Low TSH

[6171955]

I just got my test results back.  My TSH is .006.  Free T3 and Free T4 are normal so are all the tests for Hashimoto's.
My cholesterol is elevated.  I am on Armour 90 mg and have been for years.  Since March of 2015 I have started feeling tired, my eyes hurt, my hair is falling out and I am gaining weight.  Never have been heavy and am very physical. My PA does not know what to make of this.  Can anyone please help.Female 60 years old. Not on any other medication and never was.  Blood pressure is low.
Thank you

[gimel]

I understand that.  That is why I called the company.  I don't think there is enough firm evidence for us to conclude that Armour was changed and doesn't work anymore.  Just enough evidence that we should be alert to the possibility, not assume it is factual.  

[Dustygirl01]

I googled Armour consumer affairs and there were a lot of comments posted.

[gimel]

I don't know where that info about Armour comes from.  Because it was raised on another thread I contacted the company that bought out Forest Pharmaceuticals, the previous maker of Armour.  They put me in touch with someone that was very familiar with the product and she assured me that it was still being made in the same place, with no changes at all to either the ingredients or the filler material.  

[Dustygirl01]

Wow...that's awful about armour having issues again!  Looks like they switched manufacturer and the formulation has changed.  I wonder if naturethroid would be better if you can get it.

[6171955]

Thank you so much for your reply.  The doctors won't listen to symptoms just blood tests.  My PA said I was normal.  I am being referred to an endocrinologist, who knows when.  I have been researching Armour Thyroid and in the Consumer Affairs Website it mentioned that in March of this year people started really having problems.  Funny, that is when I started going down hill.  I believe they did another reformulation.
Is there anything you can suggest until I get my endo. appointment?  I feel rotten.  Have just about every thyroid symptom.  What tests do you suggest I take to get down to the problem?  I might just go pay for them instead of waiting so long.
Thank you again,
You are a blessing

[gimel]

There are included a lot of outdated tests that are no longer used by most doctors, such as Total T4, Total T3, T3 uptake, and Free Thyroxine Index.  You could better eliminate those and use the Free T4 and free T3 results.  Looking at those it is no wonder that you are having hypo symptoms.  Your Free T4 is actually below range, which we don't see very often.  It should be at the middle of the range at minimum.  Also your Free T3 is lower than what members say is effective at relieving hypo symptoms.  Free T3 should be in the upper third of its range, or as needed to relieve symptoms.  So you need a med increase adequate to relieve symptoms.  

Not sure what would have changed to cause you to start having symptoms.  Still not clear if it could be related to Hashi's, since I am not sure what those tests show.  The definitive tests for Hashi's are Thyroid Peroxidase antibodies and Thyroglobulin antibodies.  They are often listed as TPO ab and TG ab.  

Even though your TSH is suppressed below range, that is not a concern since scientific studies have shown that hypo patients taking adequate doses of thyroid med often find their TSH suppressed.  That does not mean hyperthyroidism, unless you have hyper symptoms due to excessive levels of Free T4 and Free T3, which is certainly not your case.  

A good thyroid doctor will treat  a hypothyroid patient clinically by testing and adjusting Free T4 and free T3 as needed to relieve symptoms, without being constrained by resultant TSH levels.  Symptom relief should be all important, not just test results.  You can get some good insight from this link written by a good thyroid doctor.

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

In the link please note the following:

"The TSH level tells us nothing about the physiology of a person on thyroid replacement therapy.  in tests done about 24 to 28 hrs after their last daily dose, most people on adequate NDT therapy have a suppressed TSH. They usually have FT4 levels that are 1 to 1.3ng/dL, and free T3 levels that are rather high in the range or even slightly above the range. The higher FT3 level compensates for the lower FT4 levels on NDT."  So this gives you a good idea of the required levels.   Also, note that since T3 acts so quickly it is recommended to defer your morning dose of Armour until after the blood draw for tests.  That avoids a false high Free T3 result.  

Another consideration is that hypo patients are very frequently low in the ranges for Vitamin D, B12 and ferritin.  All are important to a hypo patient.  D should be about 55-60, B12 in the very upper end of its range, and ferritin should be about 70 minimum.  You should get those tested and supplement as needed to optimize.  

[6171955]

T4, Free (Direct) .61  (0.82-1.77)
T3 71  (71-180)
TSH  .006
T3 Uptake  33 ( 24-39)
Free Thyroxine Index  2.2  (1.2-4.9)
Thyroid Stim Immunoglobulin  28  (0-139)
Triodothyronine, Free Serum 3.4  (2.0-4.4)
TPO  6  (0-34)
Thyroid Antibiody  0.9  0.0-0.9)
Thank you

[gimel]

If not positive for Hashi's, what was the diagnosed cause for starting you on thyroid med?    Also, please post the actual Free T4 and free T3 results and reference ranges shown on the lab report.