Hashimoto's... Low TSH but still feel very hypo... could it be b/c of low T3RU?

[beachcj]

Hi everyone,

I am new to this forum and hoping to get some input. I have a few questions so I'll try and keep this as concise as possible!

I have been hypo since I was 17 (I'm almost 23 now). Just this month I was diagnosed with Hashimoto's (my mom has it too)... I may have had it longer but my old doctor only tested TSH as far as I know (!!!). I just got my lab results back from my first appt with the new endo and I am a little confused as to what clues they might hold for me. Here is the rundown:

TSH: .77 (range .34-4.82)
Total T3: 1.19 (range .7-1.9)
T-Uptake: 26 (range 31-39) marked LOW... the nurse at the office also called this "T3 Resin Uptake" aka T3RU
T4: 11.6 (range 4.7-13.3)
FTI: 3.02 (range 1.46-5.20)
Thyroid Peroxidase AB: 73 (range up to 35)

My triglycerides also looked slightly high at 145 (range 44-148)... I have never ever had cholesterol problems so this seems weird to me. My RDW was also high at 15.9 (range 11-15)... not sure if this is pertinent either.

I am still feeling very hypo (puffy eyelids, weight gain/ can't lose on strict 1200 calorie diet + 5 hrs of cardio a week, fatigue, memory problems, constipation, etc etc etc... you know the deal). Of all of the doses of levothyroxine I have ever been on for the past 6 years I have never experienced any significant improvement.

I am on 175 mcg of Synthroid and it seems to be doing fine by the looks of my T4... but what I REALLY want to know is what you think of the low T-uptake. Could this be signaling that my body is not converting the T4 to T3 correctly? I have never been treated with T3 medication before and am wondering/hoping if this might help me. I have heard good things about cytomel and armour... I just want to feel better! and levothyroxine pills are not doing it.

The hardest side effect for me to deal with is the metabolism issues (i.e. the weight gain). Before this all started my only weight issue had been being slightly underweight! It is getting hard to continue living like this. Counting calories takes up most of my brain-space and I see no reward for it. I am disgusted with my body and I feel so helpless. People who have known me since my skinny days likely think that I eat junk and never workout --- but the opposite is true!

Sorry for the rant-- bottomline here is do you think, based on my results, that I could benefit from T3 being added to my treatment? I want to convince my doc to prescribe it but I don't know how. I have my next appointment in early June.

Additional question if you can help me with it... in the meantime, do you have any suggestions on how to manage my weight? I am trying to stick to a low GI diet (heard carb-sensitivity might be a factor in weight gain)?

I'd appreciate any input I can get!
Thank you!

[RickJ1]

Ask your endocrinologist to test your prolactin levels.

[beachcj]

Thank you both. I have another appointment in about a month (feels like a very long time to have to wait!). I'm going to request T3/Armour then.

[stella5349]

Recently I have been reading about TSH I feel TSH number are nothing when it comes to a patients well being. In most cases a patient feels better way below the normal levels on the test but doctors stick to these like glue.

As AR said T3 T4 means nothing -- you need the Frees tested. Inbound levels of the Ts do not tell anything.

I am going to assume your "T4" conversion could be a problem simply b/c your TSH is way below and you still have symptoms. I now am "way below" in my TSH ( 0.04) and still have mild hypo symptoms. No where near the symptoms I had when I was 3.34.

I also have a high free T3 at 5.7 which should be a little higher since I am on Armour. My Free T4 is 1.1 and should be a bit lower - so the reason I still am having hypo symptoms is becaus my Free T3 is not getting into the cells quite yet enough to relieve me of my symptoms.  I need a med increase and not getting it.

I believe in Armour and I crashed in Synthroid. I just got on it in Oct 07 and have been ill before for 6 years.

I do not know if it is the answer for you - I know I feel better to some degree.

[AR-10]

Your TSH is low enough that you should not be hypo, although you could still be suffering hypo symptoms from months ago.

All those T3/T4/T1 tests are old, inacurate, or irrelevant.

You need a Free T4 test and a Free T3 test.

Total T3 does not measure T3, and even if it did, your total T3 is meaningless. You need your Free T3 measured. That is what your body uses. Much of the T3 is bound up and made unusable, so there is no point in measuring what you can't use.

Your T4 is a total T4, and again, is useless for the same reasons as above. Although it does actually measure T4.

A low T3 resin uptake indicates hypothyroidism. That agrees with your symptoms, but your TSH disagrees.

I stole the following;

"The thyroid gland produces primarily T4 and a smaller amount of T3 along with the precursor thyroid hormones T1 and T2. Although their concentrations are not routinely measured, T1 and T2 also have physiological functions. While T1 has not been well studied, T2 is needed to produce several enzymes needed for proper thyroid gland functioning."


The most informative thing I could read about T1 is that it is not well understood, and is seldom measured.

There is a pattern to your tests.

You need better ones.

If the T3 resin uptake test is to be trusted, you may be hypo, and your TSH might be low for some reason connected to the pituitary gland.

You really need to get a Free T4 and a Free T3 test run to see how much hormones you have available. Then you need to find out why the T3 uptake and the TSH contradict each other.

I'm not a doctor, there are probably errors in my post, so take this as just my humble opinion.