time. Thank you for any advice.
Help - Fluctuating TSH: I'd really appreciate any... - Thyroid UK
Help - Fluctuating TSH
please add actual Ft4 and Ft3 and antibodies test results
have you tested BOTH TPO and TG thyroid antibodies
Very important to test vitamin D, folate, ferritin and B12 at least once year minimum
Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease
About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high TPO and/or high TG thyroid antibodies
Autoimmune thyroid disease with goitre is Hashimoto’s
Autoimmune thyroid disease without goitre is Ord’s thyroiditis.
Both are autoimmune and generally called Hashimoto’s.
Significant minority of Hashimoto’s patients only have high TG antibodies (thyroglobulin)
NHS only tests TG antibodies if TPO are high
20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis
In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)
Essential to test vitamin D, folate, ferritin and B12
Lower vitamin levels more common as we get older
For good conversion of Ft4 (levothyroxine) to Ft3 (active hormone) we must maintain GOOD vitamin levels
What vitamin supplements are you taking …if any
20% of Hashimoto's patients never have raised antibodies
Have you had ultrasound scan of thyroid?
healthunlocked.com/thyroidu...
Paul Robson on atrophied thyroid - especially if no TPO antibodies
paulrobinsonthyroid.com/cou...
Thank you for replying. T3 was 4.4 (range 3.1 - 6.8) down from 5.6 two months ago. T4 was14.7 (range 12 - 22) down from 16.3 two months ago. TG antibodies were 14.20 (range 0 - 115) down from 15.7 two months ago. TP antibodies were 9 (range 0-34) down from 12 two months ago. I don't take any vitamins at the moment due to having bad reactions to a lot of medication/supplements since the covid vaccine. Last time I had Vit D tested it was 37 about a year ago. I had my thyroid scanned in 2017 and was told it was normal. Please can you help me with my question about why my TSH might be fluctuating?
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...
You need folate, B12 and ferritin levels tested
Vitamin D is insufficient/borderline deficient
Have you tried vitamin D mouth spray
Vitamin D mouth spray by Better You is very effective as it avoids poor gut function.
There’s a version made that also contains vitamin K2 Mk7.
One spray = 1000iu
amazon.co.uk/BetterYou-Dlux...
suggest you retest now before starting on vitamin D supplements
Test twice yearly when supplementing
Can test via NHS private testing service
Vitamin D may prevent Autoimmune disease
newscientist.com/article/23...
It’s trial and error what dose we need
Suggest you start on 2000iu daily
Retest in 3-4 months
NHS Guidelines on dose vitamin D required
panmerseyapc.nhs.uk/media/2...
GP will often only prescribe to bring vitamin D levels to 50nmol.
Some areas will prescribe to bring levels to 75nmol or even 80nmol
leedsformulary.nhs.uk/docs/...
GP should advise on self supplementing if over 50nmol, but under 75nmol (but they rarely do)
mm.wirral.nhs.uk/document_u...
But improving to around 80nmol or 100nmol by self supplementing may be better
pubmed.ncbi.nlm.nih.gov/218...
vitamindsociety.org/pdf/Vit...
Once you Improve level, very likely you will need on going maintenance dose to keep it there.
Web links about taking important cofactors - magnesium and Vit K2-MK7
Magnesium best taken in the afternoon or evening, but must be four hours away from levothyroxine
betterbones.com/bone-nutrit...
medicalnewstoday.com/articl...
livescience.com/61866-magne...
sciencedaily.com/releases/2...
Recipe ideas
bbc.co.uk/food/articles/mag...
Interesting article by Dr Malcolm Kendrick on magnesium
drmalcolmkendrick.org/categ...
Vitamin K2 mk7
betterbones.com/bone-nutrit...
healthline.com/nutrition/vi...
I had my thyroid scanned in 2017 and was told it was normal. Please can you help me with my question about why my TSH might be fluctuating?
Suggest you rescan
And test and maintain GOOD vitamin levels
Thank you. I'll try the Vit D supplement you recommended and see if I can arrange for a scan.
ultrasound sound scan info
I would suspect other vitamin levels may be low
Low vitamin levels tend to lower TSH
Oh, no! 3.27 is not normal. It's hypo. Normal would be around 1.
Actually, as TSH results go, yours hasn't fluctuate that much. In single figures it looks a lot, but imagine it was 75.37 and 73.27. The difference is irrelevant, just normal TSH fluctuations - you can hardly expect it to be exactly the same every time because it depends of so many things and is affected by so many things. But whether is 5+ or 3+, it's still hypo.
A TSH of 3.27 indicates that your thyroid is struggling. Most healthy people are around 1 or 2. Your thyroid hormones are also getting lower:
T3 was 4.4 (range 3.1 - 6.8) 35% through the range
T4 was14.7 (range 12 - 22) 27% through the range
Both free hormones are quite low. Most people feel best when their T4 and T3 are between 60 and 80% through the range, which means that they will have enough thyroid hormones to perform important functions in your body. If your levels are too low, you will feel tired, struggle to concentrate, might feel cold and have a lack of energy. I would start on the tablets you have been prescribed and then test again after 6-8 weeks to see your levels then. You will need further increases. You might starting feeling worse first, before it gets better, but that is normal so stay with it.
A full replacement dose is 1.6 mcg levothyroxine per kg of body weight, so if you weigh 63kg, your levothyroxine requirement is around 100 mcg per day. This is documented in the prescribing guidelines
cks.nice.org.uk/topics/hypo...
Your Vitamin D level is also very low. For the thyroid hormones to work properly, you need good levels of Vitamin D, so as slowdragon has suggested, it would be good for your to start supplementing to bring your levels up.
Thank you. I didn't know that about T3 and T4.
I find this chart helpful when understanding TSH. This is a chart TSH results in a euthyroid population (ie, no thyroid issues.)
I think it does a good job illustrating the probability at any given result that your thyroid isn’t functioning properly.
Once you hit about 4 and beyond, there is statistically very little chance the thyroid is functioning.
That being said - you’re still left with “why” and “what to do” about it. For that the replies above are, as always, on point.
But with a TSH even at 3.25 but certainly higher, don’t be confused - those are all too high.
Fluctuating TSH 
Fluctuating test results 
Raised antibodies, fluctuating TSH, experiencing symptoms and doctor confused...can anyone help me please?
