TSH result .22 and Dr thinks this is too low

[Heather77]

I had asked for a thyroid blood test because I seem to have hypothyroid symptoms. However, obviously this is not the case as TSH level is .22. Doctor contacting me Monday probably to lower my dose of levothyroxine. I am taking 125mcgs at the moment. However, I normally feel better when I am under a TSH level of 1, which is not the case at the moment judging by my TSH result, although I will have ask her if there is a free T4 result too.

Not sure why I have symptoms eg. very tired, aching leg muscles, constipation, hoarse voice sporadically. If I am in hypermode, I would have thought that I would energetic and certainly not so tired with aching muscles.

Any advice would be very much appreciated.

Thank you

Heather

[greygoose]

I very much doubt if you are in hypermode on a dose of 125 mcg of levo. Your TSH is low but that is irrelevant. Your doctor obviously knows nothing about thyroid. You definately need not only an FT4 result but an FT3 as well. Only by the FT3 can one get an idea what is going on. I know that labs won't do them if they 'consider' the rest to be 'normal', but I think that is scandalous.

Don't let her reduce your dose because of a TSH of 0.22 - which isn't even suppressed! Refuse to accept it if you are feeling well on your present dose.

Hugs, Grey

[Heather77 in reply to greygoose]

Thank you, Grey. During my consultation the doctor also said that too low TSH and you could get oesteoporisis, although she did say that symptoms need to be taken into consideration, but as she wants to call me, I am assuming that she will want me to decrease thyroxine meds, but I will argue the case for not doing this. I had already told her that I did not feel good when TSH levels were above 1.

Good wishes

Heather

[greygoose in reply to Heather77]

Yes, they often make that mistake about oesteoporosis, but it is just that, a mistake. It's not the low TSH per se that affects the bone, it's the high T3 that you get in hyperthyroidism. When you are taking your hormone orally, it's a totally different story. The TSH becomes meaningless because the link with the pituitary is broken. They might just as well dose your levo according to the level of petrol in your car! That would be just a intelligent! But, what can you do...

Just stand your ground, gal! Don't let them short change you!

[shaws Administrator]

Read the second letter on this link and there are other topics at the top of the page which may interest you. Some of the links within may not work.

web.archive.org/web/2010122...

thyroidscience.com/hypothes...

My TSH is 0.01 and Dr Toft ex of the British Thyroid Association says in a Pulse article. If you wish to have a copy email [e-mail] and send a copy to your GP before your next appointment, marking the relevant question:-

The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range – 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l. Most patients will feel well in that circumstance.

But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This ‘exogenous subclinical hyperthyroidism’ is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l).

Even while taking the slightly higher dose of levothyroxine a handful of patients continue to complain that a sense of wellbeing has not been restored. A trial of levothyroxine and tri-iodothyronine is not unreasonable. The dose of levothyroxine should be reduced by 50µg daily and tri iodothyronine in a dose of 10µg (half a tablet) daily added.

[Heather77 in reply to shaws]

Thank you for the links and information, Shaws. It is appreciated. I will argue my case for not decreasing the dose and also find out if there is a way to find my FT3 and T4 results, but somehow I doubt it.

Heather

[shaws Administrator in reply to Heather77]

If he reads Dr Toft's article, he cannot really say that Dr Tofts views are irrelevant.