Aa
Almost low tsh, normal free t3
I got tested and the results are
TSH .88 Range 0.40-4.50 mIU/L
Free T3 3.3 Range (2.-4.2)
Why is the TSH so low? I am on synthroid but my tsh is almost always high, like 4 to 8 and I usually have free t4 in the 50% area of range.
Do I need to test Free t4?
I am on 88 mcg synthroid one day and 100 mcg the next.
I do not feel well but I honestly think maybe it is unrelated to thyroid.
TSH .88 Range 0.40-4.50 mIU/L
Free T3 3.3 Range (2.-4.2)
Why is the TSH so low? I am on synthroid but my tsh is almost always high, like 4 to 8 and I usually have free t4 in the 50% area of range.
Do I need to test Free t4?
I am on 88 mcg synthroid one day and 100 mcg the next.
I do not feel well but I honestly think maybe it is unrelated to thyroid.
T4 has to be converted to T3 before being metabolized in cells. Hypothyroidism can be considered as "inadequate T3 effect in some or all tissues of the body".
So, let's go back and recall that you had many hypo symptoms in the past, With the thyroid med, as you described, your hypo symptoms got much better. Now you have some symptoms that you think are hyper, yet your FT4 and FT3 levels are nowhere near being hyper. Note that there are some symptoms that can be associated with either hypo or hyper. I suspect that your symptoms are really hypo related and/or a reaction from cortisol or ferritin not being optimal.
Since you don't want to do further testing at this time, it only makes sense to me to consider increasing your FT3 level by adding some T3 to your med, and reducing your T4 dosage. What other alternative do you see? If you just reduce your T4 dosage on the assumption that you are feeling hyper symptoms, that is only gong to bring back prior hypo symptoms.
So, let's go back and recall that you had many hypo symptoms in the past, With the thyroid med, as you described, your hypo symptoms got much better. Now you have some symptoms that you think are hyper, yet your FT4 and FT3 levels are nowhere near being hyper. Note that there are some symptoms that can be associated with either hypo or hyper. I suspect that your symptoms are really hypo related and/or a reaction from cortisol or ferritin not being optimal.
Since you don't want to do further testing at this time, it only makes sense to me to consider increasing your FT3 level by adding some T3 to your med, and reducing your T4 dosage. What other alternative do you see? If you just reduce your T4 dosage on the assumption that you are feeling hyper symptoms, that is only gong to bring back prior hypo symptoms.
1 Comments
Interesting. Thank you, I will consider talking to my doc about some t3. :)
I have copied your most recent post and pasted it here so that we can keep your info in one area.
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Ok so I got my free t4 results.
They are
Free t4 1.5 (range 0.8-1.8 ng/dL)
Free t3 3.3 ( range 2.3-4.2 pg/mL)
TSH 0.88 (range 0.40-4.50 mIU/L)
I feel hyper sometimes with palpitations, can't see to get a full breath sometimes but that comes and goes. I am on 88 one synthroid and 100 the next day alternating. I have hashimoto's.
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From those test results your FT4 is at 70% of its range, but your FT3 is only at 52% of its range. From just those results I would not expect any hyper symptoms. If anything your FT4 is higher than needed, but your FT3 is lower than optimal for many people. Even though TSH is a poor indicator of thyroid status, the majority of hypo patients find that their TSH becomes suppressed when taking thyroid med adequate to relieve hypo symptoms. So in my opinion your TSH being .88 is another indicator of still being hypo.
Of course serum FT4 and FT3 may not reflect tissue thyroid levels, plus there are other variables such as mentioned previously that can affect tissue thyroid effects. That is why I suggested tests for Vitamin D, B12, ferritin, and cortisol. Cortisol is even an antagonist of thyroid hormone. Without knowledge of those test results, If it were me I would try to get some T3 added to the med dosage, and slightly reduce the T4 dose. Is that possible for you to do?
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Ok so I got my free t4 results.
They are
Free t4 1.5 (range 0.8-1.8 ng/dL)
Free t3 3.3 ( range 2.3-4.2 pg/mL)
TSH 0.88 (range 0.40-4.50 mIU/L)
I feel hyper sometimes with palpitations, can't see to get a full breath sometimes but that comes and goes. I am on 88 one synthroid and 100 the next day alternating. I have hashimoto's.
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From those test results your FT4 is at 70% of its range, but your FT3 is only at 52% of its range. From just those results I would not expect any hyper symptoms. If anything your FT4 is higher than needed, but your FT3 is lower than optimal for many people. Even though TSH is a poor indicator of thyroid status, the majority of hypo patients find that their TSH becomes suppressed when taking thyroid med adequate to relieve hypo symptoms. So in my opinion your TSH being .88 is another indicator of still being hypo.
Of course serum FT4 and FT3 may not reflect tissue thyroid levels, plus there are other variables such as mentioned previously that can affect tissue thyroid effects. That is why I suggested tests for Vitamin D, B12, ferritin, and cortisol. Cortisol is even an antagonist of thyroid hormone. Without knowledge of those test results, If it were me I would try to get some T3 added to the med dosage, and slightly reduce the T4 dose. Is that possible for you to do?
1 Comments
Don't really want to spend. Let me ask you, does high free t4 cause hyper symptoms or high free t3? Which one has more of an affect?
In a subsequent post you said:
Feel hyper semi normal labs
ando35
I am on synthroid 100 mcg one day and 88mcg the next.
I feel lousy. I am very irritable, agitated have heart palpitations etc.
I got a blood test and my tsh is .88 (Range.40-4.50) and my free t3 is 3.3 (Range 2.3-4.2 )
Could I be hyper with these numbers? My tsh is usually at 3 or 4 it has never been this low. My free t4 is usually at 50% or 60%. I did not check free t4 because I am paying labs out of pocket. The important number is free t3 right? I mean free t4 is converted into free t4 eventually.
Should I get my free t4 tested now a week later?
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That Free T3 is not indicative of being hyper. Agitation/palpitations can also be associated with hypothyroidism, and also possible reaction to taking thyroid med when cortisol or ferritin is too low. I realize you are having to pay out of pocket for tests, but I don't think you will be successful in resolving your problem unless you test enough to find out what is going on. I again suggest that you test for Free T4 and Free T3 each time you go for tests, so yes, do get the Free T4 now. You also need to know cortisol, Vitamin D, and ferritin levels. Can you get those done?
Feel hyper semi normal labs
ando35
I am on synthroid 100 mcg one day and 88mcg the next.
I feel lousy. I am very irritable, agitated have heart palpitations etc.
I got a blood test and my tsh is .88 (Range.40-4.50) and my free t3 is 3.3 (Range 2.3-4.2 )
Could I be hyper with these numbers? My tsh is usually at 3 or 4 it has never been this low. My free t4 is usually at 50% or 60%. I did not check free t4 because I am paying labs out of pocket. The important number is free t3 right? I mean free t4 is converted into free t4 eventually.
Should I get my free t4 tested now a week later?
_______________________________________________
That Free T3 is not indicative of being hyper. Agitation/palpitations can also be associated with hypothyroidism, and also possible reaction to taking thyroid med when cortisol or ferritin is too low. I realize you are having to pay out of pocket for tests, but I don't think you will be successful in resolving your problem unless you test enough to find out what is going on. I again suggest that you test for Free T4 and Free T3 each time you go for tests, so yes, do get the Free T4 now. You also need to know cortisol, Vitamin D, and ferritin levels. Can you get those done?
1 Comments
I can get free t4 but I don't really want to do cortisol, vitamin d and ferritin. I will go get a free t4 done tomorow. Then I will know free t4 and freet3 and tsh from last week
My suggestion is to ignore the TSH while taking replacement thyroid hormone med, and always test for both Free T3 and Free T4. The last I recall from your prior thread was that you seemed to be close to an optimal dose at 94 mcg of T4 med. If not tested for Vitamin D, B12 and ferritin, those should be done and then supplemented 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. All 3 are important for a hypothyroid patient.
For someone on thyroid med, I don't see your TSH as being "so low". Most hypo patients taking thyroid med adequate to relieve symptoms find that their TSH becomes suppressed below range. That does not mean hyperthyroidism, unless there are hyper symptoms due to excessive Free T4 and Free T3 levels. Your Free T3 is lower than many people have found optimal; however, everyone is different and may need different thyroid hormone levels to feel their best. You do need to be tested for both Free T4 and Free T3 each time. They are the important tests when taking thyroid med, not TSH.
Please tell us about symptoms that you have. .
Please tell us about symptoms that you have. .
1 Comments
Hm just some heart palps and occasionnaly hyper at bedtime.
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