# TSH suppression



## KeepOnGoing (Jan 2, 2013)

With the recent changes in guidelines (I'm in the UK so we're a bit behind the US) my doctor has started to query whether my TSH should be so low, as I am considered low risk. I'm very against changing it, as for the first time since thyroidectomy (4 years ago) I finally feel well. I'm on 150 levothyroxine and 35 liothryonine. My last blood test results were:

TSH: 0.01 (0.3 - 5)

FT4: 16.1 (11 - 24)

FT3: 6.3 (3.9 - 6.8) I accidentally took my T3 before the test, which I don't normally do...

The question is, is it low TSH which carries the long term risks, or high T4? As you can see, my T4 is not at all high. If it's high T4 that is the problem, there's no need to change anything (apart from remembering when the blood test is and not taking a dose a few hours before!)

We have a bit of a disagreement as to what is keeping my TSH so low. I claim that it's the T3 (on just 150mcg T4 my TSH was 2.3) but the consultant thinks it's the T4. I don't think reducing my T4 dose will increase my TSH (although it risks making me feel unwell again - you can see why I'm not keen...)

Any insight would be welcome.


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## joplin1975 (Jul 21, 2011)

It is just the t3 that's keeping your TSH so low.

As long as you don't get out of range on the free t3 AND as long as you don't have hyper symptoms, you are ok. Usually super low TSH is accompanied with lots of hyper symptoms and THAT's the issue.


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## KeepOnGoing (Jan 2, 2013)

I thought that was the case - thank you for helping me not to give in. No hyper symptoms at all - when my FT4 was way above the top of the range, I had all sorts of hyper symptoms, which was horrible.

The next battle will be when they decide to discontinue prescribing T3 on the NHS - they have already done so in a neighbouring area, so it appears to be only a matter of time.


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## jenny v (May 6, 2012)

I'm on 90mg of NDT and 60mcg of T3 and the addition of T3 caused my TSH to become pretty much undetectable (it was 0.006 at last check). However, I feel fantastic and I have no hyper symptoms and my FT3 and FT4 are in the range. I'm like you, if my FT4 gets above range, I get totally hyper.


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## Lovlkn (Dec 20, 2009)

My last TSH was .0008 and is always below .02. My doc based dosing on FT-4 and FT-3 which are always under 3/4 of range. The minute I added T3 hormone my TSH completely suppressed. I have TBII antibodies which I understand as suppressing to TSH.


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## Sue (Mar 30, 2015)

KeepOnGoing - I'm UK too!!

I had my TT 5 years ago and I've had a big shock when it comes to how long to keep my TSH down for. For years I was on a dose of T4 that kept me at around 0.03. Highest it ever went was about 0.01 and that was rare. I kept being told 'we face bone and cardiac problems if you keep having TSH so suppressed' but I felt ok so didn't really listen.

I had borderline papillary carcinoma (follicular variant) so like you was considered low risk.

Then last year for the first time I had a DEXA bone scan. What a shock. I am healthy but this showed I had the bones of an older person. Now I'd not had one before so of course it could have been genetic but I went to see a private endocrinologist who hypothesised that yes it WOULD be the T4/thyroxine so I cut the dose down. Now ten months on I've had a second bone scan (just this week) and amazingly my bones have got a bit thicker - the T scores on the bone scan were up.

So certainly in my case I think this proves that I must not be on a T4 dose that pushes my TSH too low as it has had an impact on bones for me.

Sue


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