Aa
Aa
A
A
A
Close
Avatar universal

TSH / Endo problems

Does Cytomel (T3) or Synthyroid cause a low TSH ? My Endo says I'm hyper because my TSH is so low and Im going to die of Heart Disease. I don't feel hyper I feel ok below are my numbers he's freaking out over. I'm on 100mcg synthyroid  and 15mcg Cytomel and I had DEXA Scan thats seems to be making them freak out I had Osteopenia (Low risk) for Osteoporosis per Endo.

Test done in March. Had New Blood test done last week.

FT3 (2.0 - 4.4) 2.980

FT4 (0.93 - 1.7) 1.23

TSH (0.27-4.20) ......0.076 (L)

Reverse T3 (9.2 - 24.1) 19.3
2 Responses
Sort by: Helpful Oldest Newest
Avatar universal
I agree with Gimel.

Yes it is extremely common for TSH to be suppressed when taking medication with T3 in it (Cytomel) and even if taking sufficient amounts of T4 medication to relieve symptoms of Hypo.

The fact that the Dr was not or is not aware that T3 can cause suppression of TSH is an indication to me that he/she doesn't know how to effectively treat Hypo.

you are only hyper if you have symptoms of hyper.  And  as stated, your blood labs would other than TSH  indicate if anything Hypo, NOT Hyper.

What are the symptoms you are having?  What is your resting heart rate?

Also Osteoporosis is more a function of lack of testosterone than anything.  even in women! plenty of studies that show getting testosterone levels back up to the age of a 29 year old reverses bone loss.  29 is the age that they use as a baseline for bone density. Unfortunately, "they" do not use 29 year old sex  hormone levels to correspond to healthy, rather they are "age related" at best.  And just because everyone has low testosterone at increased age, does not mean that it is healthy, only normal.

If every one has osteoporosis does that make it "normal".  And if so would you really want to be "normal?"  Or would you rather be healthy?

Therefore I'd recommend that you have your sex hormones tested  (Estradiol, testosterone, progesterone, SHBG, and DHEA-S)  if for no other reason than to establish a baseline for future reference.
Helpful - 0
1 Comments
Hi Flying Fool
The Endocrinologist that called me called me out of the blue I did not initiate contact with this person since I fired him over 6 months ago "when he refused to change my medication (synthyroid and cytomel) because my LAB NUMBERS were in range and I just need to see a head shrink and take diet pills because I'm unhappy with my health, so I fired him.

My current Endo is out on baby leave she adjusted my meds and I have been doing "ok" not great but I suspect that feeling great is a thing of the past.  I was due for blood work in June and I knew I had to see a temporary endo but this would all have to be initiated by me It appears that the Endo I fired decided to harass me about blood work from 2 months ago, he talked to me like I was an idiot. I sincenwent to the Endo office and filed a complaint against him for harassing me about blood test that are due to be redone next month and I told person in charge of clinic he is never allowed to access my health record or call me ever again because if he does I going to the person that runs the entire hospital.  Him and I do not mix he makes me feel bad about myself and that my complaints were all in my head, once my current endo changed my meds within weeks my moods have lightened up and I stop thinking about dying .  To answer your question I have no health issues at all I feel better than I have in a long time I wish I could shed this fat suit I acquired after thyroidectomy but I feel that's never going to happen. If I was never given the DEXA Scan and my lab results stayed inside the ranges they wouldn't have cared less about low TSH which is their requirement because I have thyroid cancer.
Avatar universal
Your Endo has no clue.  TSH is a pituitary hormone that is affected by so many things that only at extreme values, in the untreated state, does it have any correlation with your thyroid status.   Your thyroid status is best defined by the amount of T3 Effect in tissues throughout the body, which is dependent on the supply of, and response to, thyroid hormone.    In turn, the supply of thyroid hormone is represented by serum Free T4 and Free T3 levels.    TSH has only a weak correlation with Free T4 and Free T3, and a negligible correlation with Tissue T3 Effects.    In addition there are other variables such as Vitamin D, cortisol and ferritin that affect the response to thyroid hormone at the tissue level.  

It is also important to know that there are studies that have shown that many patients taking thyroid hormone at a dosage adequate to relieve their hypothyroid symptoms will have suppressed TSH levels.   This is a result of taking a full dose of thyroid hormone once daily and the fact that T4 med establishes an equilibrium that is quite different from that with the usual continuous low flow of natural thyroid hormone in the untreated state.    a suppressed TSH is a treated person does not mean hyperthyroidism unless there are attendant hyper symptoms due to excessive serum levels of Free T4 and Free T3.  So TSH should not be used to determine thyroid hormone dosage.  

The concern about low TSH and osteopenia is unnecessary.  Note this quote from an excellent thyroid doctor.   "Thyroid hormone replacement does not cause bone loss as is commonly believed; it simply increases all metabolic activities in the body. If a person is already in a bone-losing state, such as a postmenopausal woman who is not on proper bioidentical hormone replacement therapy, then she will lose bone faster with better thyroid levels".  The solution to that is not to withhold necessary thyroid hormone, but to fix the underlying causes for the bone loss.  

Excessive thyroid hormone levels can affect some heart issues; however, as explained above a low TSH does not indicate excess FT4 and FT3 in treated patients.  Your results clearly show that.  Even with the suppressed TSH, your Free T4 and Free T3 are not even up to mid-range, so why is your TSH to be accepted as an infallible indicator rather than your actual thyroid hormone levels?

Also, hypothyroid patients are frequently deficient in Vitamin D, B12 and ferritin.  So you should be tested for those and then supplement as needed to optimize.  D should be at least 50 ng/mL, B12 in the upper end of its range, and ferritin should be at least 100.  

If you have any questions about any of this, please click on my name and then scroll down to my journal.  At the end of the journal you will find a one page overview of a paper that I highly recommend reading, at least the first two pages, and more if you want to get into the discussion and scientific evidence for all that is stated here.    Also, in the full paper see recommendation 13 on page 13 about suppressed TSH.  
Helpful - 0
Have an Answer?

You are reading content posted in the Thyroid Disorders Community

Top Thyroid Answerers
649848 tn?1534633700
FL
Avatar universal
MI
1756321 tn?1547095325
Queensland, Australia
Learn About Top Answerers
Didn't find the answer you were looking for?
Ask a question
Popular Resources
We tapped the CDC for information on what you need to know about radiation exposure
Endocrinologist Mark Lupo, MD, answers 10 questions about thyroid disorders and how to treat them
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
STIs are the most common cause of genital sores.