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.

[tgstock]

Hi,
Got my latest results:
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.  My doc appt was supposed to be last week, but I had to cancel and they can't reschedule till April.

Your thoughts, please?

[goolarra]

It's likely peri-menopause is a factor at the very least.  I started noticing changes a good ten years before the actual event (or non-event).    

Your latest FT4 was quite low.  Drop in BP is a symptom of hypo, so if yours tends to run low anyway, that might be what's making you feel faint.  

Ugh...no longer test T3?  Things do not get better...

Post your new results when you get them.  Merry Christmas!

[tgstock]

Thanks.  Maybe menopause is a factor.  I'm 47.  I have very low blood pressure.  I quit taking the meds for 2 days just to see if it would help.  Also, had blood drawn yesterday.  Doc said that we no longer test T3.  

[goolarra]

Your FT4 is still on the low side.  Flushing isn't usually a symptom of hypo.  Do you have and blood pressure issues?    Could menopause be a factor?

[tgstock]

Hi Goolarra,

I have thyroiditis.  I've been taking Synthroid.  Yesterday, I started to feel flushed.  I was quickly exhausted and went to sleep.  This happened twice, really uncomfortable flushing causing me to feel faint.

I didn't take any Synthroid today.  I'm on an 88 dose.  I go back to doc in January.
Bloodwork history below:

Here is a history:
      7/18/12   7/31/12   8/29/12   9/25/12   11/8/12 (Synthroid 75 for 3.5 wks)
TSH  0.02      0.01       0.03         1.8          1.37*
T4,Fr 1.7        1.5          1.1         0.8          1.0*

[goolarra]

Your FT4 is still a little low in the range; many of us find it has to be around 50% of range.  However, that really depends on how you feel.  If you feel good and don't have any lingering symptoms, then I wouldn't do a thing.  Of course, we don't have an FT3, but once again, how you feel is the most important.  There is plantly of room in your labs for a little increase if anything still bothers you.

Please refresh my memory and save me from having to read through what has become a long thread...have you had TPOab and TGab tested before?  Sorry, i also don't remember why glucose was an issue???