Are my thyroin labs crazy?

[LilDMD]

Labs  TSH,HS   < .005  (.358-3.74) FT4.78 (.76-1.46) FT3 3.41 (2.18-3.98)

Current Meds:Levothyroxine 50 MCG   and  25  Liothyronine 25 MCG
My dr. wants to decrease   Levothyroxine to 25MCG  because of low TSH, but I have low FT4. Does this make sense?  

[gimel]

The most important question is how you are feeling?  What symptoms do you have?  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 and especially not TSH results when already taking thyroid med.  While you answer the questions I will find a couple of links to scientific studies that show that a suppressed TSH is very common when taking adequate thyroid meds.

[LilDMD]

Thanks for the response. I think ignoring the TSH would be a hard sell to my Dr., as she refers to it often - scientific studies would definitely be needed.  I feel good on current meds, but I was wondering if there is a reason it would be beneficial to raise the FT4 (I read that certain organs need T4 specifically). Also confused as to why I would have the current lab results in this combination  -Great T3 very low T4 and  suppressed TSH?
Any thoughts?
Thanks

[flyingfool]

Question:

Did you take your Cytomel (T3) medication PRIOR to the blood draw?

reason I ask is that T3 gets into the blood stream VERY fast. the T3 levels ramp up quickly to a peak about 2-4 hours after taking the medication. So if you had taken your T3 medication prior, it would result in a 'false high" reading.

Also do you take your T3 medication all at once or do you split it into two doses?  

Reason I ask is for the same reason.  T3 ramps up fast and is used up fairly quickly.  By taking it in two doses it helps even out the T3 levels through the day so that if you take the 1st dose in the morning, and the 2nd half in the early afternoon, the 2nd dose is starting to ramp up as the 1st dose is waning down.  And also helps keep your energy level up into the evening better rather than all the T3 be used up by the evening.

It is not at all unusual to have TSH suppressed when your FT3 levels are higher in the range.

The test result you posted has the FT3 to be 68% of the range which is about exactly what the rule of thumb is (upper half to upper 1/3 of the range)

Yes your FT4 levels are low in the range.

It is pretty clear that your Dr is only using the TSH. And I would recommend that you maybe consider finding a new Dr. Because as you are now experiencing, this Dr may keep you feeling less than well in an effort to chase TSH.

[gimel]

I sent info by PM.  To access, just click on your name and then from your personal page, click on messages.

[gimel]

In the words of a good thyroid doctor, ""The free T3 is not as helpful in untreated persons as the free T4 because in the light of a rather low FT4 the body will convert more T4 to T3 to maintain thyroid effect as well as is possible. So the person with a rather low FT4 and high-in-range FT3 may still be hypothyroid. However, if the FT4 is below 1.3 and the FT3 is also rather low, say below 3.4 (range 2 to 4.4 at LabCorp) then its likely that hypothyroidism is the cause of a person's symptoms."  It appears that your body is trying to maintain thyroid effect by converting a lot of T4 to T3.

I will post links on TSH suppression when I return.