Thyroid Disorders Community
26.1k Members
14197800 tn?1433340505

What is my next step? Still "feeling" hypothyroid

Hi everyone,

I was Googling my results from my recent blood tests and stumbled on this forum that seemed to have some great information.  I am still not feeling great, but my TSH's have tanked (which I am reading is normal on Armor Thyroid).  Looking at the results below, does anyone have some suggestions on what my next step should be?

12/12/14 - no meds
TSH 0.84
T4, Free 1.1
T3, Free 2.4

2/21/15 - 30 mg of Armour Thyroid
TSH 1.19
T4, Free 1.1
T3, Free 2.8

5/21/15 - 60 mg of Armour Thyroid
TSH 0.03 - WOW?!?
T4, Free 1.0
T3, Free 2.7

Does anyone else find it odd that when I take more Amrour, my T3 and T4 went down? I still feel horrible.  Barely able to stay away, hair loss, the usual.  Any suggestions?
1 Responses
Avatar universal
Not odd at all.  Hypo patients frequently find that their serum levels of Free T4 and Free T3 do not start to rise until after their TSH becomes suppressed below range.  That is because serum levels are comprised of endogenous thyroid hormone from the thyroid gland as well as from exogenous sources (thyroid med).  As med is increased, TSH goes down and the thyroid gland produces less.  The net effect can be basically nothing until your body is totally dependent on thyroid med.  For example, my TSH has been .05 or less for probably 35 years in order to get my serum thyroid levels high enough.

This is a link to a scientific study showing that "Suppression of TSH by thyroid replacement to levels below 0.1 mU/L predicted euthyroidism in 92% of cases, compared to 34% when TSH was above 1 mU/L (p < 0.0001). In conclusion, in central hypothyroidism baseline TSH is usually within normal values, and is further suppressed by exogenous thyroid hormone as in primary hypothyroidism, but to lower levels. Thus, insufficient replacement may be reflected by inappropriately elevated TSH levels, and may lead to dosage increment."


So your next steps should be to continue to gradually raise your med in order to get your Free T4 to the middle of its range, and your Free T3 into the upper part of its range, as necessary to relieve hypo symptoms.  I say that because Free T3 has been shown to correlate best with hypo symptoms, while Free T4 and TSH did not correlate.  

In addition since hypo patients are frequently too low in the rnages for Vitamin D, B12 and ferritin, you should make sure to get those tested as well.  D should be about 55-60, B12 in the upper end of its range, and ferritin about 60 minimum for ladies.  

Have an Answer?
Top Thyroid Answerers
649848 tn?1534633700
Avatar universal
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
For people with Obsessive-Compulsive Disorder (OCD), the COVID-19 pandemic can be particularly challenging.
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Here’s how your baby’s growing in your body each week.
These common ADD/ADHD myths could already be hurting your child