Joined the gym and lost weight but my TSH levels have dropped

[Gilli54]

I decided I wanted to stay functionally fit to enjoy life and especially my little granddaughter. So I joined the Nuffield and have been doing Aqua two or three times a week, Pilates and a gym session. I appear to have lost some weight and it’s really helped my strength and my balance and my arthritis. So all good.

however, I have also been feeling more anxious and my hair is falling out again. And a bit light headed when going from lying down to sitting up.

My recent TFT show that my TSH is towards the very bottom of the range and for me that usually means too much levothyroxine. I also have AF controlled by medication and I know there’s a very fine balance for me to stay at the optimum medicated level.

I have no thyroid just to put things in the picture.

I currently take 125mcg Monday, Friday and alternate Wednesdays. I take 100mcg on the other days.

I think I am taking slightly too much now and wonder if dropping the alternate Wednesdays would be enough. Or would taking 125mcg every Wednesday and not on Monday and Friday work?

Small adjustments do affect me.

I just know from my nails and hair the dose is a bit too high.

is this because of the exercise?

FREE T4+FT3+TSH

Serum free T4 level 16.7 pmol/L [9.1 - 17.6]

Serum TSH level 0.66 mu/L [0.35 - 4.9]

Serum free triiodothyronine level 3.3

I’ve looked back at my results and I seem to be better at a slightly higher TSH level.

Just wondered if anybody could let me know how much small adjustments affect the results? For tve doctor these results are all within range and normal. But I know I’m over medicated.

Not by a lot. But I’m better at a TSH of around 1.2.

Any useful comments welcome. . Thank you.

oh and I eat a very healthy diet.

😊

[pennyannie]

Hello again :

Do you have a range for your T3 please - it looks horribly low ?

I think I wrote in some length to you a couple of years ago.

I remember talking of your low T3 then -exercise will deplete levels of T3 faster than say, walking, or just following your normal everyday routine.

The TSH, when already diagnosed Graves is meaningless - let alone when living without a thyroid and taking any form of thyroid hormone replacement.

[Gilli54 in reply to pennyannie]

hi

The range is 2.4 to 6. I forgot to put that on.

And contrary to my usual practice of going for test at 7.30am at the local hospital before meds and food, I had to have this test at 11.35am and had my meds at 8.20am and had an oat milk coffee and a slice of fruit toast at about 10.15am circumstances just meant that was what I had to do

I realise T4 might be a bit higher

But I’d persuaded them to do the T3 and T4 so I had to go to GP.

I remember you replying before, I’ve tried to find that reply but there’s been a lot going on between then and now.

Thank you for getting back to me again

I’ve been unwell for a few weeks with a couple of viruses and a bad back - my throat issues with the viruses stopped me eating my usual nut portion, including Brazils, as the nutty bits made me choke but I’ve started those again this week

So more selenium getting on board to help with conversion 😊

[Gilli54 in reply to Gilli54]

Also in August 24 my TSH was 1.4 and I really felt good. No T3 level I can’t always get that done

February 24 TSH was 1.0 (0.35-4.9)

November 22 TSH 1.5 (0.35 -4.9)

T3 3.6 (2.4 - 6.0)

[pennyannie in reply to Gilli54]

Just press the Profile icon that sits on the same task bar as the Alerts icon - and that takes you back to all you have written and all your replies.

So your T3 is coming in at around 25% with to your T4 coming in at around 89% :

If I divide your T4 by your T3 your conversion ratio is coming in at just over 5 -

The accepted T3/T4 conversion ratio when on T4 monotherapy and once the T4 is up in the top quadrant of its range - is said to be - 1 / 3.50 - 4.50 T3/T4 - with most people feeling at their best when they come is this little ratio at 4 or under.

Your core strength vitamins and minerals - ferritin, folate, B12 and vitamin D do need to be maintained at optimal levels and if metabolism has slowed your body will be struggling to extract these key nutrients from your food - no matter how clean and healthily you eat.

Considering you have lost your thyroid - you have lost your own natural production of T3 - and it's quite likely that's all you need - around 10 mcg T3 - Liothyronine and likely a small dose reduction in T4 - Levothyroxine to rebalance your thyroidal hormones.

[SlowDragon Administrator]

what vitamin supplements are you taking

ESSENTIAL to test and maintain OPTIMAL vitamin D, folate, ferritin and B12

Which brand of Levo are you taking

Do you always get same brand

Request GP test vitamin levels or you retest privately including vitamin levels and with correct timings

Ft4 result is falsely high as you took Levo before test

Free T3 (fT3) 3.3 pmol/L (2.4 - 6) 

Ft3 only 25.0% through range

You’re either on inadequate dose Levo or poor vitamin levels or poor conversion rate or mix of all three

Likely to need T3 prescribed alongside levothyroxine

Most people when adequately treated will have Ft3 at least 50-60% through range

much easier these days to get T3 prescribed

Though initially likely to be prescribed privately

Essential to get vitamin levels checked and improved before considering adding T3

Here’s link for how to request Thyroid U.K.list of private Doctors emailed to you, but within the email a link to download list of recommended thyroid specialist endocrinologists who will prescribe T3

Ideally choose an endocrinologist to see privately initially and who also does NHS consultations so that might eventually transfer to getting T3 on NHS

thyroiduk.org/contact-us/ge...

[Gilli54 in reply to SlowDragon]

I just take vitamin D.

I have to be careful about general supplementation as a lot of things interact with warfarin, flecainide and bisoprolol.

I try to get vitamins necessary from eating a wide variety of fruit and vegetables, fortified plant milks and good quality meat or vegetable protein.

I did get a referral for an endocrinologist and looked carefully at their interests and credentials but none of them have a joint interest in cardiology and the last thing I want to do is upset my AF.

The hyperthyroid triggered it in the first place and it is closely interconnected with my cardiac functioning.

So it’s not as simple as taking T3 as that in itself could cause a chain reaction that triggers my AF.

I’d need somebody with an interest and expertise in both areas of medicine .

In simple terms for me, low TSH pushes me towards episodes of AF, anxiety and hair loss and nail breakages. TSH around 1.4 seems to keep AF and hair loss at bay.

So I need to know how to achieve that by altering my levo dose just slightly.

It’s complicated, as like many others I have coexisting conditions that interact with my medication levels.

😊

I’ll go through the comments about T3 again and see what my next step is.

[SlowDragon Administrator in reply to Gilli54]

AF can also be triggered by low Ft3

Heart needs Ft3

How much vitamin D are you taking

Test twice a year

Are you taking magnesium, also important for heart as well as vitamin D

B vitamins can also be important

Levels at least need testing annually

journals.lww.com/jhypertens...

[Gilli54 in reply to SlowDragon]

Always have same brand/licence holder for all my meds. Very picky about that. I only use the one that is Wockhardt for 25mcg and Accord/Almus type for 100mcg. I always check the licence holder. 😊There are several that are all identical

Never take Teva.