Both TSH and Free T4 keeps dropping together HELP With these TESTS? PRETTY PLEASE?

[jenniferk86]

So.... I am curious I have taken 3 thyroid tests now to date.  One in September , One in October and then one in December. I will post them.  If my TSH is going down, then shoulding my free t4 be rising?  That is not happening with me.  They are both droppping My TSH is dropping slightly faster than my free t4 , but both still dropping. And should they be changing this much in a matter of 3 months? Here are my test results, please help me decipher these tell me what you think.

09/07/10

TSH - 1.83 (.4-4.5)All Tests Had these reference ranges.
Free T4- 1.1 (.8-1.8
NO FREE T3 Done

10/13/11

TSH - 1.48(see above)
Free T4- 1.0

11/2
Tested for Cortisol levels.  it was 16.2 at 4 pm (No reference Range, but found something online saying 23 is high end at 9am and 13 is high end at midnight? so I am not sure what a 4pm readout should be for cortisol but I am assuming this is normal or a little high?

12/03

TSH 1.0 (.4-4.5)
Free T4 - .8 (.8-1.8)
Free T3 - 3.5 (2.3-6.9)Dr. Said this is very good.  

Everything I have read says that TSH should go up if your frees are low... and why would my freet3 be more normal /higher than my free t4?  

Any help would be greatly appreciated.  I am hurting so bad I could starve my self for 3 days and not lose a pound ( I have only done this once, just to see) my whole body feels like the flu every day.  Could I have like Hashi's and its just beginning? or does that not correlate with my TSH dropping? Also could it be pituitary or are my numbers too NORMAL for that?  

And are there any further tests I should be asking for? and how should I ask him?

[jenniferk86]

So here is my detailed history in case anybody wanted to know:



I have had a long haul here. I had a grandmal seizure almost a year ago this march. It resulted in a major concussion where I didn’t remember anything for 15 min not even my name.  My memory returned to normal ( well more normal) I cannot remember a lot, like why I am going to another room) and nobody could ever find the cause. I found out I have factor 5 lieden and protein s def. which means my blood clots easier but that is about it everything else seemingly normal.  So about 2 months after, I began getting so tired I could not drive TO work even after 12 hours of sleep. Tried everything to see if it would help for 2 months. Nothing so I saw a dr. did thyroid tests and a barrage of other tests with everything seemingly normal.  My lipase was high, albumim was low, mean platelet high, but dr.s were not concerned about those levels.  I have every hypo thyroid symptom out there and my pain is especially bad. I have to take percocets to function. It seems as though the only test I haven't done is hormonal tests I asked my obgyn and she said there is no need if I am not missing my period completely.  My complete list of symptoms is( I took most of this from a list of symptoms and deleted the ones I didn’t have of stop the thyroid madness.com):

-I have been for 10 months now been experiencing extreme fatigue, I can't even drive myself home from work unless I take an energy drink first to keep me awake. I can't lose weight even though I'm exercising 5 times a week at an hour and a half (800-900 cals burned)  & eating right foods ( 1800 cals or less per day, 6 small meals per day),

- Less stamina than others
- Less energy than others
- Long recovery period after any activity
- Inability to hold children for very long
■Arms feeling like dead weights after activity
■Chronic Low Grade Depression
■Suicidal Thoughts
■Often feeling cold
■Cold hands and feet
■High or rising cholesterol
■Plaque buildup
■Hard stools
■Constipation
■Dry Hair
■Hair Loss
■White hairs growing in
■Dry cracking skin
■Nodding off easily
■Requires naps in the afternoon  
■Air Hunger (feeling like you can’t get enough air)
■Inability to concentrate or read long periods of time
■Forgetfulness
■Foggy thinking
■Inability to lose weight
■Always gaining weight
■Inability to function in a relationship with anyone
■NO sex drive
■Moody periods
■PMS
■Excruciating pain during period
■Nausea
■Swelling/edema/puffiness
■Aching bones/muscles
■Bumps on legs  
■Hives
■Exhaustion in every dimension–physical, mental, spiritual, emotional
■Inability to work full-time
■Inability to stand on feet for long periods
■Complete lack of motivation
■Slowing to a snail’s pace when walking up slight grade
■Extremely crabby, irritable, intolerant of others
■Internal itching of ears – wow this happens all the time, but I didn’t think anything of it.
■Broken/peeling fingernails
■Dry skin or snake skin
■Major anxiety/worry
■Ringing in ears – rarely but it happens
■Joint pain
■Carpal tunnel symptoms
■Blood Pressure problems – Low almost always, when I am in lots of pain, high.
■Varicose Veins
■Dizziness from fluid on the inner ear
■Low body temperature
■Tightness in throat; sore throat
patients)
■Headaches and Migraines
■Sore feet (plantar fascitis); painful soles of feet
■irritable bowel syndrome
■painful bladder
■Extreme hunger, especially at nighttime
■Dysphagia, which is nerve damage and causes the inability to swallow fluid, food or your own saliva and leads to “aspiration pneumonia”. –This happened to me only once for about 2 days.

I have taken 3 thyroid tests now to date.  One in September , One in October and then one in December. I will post them.  If my TSH is going down, then shouldn’t my free t4 be rising?  That is not happening with me.  They are both droppping My TSH is dropping slightly faster than my free t4 , but both still dropping. And should they be changing this much in a matter of 3 months? Here are my test results, please help me decipher these tell me what you think.

09/07/10

TSH - 1.83 (.4-4.5)All Tests Had these reference ranges.
Free T4- 1.1 (.8-1.8
NO FREE T3 Done

10/13/11

TSH - 1.48(see above)
Free T4- 1.0

11/2
Tested for Cortisol levels.  it was 16.2 at 4 pm (No reference Range, but found something online saying 23 is high end at 9am and 13 is high end at midnight? so I am not sure what a 4pm readout should be for cortisol but I am assuming this is normal or a little high?

12/03

TSH 1.0 (.4-4.5)
Free T4 - .8 (.8-1.8)
Free T3 - 3.5 (2.3-6.9)Dr. Said this is very good.  

Everything I have read says that TSH should go up if your frees are low... and why would my freet3 be more normal /higher than my free t4?  

Any help would be greatly appreciated.  I am hurting so bad, I seriously think there is no possible way that a thyroid disorder could cause this much joint pain and muscle pain.  My soles of my feet hurt in the morning and I am so stiff I can hardly walk.  I am dizzy and recently started experiencing blurred vision. I could starve my self for 3 days and not lose a pound (I have only done this once, just to see) my whole body feels like the flu as far as achiness and nausea every day.  Could I have like Hashi's and its just beginning? or does that not correlate with my TSH dropping?

I also have recently developed a sore throat and scratchy voice like I lose my voice if I talk too much.  I never had this symptom before a couple of days ago.

And are there any further tests I should be asking for? and how should I ask him?

[goolarra]

Your FT3 should be higher in its range than FT4 is in its.  Many of our members find that FT4 must be midrange, or even above, before all hypo symptoms are relieved.  FT3 often has to be in the top third of the range.  Your FT4 is on the floor, and your FT3 is in the bottom third of the range...much too low in both cases, but with FT3 and FT4 in their proper relationship to each other.

In theory, you're right...when FT3 and FT4 go down, TSH should go up.  However, anything in the thyroid/hypothalamus/pituitary axis can affect TSH, so it often becomes a very unreliable indicator of thyroid status.

The fact that your FT3 is in reference range shows that you convert well.  Conversion is not technically a thyroid process, but a metabolic process.  It looks like your thyroid is not producing enough T4, but what it is producing is being converted just fine to T3.

You could have Hashi's.  Have your doctor test TPOab (thyroid peroxidase antibodies) and TGab (thyroglobulin antibodes).  If either is elevated, you have Hashi's.

It could also be pituitary.  You might google "secondary hypothyroidism".  This is actually a pituitary issue, not a thyroid issue, but the result is that you are hypothyroid.  Your pituitary doesn't put out enough TSH to stimulate your thyroid to produce hormones.

You might also request an ultrasound to see if you might have nodules that could be producing T3.

I'm sure you'd feel much better on thyroid meds, and you should find the cause.  Antibody testing is relatively easy (blood test) and inexpensive.  Confirm or rule out Hashi's with those, then move on to other possibilities if you still don't have an answer.

Best of luck...