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Low Free T4 and Low TSH - Please Help
Hi There ~
I have been on Synthroid for about 4 months now... a fairly low dose of .50mcg for hypothyroid.
My labs have always come back with my TSH around 2.4-ish but lately I have been feeling really off, extremely fatigued, and connot lose weight for anything despite weight watchers and daily hour workouts - So I was going to ask my Endo about upping my dose to .75mcg
BUT...............
When I arrived for my visit he was perplexed by my labs. Apparantly they were way off and very odd.
My TSH was low.... showing I was hyper-thyroid despite any hyper symptoms and my Free T4 was low, so low in fact that it was showing that I had virtually NO circulating thyroid hormone in my body - which makes no sense. Its like a medical oxymoron? I'm baffled....
Here are my labs:
Free T4 0.03 low Range: 0.82 - 1.77
TSH 0.058 low Range: 0.450 - 4.500
How can I be hyperthyroid (asymptomatic) with NO thyroid hormone?
While researching I found that a Low TSH and Low T4 can mean a pituitary issue - if you are not medicated, but I am and have been - so does that discount a possible pituitary issue?
I also read that some MDs don't even go by the TSH at all and only use the T4 and T3 to medicate... which would mean that I am grossly undermedicated?
Or could this be a thyroiditis attack? My sister has Hashimotos - but I have never had any antibodies. However, going from hypo at TSH of 6.0 to being medicated and supressing my TSH to around 2.4 for 4 months to THIS is odd, so could this be a Thyroiditis?
My MD did order a lab re-test with T3, T4, TSH - when I got that bad boy lab slip, I took it upon myself to circle the antibodies just to make sure. I didn't know what else I should have added, so I just left it with those.
My MD is thinking it is lab error and thats all - BUT I FEEL LIKE CRAP. I am so tired I am barely functioining, afraid to drive due to fatigue and feel like I am going to pass out, I just feel OFF and I am not living at this point - just existing day to day.
I need some help.
Thank you so much!!
I have been on Synthroid for about 4 months now... a fairly low dose of .50mcg for hypothyroid.
My labs have always come back with my TSH around 2.4-ish but lately I have been feeling really off, extremely fatigued, and connot lose weight for anything despite weight watchers and daily hour workouts - So I was going to ask my Endo about upping my dose to .75mcg
BUT...............
When I arrived for my visit he was perplexed by my labs. Apparantly they were way off and very odd.
My TSH was low.... showing I was hyper-thyroid despite any hyper symptoms and my Free T4 was low, so low in fact that it was showing that I had virtually NO circulating thyroid hormone in my body - which makes no sense. Its like a medical oxymoron? I'm baffled....
Here are my labs:
Free T4 0.03 low Range: 0.82 - 1.77
TSH 0.058 low Range: 0.450 - 4.500
How can I be hyperthyroid (asymptomatic) with NO thyroid hormone?
While researching I found that a Low TSH and Low T4 can mean a pituitary issue - if you are not medicated, but I am and have been - so does that discount a possible pituitary issue?
I also read that some MDs don't even go by the TSH at all and only use the T4 and T3 to medicate... which would mean that I am grossly undermedicated?
Or could this be a thyroiditis attack? My sister has Hashimotos - but I have never had any antibodies. However, going from hypo at TSH of 6.0 to being medicated and supressing my TSH to around 2.4 for 4 months to THIS is odd, so could this be a Thyroiditis?
My MD did order a lab re-test with T3, T4, TSH - when I got that bad boy lab slip, I took it upon myself to circle the antibodies just to make sure. I didn't know what else I should have added, so I just left it with those.
My MD is thinking it is lab error and thats all - BUT I FEEL LIKE CRAP. I am so tired I am barely functioining, afraid to drive due to fatigue and feel like I am going to pass out, I just feel OFF and I am not living at this point - just existing day to day.
I need some help.
Thank you so much!!
Thank you so much!!
I did read that about the TSH - that it should not truly be trusted in the treatment of thyroid, as using the FT3 and FT4 are more accurate.
He did circle the T3 on this last test, so I guess we wait and see what that shows so we can proceed with treatment...
Its nerve racking because we have always been told, tested and treated by the TSH - and then to read about the inacuracy of prescribing by TSH alone - it is kind of scary.
The research pasrt of my brain want to walk in, tell him - Hello I am HYPO - LOOK at my T4 - and take a larger dose and feel better
But my 40yr old brain that has seen only the TSH on lab slips for the last 20 years is thinking - Oh No.....what if I take MORE synthroid and I am hyper according to labs - will it send me into Thyroid Storm??
Ugggg
You all are SO helpful and SO knowledgeable. Thank you so very much!!
I will keep you posted about the labs and my T3
Thank you!!
I did read that about the TSH - that it should not truly be trusted in the treatment of thyroid, as using the FT3 and FT4 are more accurate.
He did circle the T3 on this last test, so I guess we wait and see what that shows so we can proceed with treatment...
Its nerve racking because we have always been told, tested and treated by the TSH - and then to read about the inacuracy of prescribing by TSH alone - it is kind of scary.
The research pasrt of my brain want to walk in, tell him - Hello I am HYPO - LOOK at my T4 - and take a larger dose and feel better
But my 40yr old brain that has seen only the TSH on lab slips for the last 20 years is thinking - Oh No.....what if I take MORE synthroid and I am hyper according to labs - will it send me into Thyroid Storm??
Ugggg
You all are SO helpful and SO knowledgeable. Thank you so very much!!
I will keep you posted about the labs and my T3
Thank you!!
Thank you all SO much!!
No I have never had a Free T3 run, but he did circle it on the last test.
I think he was trying to suggest that I was hyper - so I am really glad I posted here to get the validation to question him.
I am going to call on Friday to get the latest results of the TSH, T3, T4 and TPO antibodies.
I am hoping it was a lab error and we can increase the dose, because I am a walking Zombie.
George Romero could cast me in his next movie and not need makeup!!
Thank you all so much.
Goolarra - Very interesting about the TSH being so low... I thought went it was so low, that meant hyper to most docs, but what you are saying is that it is SOOO low that it surpassed hyperthyroid and isnt even producing?
No I have never had a Free T3 run, but he did circle it on the last test.
I think he was trying to suggest that I was hyper - so I am really glad I posted here to get the validation to question him.
I am going to call on Friday to get the latest results of the TSH, T3, T4 and TPO antibodies.
I am hoping it was a lab error and we can increase the dose, because I am a walking Zombie.
George Romero could cast me in his next movie and not need makeup!!
Thank you all so much.
Goolarra - Very interesting about the TSH being so low... I thought went it was so low, that meant hyper to most docs, but what you are saying is that it is SOOO low that it surpassed hyperthyroid and isnt even producing?
If the FT4 is so low you need a big increase in thyroid meds regardless of where the TSH is. TSH is not the key to medication, FT3 and FT4 are.
You definitely need FT3 Tested as well.
If your MD tries to suggest you are hyper run! You are hypo.
You definitely need FT3 Tested as well.
If your MD tries to suggest you are hyper run! You are hypo.
Good for you on circling the antibody tests! Whatever it takes to get it done.
I'm wondering about your FT3 as well.
A pituitary issue is still a possibility, whether you are taking meds or not. As you said, you have been on a low dose (50 mcg) of Synthroid. If your thyroid is putting out almost no thyroid hormone, 50 mcg is still most likely going to leave you very hypo. Your TSH is so low that your thyroid is not being stimulated to produce hormone.
I think a repeat test was a very wise first move. When do you get those results?
Do you have previous FT3 and FT4 results from the past 4 months?
I'm wondering about your FT3 as well.
A pituitary issue is still a possibility, whether you are taking meds or not. As you said, you have been on a low dose (50 mcg) of Synthroid. If your thyroid is putting out almost no thyroid hormone, 50 mcg is still most likely going to leave you very hypo. Your TSH is so low that your thyroid is not being stimulated to produce hormone.
I think a repeat test was a very wise first move. When do you get those results?
Do you have previous FT3 and FT4 results from the past 4 months?
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