Low TSH and feeling awful: Hi Everyone, I have... - Thyroid UK

Thyroid UK

143,113 members168,440 posts

Low TSH and feeling awful

Woochan profile image
6 Replies

Hi Everyone, I have just got off the phone to my Endocrinologist and I'm feeling pretty hopeless about things right now. I am hoping that sone of you will be able to give me some advice.

I have hypothyroidism and have been taking 2 grains of natural dessicated thyroid for around 8 years and have felt well on it. I also have fibromyalgia which has been well managed and has never effected me too badly.

In the spring last year I suffered from severe fatigue and a big fibromyalgia flare which left me in bed for weeks. My blood tests showed my TSH was suppressed at 0.03 mu/L

(Range:0.32 - 4.94 mu/L). My T4 was 10 pmol/L

(Range:9 - 19 pmol/L). Historically I have always felt better with my T4 at the top of the range. My GP reluctantly agreed that I could try increasing to 3 grains. She did a referral to my Endocrinologist for their opinion.

I quickly started to feel better after the increase and in the 6 months I was waiting to see the Endocrinologist life got back to normal. I started a new job training to be a mental health practitioner for kids and started a post grad uni course as part of my training. At the end of November I saw my Endocrinologist and she said that the amount of T3 in my NDT was far too high and asked me to reduce down again. She said that the higher dose was masking my symptoms but would be doing damage to my heart, bones etc. My blood results were:

TSH 0.02 mu/L

Range:0.27 - 4.2 mu/L

T4 11.5 pmol/L

Range:11.1 - 22 pmol/L

T3 9 pmol/L

Range:3.1 - 6.8 pmol/L

I couldn't argue with the blood results so reduced back to 2 grains. By January I was feeling just as ill as I did back in the spring. Extremely exhausted and having another big fibro flare. I have been in bed for the last month with no improvement. In January my GP retested my bloods and my TSH was now just in range at 0.39 mU/L (Range:0.32 - 4.94 mU/L).

My GP and Endocrinologist now want me to stay where I am with my thyroid meds and don't have anything else to offer me in terms of suggestions to help me feel better. Despite the fact that this has ruined my life. My employer has been very understanding, but I have had to withdraw from my Uni course until next year and will most likely have to be medically redeployed to another role. This is a job that I waited years for the opportunity to do 😔. Does anyone here have any insights or suggestions that might help?

Written by
Woochan profile image
Woochan
To view profiles and participate in discussions please or .
Read more about...
6 Replies
Jazzw profile image
Jazzw

2 grains to 3 grains (and back again) is a huge jump. You can adjust by quarters and halves.

Looking at your results, 2 and a half might be nearer your sweet spot?

greygoose profile image
greygoose in reply toJazzw

Exactly what I was going to say! But they do like to dose with a sledgehammer, don't they! No finesse.

SlowDragon profile image
SlowDragonAmbassador

Try 2 and 1/4 grains ….retest in 8 weeks

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

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

NDT ….day before test split as 2 or 3 smaller doses spread through the day, with last dose approximately 8-12 hours before test

What vitamin supplements are you taking

When were vitamin D, folate, ferritin and B12 last tested

is your hypothyroidism autoimmune

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 not autoimmune

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...

IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 5-7 days before ALL BLOOD TESTS , as biotin can falsely affect test results

endocrinenews.endocrine.org...

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 if last test result serum B12 was below 500 or active B12 (private test) under 70:

SlowDragon profile image
SlowDragonAmbassador

also on NDT Ft4 is often very low

Some people are fine with this others find it better to improve Ft4 by adding a little levothyroxine alongside NDT

pennyannie profile image
pennyannie

Hello Woochan :

Once taking any form of thyroid hormone replacement the TSH is the least important blood test reading -

When optimally medicated on NDT you will likely have a suppressed low TSH and that does not matter - and the TSH has no bearing on the symptoms being tolerated.

We track on the T3 - the most important of the all the blood test results - and this needs to be measured around 10 - 12 hours after your dose of NDT and be from a fasting blood draw blood test -

Your T3 is likely going to be in the top quadrant of it's range - your T3 result is is just a little over the range and probably with a dose reduction of 1/4 or 1/2 a grain NDT you will be in the range -

and the T4 can be much lower in its range than when on synthetic thyroid hormone replacement options and this does not matter if you feel well.

We also adjust NDT in 1/4 grain increments and decreases

No thyroid hormone replacement works well until the core strength vitamins and minerals are up and maintained at optimal levels -

Do you have any current readings for ferritin, folate, B12 and vitamin D ?

Woochan profile image
Woochan

Thank you all for the advice.

My B12 and folate were fine in my recent test. I have B12 injections and take folate. My ferritin was low in January. My test a week ago showed it is now in range but still at the bottom. I haven't had the result of my vitamin D test yet, but have been taking supplements since September so I expect it to be ok.

I didn't take my NDT on the morning of my tests and I don't eat breakfast so probably hadn't had more than a cup of tea before the tests. I'll make a note of all your suggestions for the next one though.

I don't have another NHS T3 test scheduled until my next Endo appointment in 6 months. I think I'll try going up gradually this time and see how I get on. Then I can test privately if I'm feeling better and see what effect it has had on my bloods.

Not what you're looking for?

You may also like...

Transient low tsh result

I am female in my forties, Over the past 10 years when having my thyroid tests done they were all...
swediepie profile image

are these normal levels

Hi, I’ve had two thyroid tests with my GP and one private one with Yorktest. The GP says my levels...

Suppressed TSH AND LOW T4

Hi all, was wondering if any one can help me with my results as my Endocrinologist has reduced my...
Shug1974 profile image

Understanding test results and next steps please

Gosh, I hadn’t realised it was two years ago I asked you lovely lot for help. Sadly, I just...
Jocat profile image

Low TSH on Levothyroxine

My results have now been updated, any comments would be greatly appreciated. 5th. March 2018 TSH...
grahamgraham profile image

Moderation team

See all
GlowCoach profile image
GlowCoachAdministrator
PurpleNails profile image
PurpleNailsAdministrator
helvella profile image
helvellaAdministrator

Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.

Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.