TSH low, FT4 normal....Questions on Dr's note and what to think

[mastertmh]

My thyroid panel results came back and I got a note from the doctor asking if I feelt high. I think I feel normal.  For a bit my fingers were abnormally cold.  My results were: TSH 0.02 and FT4 1.1.  I believe from what I have read from other posts that it doesn't matter too much about TSH.  Is this true?  I take Armour and the Dr. said the lab results could be like this because of taking Armour.   I know when I think I have too high a dose of meds since I used to take synthroid my mouth , lips and teeth, would feel kind of funny.  ANy thoughts on this?  Background on me: I had thyroid cancer in 2005, Hodgkin's Lymphoma in 2007 (symptoms started in 2006), started with synthroid but switched to Armour 7 months ago.

[laura1967]

I am in Florida too...what area are you looking for a doctor in? You can message it to me if you want so it isn't put on board for everyone to see. lol

[goolarra]

You can pre-interview doctors, either on the phone (probably through a nurse) or I faxed out questionnaires with relevant questions.  I asked which tests the doctor regularly ordered for his hypo patients, which meds he was open to using, if he'd ever treated patients with the other health problems I had, etc.  It was multiple choice so it only took a few minutes to fill out.  I've found many of the people in medical offices give surprisingly candid answers.  

One of my questions is always if the doctor expects to be blindly followed or if he's open to patient input.  I would have thought that virtually no one would answer "blindly followed".  Wrong!  I actually had one person tell me that in their office you did what the doctor said...period!

It's a lot cheaper and more efficient than making an appointment with every endo in town.

[RenKat]

I read your response to mastertmh and I agree.  I live in Florida and have had a succession of bad doctors, refusing to listen to any of this, and at my expense, in cost and symptoms.  I see one last hopeful prospect on Friday.
Any advice on how to find this sort of endocrinologist?  I am asking in all sincerity.  Thanks

[laura1967]

Your doctor should understand that when treating with a combo med or including a T3 medicine, that you can no longer go by a TSH level. He should be treating you by your Free T4 and Free T3 levels.  Any T3 medicine will supress your TSH and make you look hyper when you are Not.  Your free T4 should be mid normal range and your free T3 should be at least mid normal to high normal range, in order for you to really be optimal.
Unfortunately this is why so many patients remain ill and are undermedicated and undertreated, due to them not understanding how to treat with T3 meds.

[goolarra]

Yes, it's true, taking Armour can suppress TSH.  I wouldn't worry about your TSH at all.  Furthermore, after thy ca, doctors usually want to suppress TSH as much as possible to discourage regrowth of thyroid tissue.

Please provide the range on your FT4.  It's usually in the vicinity of 0.8-1.8.  If that's what your lab report says, then, if anything, it looks slightly on the low side to me.  However, I'm glad to hear that your doctor is consulting your symptoms before jumping to the conclusion that your dose is too high just because your TSH is suppressed.  Your doctor should also be testing FT3 regularly, especially since you are on T3 meds.