Tsh 0.83 & T4 23.8 advice would be much appreciated

[_Claire]

My thyroid was removed in 2019 as I had thyroid cancer. How can I bring my t4 down?? I would like to conceive too so I am not sure if this will help having a high t4. Any advice would be much appreciated 🙏

[pennyannie]

Hello Claire and welcome to the forum :

You can bring your T4 down by taking less thyroid hormone replacement - but this could be a retrograde step as it all depends on how well your convert T4 - a pro-hormone - into T3 -

which is the active hormone that runs the body with the thyroid hormones responsible for maintaining your physical health and stamina, your mental, emotional, psychological and spiritual well being, your inner central heating system and your metabolism.

Before you had surgery were you aware of where your T3 and T4 needed to sit, within the ranges, to give your health and well being - as that's where we need to try and get back to.

A fully functioning working thyroid would be supporting you on a daily basis with trace elements of T1. T2 and calcitonin + a measure of T3 at around 10 mcg + a measure of T4 at around 100 mcg. with T3 said o be around 4 x more powerful than T4.

No thyroid hormone replacement works well until your core strength vitamins and minerals = those of ferritin, folate, B12 and vitamin D are up and maintained at optimal levels - so it might be an idea to get these run - as well as a TSH, Free T3 and Free T4 + antibodies and inflammation -

as with these 10/11 biomarkers we can then advise you better of your next best stop back to better health.

If your doctor is unable help you run this Advanced Full Thyroid panel - Thyroid Uk - the charity who supports this patient to patient forum have a whole page listing of Private companies who can do this for you - and then you just start a new post with the results and ranges and you will be ta;led through what it all means. thyroiduk.org

We need a fasting early morning by around 9,00 am blood draw - and a 24 hour window from your last dose of T4 - Levothyroxine - and if taking any supplements you are testing or anything containing biotin these need to be stopped around a week beforehand so we measure what your body is holding and not that just ingested.

Do you any current blood tests results to share with forum members so we can understand and explain better what they mean - and do you need to keep a suppressed TSH - as for some cancers and what other medications are you taking, if any.

P.S. Just seen you wrote 5 years ago re Suppressed TSH - is this still to be suppressed ?

[SlowDragon Ambassador]

Just testing TSH and Ft4 is completely inadequate

How much Levo are you taking

Do you always get same brand Levo at each prescription

For full Thyroid evaluation you need TSH, FT4 and FT3 tested

Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

is this how you do your tests?

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

what vitamin supplements are you taking

Testing options and includes money off codes for private testing

thyroiduk.org/testing/

Medichecks Thyroid plus BOTH TPO and TG antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes BOTH TPO and TG antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee

Only do private testing early Monday or Tuesday morning.

Tips on how to do DIY finger prick test

support.medichecks.com/hc/e...

If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test

If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal

Monitor My Health (NHS private test service) offer thyroid and vitamin testing, plus cholesterol and HBA1C for £65

(Doesn’t include thyroid antibodies)

monitormyhealth.org.uk/full...

10% off code here

thyroiduk.org/testing/priva...

[tattybogle]

lowering levo dose will bring Ft4 down , but it will also raise your TSH , which was being kept deliberately supressed by high dose levo to reduce the risk of your thyroid cancer regrowing .

so you should seek opinion from endocrinology/ ( ?or whoever treated you for thyroid cancer) as to whether they think you still need to keep your TSH supressed or not , before considering reducing your levo dose .