Confused! Low TSH and free T4--normal free T3

[bammity]

Hello,
I am normally hypothyroid. In Jan 09, I started seeing a new internist who put me in a high dose of T3 to deal with extreme fatigue. I had been on Armour until then, and I'm on it again now (as of 5 weeks ago). Here are my new lab results. I'm very confused...
TSH 0.024 (range 0.55-4.78)
Free T3 2.8 (range 2.3-4.2)
Free T4 0.81 (range 0.89-1.76)

My Free T4 indicates I'm hypothyroid, but the TSH would say I'm hyperthyroid. My symptoms are not conclusive. I'm fatigued (which could be either of the thyriod disorders). My hair is falling out and I have bald spots. My blood pressure is low and I don't have a rapid pulse.

I have an endo who I really like, but she's telling me I'm hyperthyroid because I'm over medicated (I was taking 2.5 grains of Armour), and yesterday after seeing these results, she lowered my dose to 2 grains. I'm concerned the T3 will drop as a result of the decrease.

I would love any feedback from any or all of you! I've found that sometimes you have to be your own advocate...

Thanks all!
B

[gimel]

Many doctors don't recognize that TSH is often suppressed when taking thyroid meds.  My own TSH has been less than .05 for over 25 years for that reason, and I still had lingering hyhpo symptoms until I found out here on the Forum about the importance of FT3 and got my meds changed to include T3.  

A low TSH does not automatically mean that you are hyper when taking meds.  You are hyper only if you have hyper symptoms due to excessive levels of FT3 and FT4, which is not the case for you.  You are still having hypo symptoms due to your FT3 and FT4 being too low.    

You may have difficulty getting your doctor to understand and accept this.  Maybe a copy of this article might have some influence on her.

http://www.hormonerestoration.com/Thyroid.html  

[bammity]

Thank you for your response and the article. I will print it for her. I have another question for you--do you think my FT3 is too low? I know my FT4 is low, but the Ft3 seemed to be in range, though low in range.

Any advice on how to get the hair from falling out? I have a wad the size of a golf ball at the end of each day (I have long hair so luckily I can comb over the bald spots). I'm on mega doses of vitamins--Bs, biotin, D, etc.

I was severely depressed and exhausted before starting this new round of Armour. So I'm hopeful that I have more energy now.

Thanks again,
B

[gimel]

The FT3 is too low as well.  I say that because the ranges for FT3 and FT4 have never been corrected like was done for TSH over 8 years ago.  At that time the AACE recommended that the TSH range be reduced from .5 - 5.0 down to .3 - 3.0, which is a big change.  Their reason for doing this was because they came to the conclusion that there were a lot more hypothyroid patients out there than predicted by the old range limits.  When they went back and purged their data base of suspect hypo patient data, and recalculated,  the new range was significantly different.  

This has not been done for FT3 and FT4, yet the old data bases would have included those same suspect hypo patients' data.  With some training and experience in statistical analysis, I have previously estimated that if the same correction was done for FT3 and FT4, that the new ranges would be about 1.0 - 1.55 for FT4 and 3.2 - 4.3 for FT3.   So, essentially it would be about the upper half of the current ranges.  

I think this is why we hear from so many members that symptom relief for them required that FT3 was adjusted int the upper part of its range and FT4 adjusted to at least midpoint of its range.