What Does Low TSH With Synthroid Usage Indicate?

Posted on Sat, 24 May 2014

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Sat, 24 May 2014 Answered on

Thu, 12 Jun 2014 Last reviewed on

Question : Dr did not order any scripts for this recent lab test. My tsh is low but by how much? Do I increase or decrease my synthroid?
recent Tsh: 0.16 uIU/mL
Vitamin D,25-Oh, Total: 17 ng/mL . This is always low. But what is normal?

High Cholesterol: 256 mg/dL Final
High Triglyceride: 354 mg/dL Final
Hdl: 51 mg/dL Final
High CHOL/HDL: 5.02 Final
High Ldl: 134 mg/dL Final
Vldl: 70.8 mg/dL Final
Non-hdl, Calc: 205

Answered by Dr. Hardik Thakker (1 hour later)

Brief Answer:
step down thyroxine, add fibric acid derivative

Detailed Answer:
Dear Madam,

Greetings from health care magic!!! I am Dr Thakker and shall be answering your question.

I have been through your health record and have the following recommendations for you:

1) TSH levels are too low. Thyroxine levels should be titrated to a TSH 2.5 to 4.5. Currently you are receiving excess of thyroxine. we can step down your thyroxine to 75 mcg from 112/125 mcg and recheck TSH after 6 weeks.

2) Your triglyceride levels are very high. Currently you are on 2 statin drugs which isn't the best plan. I would stop one statin and add a fibric acid derivative. They help reduce triglyceride levels. Rules of the website prevent me from prescribing a particular drug.

3) Your vitamin d3 levels are not in the normal range. We need them above 20. I would recommend you vitamin D3 oral supplementation 60,000 IU once a week for 8 weeks and then maintenance dose of 1000 IU for few months.

I hope this helps you out. If you have any more questions, please do not hesitate to write back to me.

Yours sincerely,
Dr Thakker.

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Above answer was peer-reviewed by : Dr. Prasad