below range TSH

[Gardeningaddict]

Hi everyone.

These are my latest results after increasing to 100mcg levo on 9th September (from 75mcg).

TSH 0.05 (0.27-4.20) -5.6%

FT4 18.6 (12-22) 66%

FT3 4.5 (3.1-6.8) 37.84%

I’m due to get NHS bloods done in December and I know they’ll want to reduce my dose with TSH so low. They don’t test FT4 & FT3. I don’t have any symptoms of over-replacement and the numbers say I’m not but not sure they’ll care about that. My FT3 is still only 38% through the range, so why is my TSH so low?

Thanks in advance.

[Regenallotment Ambassador]

when you increase dose the TSH can drop and then eventually 12 weeks later might start to rise again. (This from my private pharmacist prescriber)

Refuse all adjustments, explain it’s settling and you would like to check in 3 months. Plus you feel better and didn’t do well on the previous dose. I’ve managed to do this for 2 years now.

In some people TSH remains stubbornly low anyway.

I have a similar scenario, NHS bloods in 2 weeks and take a small dose of T3 so they’ll be getting all worked up about TSH for me too. I shall just have to follow my own advice too 🤣

[Gardeningaddict in reply to Regenallotment]

Thanks Regenallotment. I had my vitamin levels checked two weeks after the increase and they checked my TSH accidentally, it was 0.30 (0.35 - 4.94). It was marked as low but comment was ‘level ok for this patient’. My prescription was put on repeat again and I’m hoping they’ll leave me alone for a year. Trouble is, the GP that gave the increase marked on my notes that levels should be checked after 3 months. I’ll wait and see if they’re actually that organised 🤣

[SlowDragon Administrator in reply to Gardeningaddict]

I had my vitamin levels checked two weeks after the increase

What were vitamin D, folate, B12 and ferritin levels

What vitamin supplements are you taking

[Gardeningaddict in reply to SlowDragon]

Hi SlowDragon.

Vitamin D. 84.9 (50-150) up from 55

Folate 3.7 (3.1-20.5) up from 3.5

Vit B 12 233 (187-883) up from 209

Ferritin 52 (20-204). First test.

I take Better You D3 with K2 spray x 2 sprays, Better You B12 spray and recently started igennus superB complex.

I’m presuming the lowish levels can keep the TSH low?

[SlowDragon Administrator in reply to Gardeningaddict]

Folate 3.7 (3.1-20.5) up from 3.5

Vit B 12 233 (187-883) up from 209

These are still terrible

Suggest you try different B12 supplement

Highly effective B12 drops

natureprovides.com/products...

Or

B12 sublingual lozenges

uk.iherb.com/pr/jarrow-form...

cytoplan.co.uk/shop-by-prod...

B complex

Igennus B complex popular option. Nice small tablets. Most people only find they need one per day. Suggest you take 2 initially

But a few people find folate is not high enough dose and may need separate methyl folate couple times a week

In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg) and continue separate B12

important to maintain optimal vitamin levels for good conversion

Folate around 18-20

B12 over 500

[Gardeningaddict in reply to SlowDragon]

Thanks SlowDragon. Will up the B complex to 2 a day and have a look at alternative B12’s you’ve suggested.

[SlowDragon Administrator in reply to Gardeningaddict]

Ferritin 52 (20-204). First test.

Far too low, aim for at least over 70

Look at increasing iron rich foods in diet

Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption

List of iron rich foods

dailyiron.net

Links about iron and ferritin

irondisorders.org/too-littl...

davidg170.sg-host.com/wp-co...

Great in-depth article on low ferritin

oatext.com/iron-deficiency-...

drhedberg.com/ferritin-hypo...

This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.

Thyroid disease is as much about optimising vitamins as thyroid hormones

healthunlocked.com/thyroidu...

restartmed.com/hypothyroidi...

Post discussing just how long it can take to raise low ferritin

healthunlocked.com/thyroidu...

Iron and thyroid link

healthunlocked.com/thyroidu...

Posts discussing why important to do full iron panel test

healthunlocked.com/thyroidu...

Good iron but low ferritin

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Chicken livers if iron is good, but ferritin low

healthunlocked.com/thyroidu...

Shellfish and Mussels are excellent source of iron

healthline.com/nutrition/he...

Iron deficiency without anaemia

healthunlocked.com/thyroidu...

Ferritin over 100 to alleviate symptoms

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Great research article discussing similar…..ferritin over 100 often necessary

ncbi.nlm.nih.gov/pmc/articl...

Low Iron implicated in hypothyroidism

healthunlocked.com/thyroidu...

if ferritin levels drop further, consider supplementing

Never supplement iron without doing full iron panel test for anaemia first and retest 3-4 times a year if self supplementing.

It’s possible to have low ferritin but high iron

Test early morning, only water to drink between waking and test. Avoid high iron rich dinner night before test

If taking any iron supplements stop 5-7 days before testing

Medichecks iron panel test

medichecks.com/products/iro...

[Gardeningaddict in reply to SlowDragon]

Thanks for the info SlowDragon. I’ll do some reading.

[Sparklingsunshine in reply to Gardeningaddict]

I've been threatened with repeat blood tests after a dose increase. I've dodged it for a year now lol. You could always get creative and cite ill health, covid, an extended holiday, a round the world cruise, or becoming a missionary in Papua New Guinea as reasons why " I just cant make it in" for a blood test.

[Gardeningaddict in reply to Sparklingsunshine]

🤣🤣🤣

[crimple]

Gardeningaddict I have also been summoned for my annual blood test by a new GP in the practice. The form requested TSH, T4 and T3 but only TSH 0.05 and T4 were tested 14.5 and GP concerned my dose needs adjusting!!

My TSH has been 0.05 for years, I take T4 and T3. So I replied I wouldn't be having a dose reduction as T3 hadn't been tested. I now have to have another blood test to get T3 result! What a waste of money. I know my levels are fine due to my own Medichecks tests and I am also a poor converter, the reason for the T3. Other GPs in the practice are aware of my low TSH and leave my alone. Be interesting to see how things go. I know that my poor conversion of T4 to T3 is due to DIO2 gene issue.

I get very angry about the use of TSH test only and a total lack of understanding that TSH is NOT a thyroid hormone, but from the pituitary. It's T4 and more importantly T3 that they need to understand as T3 is what our bodies use.

[Gardeningaddict in reply to crimple]

Thanks Crimble. I often wonder why hyperthyroid patients are automatically referred to an endocrinologist but hypo are not. It’s like we are not important. The obsession with TSH is very frustrating. The average GP just follows the guidelines on a screen. Thank goodness for this forum, where we learn to advocate for ourselves, based on sound knowledge and research.

[Sparklingsunshine in reply to Gardeningaddict]

Hypo is regarded as easily treatable and not serious, hence we get the Sunday Dad's 5 a side whilst those with hyperthyroid get the Premier League. Mind you we hear some very alarming stories about Endos and their funny little ways so its not a guarantee that your treatment will be any better.

[crimple]

Couldn't agree with you more on all points. The only way it will change is an earthquake in Med Schools that accepts being in range = being well NOT TRUE and TSH is THE most important reading NOT TRUE.

So far I have been lucky and able to advocate for myself but it does get wearying and I wouldn't be where I am now without help from this group. The obsession with TSH numbers and rigid guidelines, I know they are not rigid but medics seem unable to think outside the box is leaving so many people unwell, mostly women because usually hypo hits at a certain age, as it did with me!!

If Wes Streating NHS is so concerned about numbers on sick he might like to get everyone tested properly for thyroid issues, TSH, T4, T3, antibodies and levels of B12, Vit D folate and ferritin. Then get an opinion from someone who actually understands Thyroid disease (TUK) I think they might find a lot of folks undertreated/not being treated. Theymight save NHS a lot of money!!!!

[Gardeningaddict in reply to crimple]

Too true!

[EPNM]

I'm under an excellent endocrine consultant. My TSH has been 0.01 for years. I'm over 80. My consultant always tells me what I could develop, - osteoporosis, Atrial fibrillation -but accepts my quality of life is more important.

[Gardeningaddict in reply to EPNM]

Yes, totally agree EPNM. We know our own bodies and it’s a balance between QOL and safety. I’m on the side of QOL!

[crimple]

Totally agree EPNM and Gardeningaddict. I have even offered to sign a disclaimer as I have had the old chestnut re AF and osteoporosis. Strangely no one seems to want to take me up on a disclaimer. QOL is so important.