TSH Levels

[Maggiemay12]

My TSH is 0.56 T4 is 20.6 , T3 is 4 . If I increase my levothyrine then will this raise my TSH

[SlowDragon Administrator]

no, taking more levothyroxine will lower TSH

please add ranges on Ft4 and Ft3

Was test done as recommended 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)

How much levothyroxine are you taking

Do you always get same brand levothyroxine at each prescription

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

What vitamin supplements are you taking

Ft3 looks low in relation to Ft4

For good conversion of Ft4 (levothyroxine) to Ft3 (active hormone) it’s important to maintain GOOD vitamin levels

Can’t see any vitamin results in any of your previous posts

[Maggiemay12 in reply to SlowDragon]

I decreased my levothyroxine as my last results were 0.66. and I felt it was too much and now there lower for some reason . Can’t understand as I cold and aching and recto get my TSH higher

[SlowDragon Administrator in reply to Maggiemay12]

Well until you test your vitamin levels you won’t know what’s going on

What’s the range on Ft3 and Ft4 results?

Ideally you want them both at similar % through range ….usually at least 60-70% though range

When you reduce dose levothyroxine (Ft4) , this frequently results in Ft3 reducing even further

Low Ft3 results in lower stomach acid and this results in reduced nutrient absorption…..and lower vitamin levels

As vitamin levels reduce, conversion gets worse …..Ft4 can increase as Ft3 drops

EXACTLY what vitamin supplements are you taking

When were vitamin levels last tested

Please add results

[Maggiemay12 in reply to SlowDragon]

The TSH range is 0.21 - 4.2 . Will get the results after Easter holiday for the rest off them printed off from doctors

[SlowDragon Administrator in reply to Maggiemay12]

Can’t understand as I cold and aching

assuming range Ft3 is 3.1-6.8

Free T3 (fT3) 4 pmol/L (3.1 - 6.8) 

Ft3 only 24.3% through range

Not surprising with such low Ft3

[Maggiemay12 in reply to SlowDragon]

yes get same brand and B12 was checked and full iron etc . No vitamins was done .

[SlowDragon Administrator in reply to Maggiemay12]

Which brand of levothyroxine

Please add results and ranges for

B12

Iron

Ferritin

Folate

Vitamin D

[Maggiemay12 in reply to SlowDragon]

I always use Teva brand and have never had any issues with this . Have t gotten range as doctors said there ok .

[SlowDragon Administrator in reply to Maggiemay12]

Never accept verbal results

Always get actual results and ranges

You are legally entitled to printed copies of your blood test results and ranges.

The best way to get access to current and historic blood test results is to register for online access to your medical record and blood test results

UK GP practices are supposed to offer everyone online access for blood test results. Easiest option is NHS app, you may need "enhanced access" to see blood results.

If you can’t currently see test results online, simply ask receptionist at GP surgery to give you access. You will need to have photo ID with you.

This currently only applies in England, not across the whole of the UK. Nether Scotland nor N.Ireland have released an NHS app for patients. (Scotland supposedly due in December '24.) Wales has an app, but only for booking appointments, repeat prescriptions and amending personal details

Link re access

patients-association.org.uk...

healthunlocked.com/thyroidu...

In reality some GP surgeries still do not have blood test results online yet

Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up.

vitamin testing

GP only tests for vitamin deficiency

Anything within range would be classed as “ok”

That’s not necessarily a GOOD vitamin result

As an example

B12 range is typically 180-680

On levothyroxine we typically need B12 over 500 to feel well and give good conversion gets

If your B12 was 190 …..GP would say it was ok

Optimal vitamin levels

Aim for

Vitamin D at least over 80nmol

Serum B12 over 500

Active B12 over 70 (private testing)

Folate at top of range

Ferritin at least over 70

Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine

And retest again 6-8 weeks after that

[greygoose]

Without ranges difficult to say anything for certain, but my guess is, your FT4 is high and your FT3 is low, because you're a poor converter.

It's low FT3 that causes symptoms, not TSH. The TSH is a pretty useless measurement once it gets below 1, it doesn't tell you very much. And you certainly shouldn't be reducing your dose because of your TSH. It's the FT3 the most important number, followed by the FT4. So, ignore the TSH and concentrate on your thyroid hormone levels.

Your doctor said they were alright because they are all in-range (I imagine). But that doesn't mean they are right for you - and they obviously aren't.

[Maggiemay12 in reply to greygoose]

They TSH was 0.66 about 5 weeks ago I I definitely knew my medication was too high as I have to raise it in the winter and reduce it around this time off year when weather is t ad cold . Always had to do this . I reduced it and my TSH number went from 0.66 to 0.55 ??

[greygoose in reply to Maggiemay12]

Irrelevant. It's not about the TSH. It's what happens to your thyroid hormone levels that counts. So many things can affect the TSH that it's really not a reliable guide to thyroid status.

[SmallBlueThing]

My results, from a recent private test, are similar to yours:

TSH 0.59 (0.27 - 4.2 mU/L)

fT4 20.9 (12 - 22 pmol/L)

fT3 3.6 (3.1 - 6.8 pmol/L)

There's a possibility my GP will see the TSH and fT4 levels from my forthcoming NHS test and want me to reduce my dose.

The bigger picture is that I've had chronic diarrhoea for nearly two months, and my micronutrients have all dropped to near bottom of range, with vitamin D below range, despite supplementing (I could rely more on sunshine, instead).

My conversion ratio (fT4 divided by fT3) is worse than a few years ago i.e. the fT3 is now lower for the same fT4. This is no doubt partly due to my current lower amounts of micronutrients, necessary for converting fT4 to fT3.