TSH w reflex to ft4 = 0.02 What does it mean?

[tgstock]

I went to the doctor because I've been having headaches behind my eyes and in my sinus area.  I'm tired much more than I used to be, my fingernails have become paper thin, and I feel like I'm having a harder time focusing. My eyes get so dry at night that I have to wake up and put drops in them.I don't have an appetite, but I gain weight easily. (I am female, late 40's, 5'5", 110 lbs) I exercise vigorously most mornings.

He did this blood test: TSH 2 reflex to ft4 - the result was 0.02.
He is on vacation, but the nurse called to ask if I have heart palpitations, or excessive sweating.  I don't.  
She said I have an overactive thyroid, and requested blood tests to confirm it.  They also came back consistent with a hyperthyroid result, but I don't know what tests they did.  It confused me because I don't lose weight easily and I don't have a big appetite - I thought those were the main symptoms.
She said they will monitor it and have me tested in another 2 weeks to see if they number stays the same.

I'm curious to know what might be going on, because the doc won't be back for another week.  The headaches linger and often I have clear blurry spots in my vision when they begin.  It's starting to worry me a little.

I appreciate any feedback about that TSH test result.
Thanks.

[goolarra]

Am i missing it, or are your 2/20/13 labs not there?

[tgstock]

Hi,
I've been breaking my 88 Synthroid in half - getting roughly 44/day depending on how precisely the pill broke.  
Last TSH (2/20)was 1.7
(3 weeks of breaking in half)
TSH range: 0.4-4.5
T4, free (0.8 - 1.8)
T3, free  
7/18/12   7/31/12   8/29/12   9/25/12   11/8/12            1/16/13 (note below)
TSH  0.02      0.01       0.03         1.8          1.37*     1.42
T4,Fr 1.7        1.5          1.1         0.8          1.0*       1.2**
*Synthroid 75 for 3.5 wks
**The 1/16 T4  note: the current lot of free T4 reagent available produces results that are approx 9% higher than previous reagent lots.
1/6/13 NOTE: I quit taking Synthroid on 12/23 - thought I was feeling too hypo.  
2/20/13: Note - taking 44 per day for 3 weeks.

I'm so confused, and the doc can't see me till April.

[goolarra]

So, it had spiked up before you stopped taking it and has since gone down.

It is really good that you had labs right when you discontinued.  Now, we know that FT4 of 1.5 is a little too high for you, and 1.2 is a little low (this may have dropped a little further since the draw), and 75 mcg is a little too much.  I suspect that you should probably have cut back a little rather than stopping altogether.

The only real problem with starting and stopping Synthroid is the time it takes to build in your system.  If you start taking it again (I'd recommend you ask your doctor about a slightly lower dosage), it's going to take 4-6 weeks to build before you know how you feel and you can repeat labs to reflect the full impact of the change.  

The last time I was hyper (overmedicated), my endo advised me to discontinue meds for three days, then resume at a lower dosage.  Ask your doctor about that.  It worked really well for me.  Most of the hyper symptoms went away during the three-day hiatus, although they continued at a much more tolerable level for a couple of weeks after.  

[tgstock]

Hi. I just got the results from a 12/24 test. That will give you a better picture.  

TSH was 0.15. T4 was 1.5. That was right after I quit taking Synthroid.

Now, a month later, I'm starting to feel exhausted again and I've lost my appetite. So confused. Lost weight but I haven't been eating muc so it's not a surprise. Any problems with stopping and starting Synthroid?
Thank you.

[goolarra]

You stopped taking Synthroid on 12/23, so most, but probably not all, of it was out of your system 3.5 weeks later when you had your labs on 1/16.  I've seen that note about the current lot of the reagent on other people's labs...yet another element to add confusion...ugh.

Anyway, your FT4 has gone up (even considering the 9%, it's gone up a little) to 1.2 despite discontinuing meds.  Of course, we have no idea how high it had been just before you discontinued, which is some 6 weeks since the 11/8 labs.  It most likely spiked in between and then dropped again.

How are you feeling now, and how have you been feeling since discontinuing?  Did it take long to stop feeling hyper?  Have you had hypo symptoms return at all?

    

[tgstock]

I meant to say in my previous note that I was feeling 'hyPER', so I quit taking the 88 synthroid that I had been on for a month.  Still haven't had any - so these 1/16 test results are without the synthroid.  The lab noted that the current lot of free T4 reagent produce results that are 9% higher than previous lots.