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very low TSH

I was diagnosed as Hypothyroidism 10 years ago. I started with one tablet 0.1 mg levo-thyroxine. It was gradually increased.  Till 6 weeks ago, I took one tablet and ¾ of a tablet. I developed pain in my thyroid region and based on my 10 years of with this disease, I reduced my dose to one tablet and half.  The pain came back in two weeks later and has continued.  A few days ago, I had a blood test. Here is the result: T3: 5.3 pmol/l (normal range:  3.1 -6.8), T4: 1.6 ng/dl (normal range  0.7 – 1.7) and TSH : 0.1 uU/ml (normal range: 0.3 – 4.0). The pain in my thyroid region does not stop. I stopped taking any tablet since yesterday out of desperation. The pain was reduced momentarily and is now back at the end of second day. My GPT,  Gamma GT and triglyceride are elevated. My HDL is low and LDL and cholesterol are slightly elevated.

Please advise me about the correct steps at this stage. For example, how much levo-thyroxine tablet should I now take?  I know that I should reduce it due to low TSH : 0.1.  I am 49 years and weigh 85 kilos. I am scheduled for an ultrasound of my thyroid and liver this week.
Best Answer
649848 tn?1534633700
COMMUNITY LEADER
Selenium is a mineral that we "should" get from food, but in many parts of the world, the soils are becoming depleted, so we don't get enough from the food we eat.  It's not a "medicine" (as in drug), it's taken as a dietary supplement, just like calcium, vitamin C, etc.  According to my research, selenium can help calm inflammation and it's also said to help with conversion of FT4 to FT3.  

My antibody count (TPOab) is going down, but I've no way of knowing if that's due to the selenium or the fact that my thyroid is pretty "dead" and my disease (Hashimoto's) may be going into remission.  

If your lab report says FT3 and FT4, then those are free results.  Yours look pretty good to me, except your FT4 is a bit high, even though in range.  Many of us need to have our free's adjusted so the FT3 is in the upper 1/3 of the range and the FT4 is about mid range.  

FT3 and FT4 don't really say anything about the pain and low TSH.  TSH is a pituitary hormone and is not really indicative of thyroid function.  It's not unusual for some of us to have a suppressed TSH, when on thyroid med.  Low TSH indicates hyper ony when your frees are too high and/or you have hyper symptoms; it doesn't sound like you have hyper symptoms.

My TSH stays at "less than" 0.01 all the time and we (my endo and I) don't worry about it as long as my frees are in line. On my latest tests, my TSH was still "less than" 0.01, while my frees have actually gone down from the last time and I'm feeling hypo.

It's not a good idea to just stop your med all of a sudden.  If you feel hyper, you can cut back a bit, but self medicating is rarely a good idea.

It would be a good idea to see if you can get the TPOab and TGab tests to confirm or rule out the presence of antibodies, which could be causing swelling/inflammation which could be the source of your pain; however. if you don't have antibodies, then I'd say they might have to look at something else.  

The pain in my neck used to get pretty bad and often I felt as though I was choking; it would help some to take an Aleve (or pain med of your choice) along with a cool cloth or ice bag on the area.  Do make sure you don't rub or palpate the area -- that tends to make the pain worse.



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393685 tn?1425812522
No it is directly related to food.

They measure the autoimmune issue of thyroid disease. Hashimoto.
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Avatar universal
Thanks very much for your answer. What do TPOab  and TgAb tests do or measure?  Assuming that Selemium is not a natural food grade element (am I right?) would it be healthy to suppress the antibodies by medicine. I am interested to address the root causes in a natural way without taking medicine if at all possible.
Helpful - 0
Avatar universal
Thanks very much for your answer. My doctor wrote in my medical report in 2005  Hypothyroidism (Hashimoto disease).  I therefore think this an autoimmune disease.

I do not know the difference between Free or Total T3 and T4.  I just looked at the recent lab test and its written FT3 and FT4. So I assume they are Free T3 and Free T4. If they Free T3 and Free T4 and they are more or less in normal range as I indicated in the previous post,  what do they actually say about the very low TSH and the pain?

As I said, I am taking Levoo-thyroxine (this is the generic name).  The brand name is Thyrex. Are you saying I should resume the prevoius dosage of taking one and a half tablet (0.1 mg) per day?
Helpful - 0
393685 tn?1425812522
Has anyone checked to see if Hashimoto thyroiditis is an issue here? If there is pain you could get the TPOab test and TgAb test to see if you have this causing inflammation

While most treatment would stay the same - some autoimmune sufferers find relief taking Selemium and do other things to suppress the antibodies to see if your condition improve.

I don't think the medication changes in dosage is the total answer here to help you. I think you need to check if this is autoimmune and maybe do some other things to see if that could help.

I don't think these are Free T3 and T4 tests either.
Helpful - 0
649848 tn?1534633700
COMMUNITY LEADER
TSH is a pituitary hormone and should not be used as the basis for increasing or decreasing your med.  

Are the T3 and T4, free or total tests?  If they are total, they are pretty much obsolete and of little value.  

The pain in your neck is indicative of something else going on, which the ultra sound will help pin point.

High cholesterol is indicative of hypothyroidism.  Have you been tested for antibodies to see if you have Hashimoto's Thyroiditis?  

What thyroid med are/were you taking?
Helpful - 0
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