Aa
Aa
A
A
A
Close
Avatar universal

Very low TSH & Exhausted

I posted this on Dr. L's forum after reading some items, but know this is where the action is!
I copy it here:
Dear Dr. Lupo, I have been reading some of your responses and have a brief question:

Since diagnosis Nov 2010, I have confirmed Hashimoto's with two types of antibodies. Tsh 55 at first test. Quickly decreased with medication (100mcg levothyroxine to start and then 112mcg for last couple of months) and is most recently UNDER 1.0 (TSH 0.220 as of 5/18/11). My FT3 was 3.21 at that same time. FT4 1.390. (earlier readings all posted here previously)  

On 112 mcg, I am as exhausted as I was in the beginning with the exception of a few weeks into medicating - felt like a rebirth. Never felt so good - ever. Then the tiredness quickly increased again. In May, even with TSH so low, my Doctor did not want to decrease Levo since my T3 was only mid-range and my complaint of exhaustion indicated, he said, that I could not be over-medicated.  (HELP).

QUESTION: How can you be exhausted with a below normal TSH? Doesn't such a low TSH usually indicate HYPER or over medication??

So confused and tired of being tired and headachy... main two complaints. Thank you so much. Nancy
3 Responses
Sort by: Helpful Oldest Newest
649848 tn?1534633700
COMMUNITY LEADER
Have you had vitamin B12 and D levels tested?  Low levels of both will cause you be exhausted.  
Helpful - 0
Avatar universal
Seems to me you may need to up dosage or even consider a combo T3/T4 med.

When on a Thyroid med it is FREQUENT that the med wil lsupress the TSH. Meaning that it will go to near zero with NO signs of being hyper.  However most Dr's freak out and immediately reduce the meds convinced that a near zero TSH means that you are Hyper. as Bar135 points out.  That she needs to basically disregard TSH in order to concentrate on the Free T3 and Free T4 to get to a point that is GOOD FOR HER.  Same is true for everyone and the blood level will be different for everyone.  But as she points out it seems to hover around mid range for T4 and upper 1/3 for T3.

Bottom line. do NOT settle for a Dr. who says "your within range so your good".  If you feel like crap then YOU are NOT good.  And you need to find a Dr. who will treat your symptoms NOT some magical number on the blood labs!
Helpful - 0
649848 tn?1534633700
COMMUNITY LEADER
Sorry, but your post leaves me with more questions.......

You do realize that TSH is not an antibody, right? Which two antibodies do you have?  

Wow - I have to commend your doctor for not decreasing your med on the basis of a low TSH.  I agree that just because you have a low TSH, doesn't mean you are over medicated.  I think there are plenty of members who would like to have his name/phone #...

Low TSH only indicates hyper if your Free T3 and Free T4 are over range and you have hyper symptoms ... My TSH typically runs < 0.01, but as long as my Frees are good (for me), we don't worry about it.

Many of us find that we need Free T3 in the upper 1/3 of the range, with Free T4 at (or in my case, above) mid range......  

Can you give us the reference range for the FT3 and FT4?  Reference ranges for these vary from lab to lab, so must come from you own report...

Sounds like you could use a small increase in med......
Helpful - 0
Have an Answer?

You are reading content posted in the Thyroid Disorders Community

Top Thyroid Answerers
649848 tn?1534633700
FL
Avatar universal
MI
1756321 tn?1547095325
Queensland, Australia
Learn About Top Answerers
Didn't find the answer you were looking for?
Ask a question
Popular Resources
We tapped the CDC for information on what you need to know about radiation exposure
Endocrinologist Mark Lupo, MD, answers 10 questions about thyroid disorders and how to treat them
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
STIs are the most common cause of genital sores.