HELP! Low TSH & Low Free T4

[andeflora1]

I just got test results back  TSH .8 (Range .6 - 5.0)  Free T4 0.8 (Range .7 to 2.0). I am having a bunch more blood work done, but I don't understand these results. I thought they were supposed to be High/ Low OR Low/High not LOW/LOW. Dr said secondary hypothyroidism or possibly subacute thyroidistis. I realize my numbers are at the bottom of the normal range, but does that mean that I don't have hypothyroidism?

What is secondary hypoT? Is it Hashimoto's or is something wrong with adrenal glands? Dr testing cortisol too along with all kinds of thyroid levels and ordered a Thyroid Scan & Uptake because he felt some swelling... what does swelling mean? Is that bad?

I have all of the symptoms of hypo and have for years... exhaustion, DRY ITCHY skin, dry itchy scalp, dry brittle nails, hair falling out, my periods are all over the place, and in 2 mths I have gained 20lbs. And in the last 4 years I have gained 70lbs. Until I was 23 I was 106lbs and wore a size zero. No matter how many miles I run a day or how many salads I eat I keep gaining weight...annoying! But now my endometriosis has gotten SO bad and the pain is worse than ever... after 4 mth course of Lupron. I had precocious andrenarche at 6 yrs old with ovarian cysts. Is this all linked????

I would be so grateful if someone could help me understand this. It's really confusing and I'm not sure if I should be worried.

Thanks for ANY and ALL help!
A

[goolarra]

I think it's great that you have a doctor who is covering all options.

Really, so much depends on antibody test results.  If you are negative for antibodies, then your hypo could spontaneously resolve.  However, if positive, it won't.  You've had symptoms of hypo for a very long time, which would indicate either thyroid or pituitary dysfunction.  If you've had symptoms for years, I doubt it's going to resolve.

Many of us have lumps, or nodules, on our thyroids.  Most often they are part of the disease and nothing to worry about, but to monitor for changes.  

A URI can cause DeQuervain's thyroiditis, which is a "temporary" thyroiditis and usually resolves itself, though it may take several months to do so.

When you get your most recent test results, post them if you'd like, and members will help you interpret them.

[andeflora1]

He is testing for antibodies... Both tests I think. Just had everything done yesterday. I think he was checking cortisol & adrenal because of prior history of overactive adrenals as a child.

What's your take on it being subacute thyroiditis and just going away on is own??? Can it do that? Also I should have mentioned a year& a half ago my eye dr (also a MD) saw a lump on my thyroid and my pcp said it was nothing so nothing was done.

Endo said it may just be from upper respiratory infection recently, but I haven't been sick in over 6 or 7 months even then it was just a runny nose not URI.

Thank you so much for the explanations!!!!!!

[goolarra]

You're right TSH/FT4 is USUALLY high/low or low/high.  However, many factors influence TSH, among them pituitary function.  Secondary hypo is when your pituitary is not producing enough TSH to stimulate your thyroid to produce T3 and T4, the two primary thyroid hormones.  So, technically, your thyroid should be capable of producing thyroid hormones, but your pituitary is not stimulating it to do so.  However, the result is that you are hypothyroid since your T3 and T4 levels are inadequate.  I hope that's not too confusing.

It is not Hashi's, although you might also have Hashi's...once again...not too confusing, I hope.  The swelling in your thyroid might indicate that you also have thyroid dysfunction.  Many of us who are hypo have swelling (goiter).

Is your doctor testing TPOab and TGab?  These are the two antibody tests that confirm Hashi's.

I don't think I'd jump to the adrenals immediately, but it's good that your doctor is covering all the bases and testing adrenal function as well.