The Wellness Q&A with Elaine Moore

Welcome to the Wellness Q&A where members can ask Elaine Moore any health-related question. Moore is a medical writer and retired clinical laboratory scientist with over 30 years experience in immunology. Get started by selecting Member Questions. This is a question-and-answer forum, and each thread represents a member question or set of questions. The question will only appear once it's answered. Thank you for joining.


TSH suppressed 18 years post TT
Last Post 04 May 2022 02:49 PM by Elaine Moore. 1 Replies.
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LakeloverUser is Offline New Member New Member Posts:
19 Apr 2022 07:24 AM
    Hi Elaine,

    Looking for opinions on why after 18 years my TSH continues to be suppressed. Thyroidectomy December 2004. TSH suppressed with 1/2-3/4 FT labs or even below 1/2 range labs. Daily replacement hormone dose 125mcg Unithroid and 11.25mcg 3 days 10mcg 4 days Lilothyronine. I have since these labs increased T3 hormone to 11.25mcg daily.

    Recent labs drawn 3/31/22

    TSH <0.005 (.45-4.5)

    FT-4 1.33 (.82-1.77)

    FT-3 2.8 (2.0-4.4)

    Doses were reduced in Nov 2021 after testing above 3/4 range for both FT-4 and FT-3 and experiencing a hives ( full body) outbreak daily after receiving Shingrex and DTap shots late Oct. At this time I also did 4 point saliva testing and found super low AM, low Noon, Evening and high Night.

    TPO <8 (0-34)

    Thyroglobulin Antibody <1.0 (0.0-0.9)

    Thyrotropin Receptor Antibodies <1.10 (0.0-1.75)

    Reverse T-3 19.9 ( 9.2-24.1)

    My questions:

    At this point is there a way to or should I be concerned about raising the TSH?

    Reverse T3 - what should I do to lower?

    Do you have any other labs or tests to suggest?
    Elaine MooreUser is Offline Veteran Member Veteran Member Posts:3822
    04 May 2022 02:49 PM
    My TSH has been suppressed, usually <.01, for more than 30 years so I don't worry about it. You likely have a low level of TSH receptor antibodies causing the suppression.
    Reverse T3 doesn't measure active thyroid hormone. It measures the inactive form that changes throughout the day. We used to use it before we had tests to measure FT3. You don't need to worry about the result.
    I'm not familiar with the 4 point saliva test for cortisol. We didn't use it in the hospital because there were so many problems with samples diluted with tissue fluid from squeezing. AM and PM blood cortisol results are more accurate.
    Best, elaine
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