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Thyroid Disorders Message Board
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Old 10-27-2002, 11:43 AM   #1
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staceylc HB User
Post Low tsh, t3 and t4...what does this mean?

I am hoping someone will be able to tell me what it means when you have hypothyroid symptoms and your blood levels all came back low? I thought if your tsh was low you should have a high t4 and t3? Is that correct? Can you still suffer from hypothyroidism even if you have a low tsh? Thanks for your help.
Lab values:
TSH .622 (.35-5.5)
T4 1.03 (.89-1.76)
T3 .57 (.60-1.70)

Stacey

 
Old 10-27-2002, 05:50 PM   #2
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MystreeGirl HB User
Question

I have a situation similar to yours that I posted about recently, although my TSH is even lower than yours.
TSH .06 (.5-6.0)
T3 260 (230-420)
free T4 .79 (.75-1.54)
I am being treated for hypothyroidism but like you, it doesn't make sense to me that my TSH would be so low and yet my other levels are not elevated. It just does not make sense to me and it is not the first time it has happened. In the past, I have had low TSH levels and the doctor reduced my synthroid and then the TSH level dropped even lower. He even accused me of failing to reduce my dose (I don't see this particular doctor anymore.) The third time this happend, I finally convinced him to check my other levels, which turned out to be normal. It is important you get your doctor to listen to you (or find another doctor) because it is entirely possible something is going on with your thyroid. We know our bodies better than these doctors do!

 
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Old 10-27-2002, 06:29 PM   #3
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mystreegirl,

Thanks for responding and sharing your situation. Have you noticed that you are feeling better after treatment? My doctor refuses to treat me because he says my tsh is normal and my t4 and t3(which is below normal ranges) aren't that low. He wants me on antidepressants. I have tried those before and have felt worse. He also says that I may just have to live with my symptoms since we chose to have so many children??? Needless to say I am not happy with him. I will look for a new doctor if others out there (like me) think there is something going on with my abnormal looking results and of course my symptoms. Oh and are you only being treated with synthroid? For how long? thanks for your help.
Stacey

 
Old 10-27-2002, 06:50 PM   #4
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staceylc,

First of all, any doctor who told me "I may just have to live with my symptoms since we chose to have so many children" would no longer be my doctor. You know when you don't feel right and I am sure you know the difference between being tired from a demanding lifestyle and when something is not right physically. I am taking Synthroid and Cytomel (T3.) I have been treated with Synthroid for 15 years but began having symptoms again 3 years ago (when the doctor started lowering my dose because of the low TSH.) The addition of Cytomel has been a lifesaver for me. I wonder if your low T3 level might be the cause of your symptoms, although I certainly am not even close to being a medical expert. If I were you, I would definitely get a second opinion, hopefully someone who will listen to your symptoms. It is too easy for doctors to try to tell us it is all in our heads just because they don't have the answer. Doctors are trained to have the answer, so sometimes it is easier for them to blame the patient rather than be able to admit they don't know. Don't fall for it!!!!

[This message has been edited by MystreeGirl (edited 10-27-2002).]

 
Old 10-28-2002, 07:31 AM   #5
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Meep HB UserMeep HB UserMeep HB User
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Low TSH with low or low-normal T3 and T4 CAN be indicative of pituitary problems, and it can also be indicative of adrenal problems, according to Dr. Bruce Rind. (go to [url="http://www.***********"]www.***********[/url] and search for his name--his website is VERY informative, but contains commercial information, so I can't link to it here.)

One of his pages has an interesting assessment of how to interpret thyroid test results, and here's what it says about having all three low combined with a low body temperature:
Quote:
Often confused with hypothyroidism because of low T4 and T3. Some doctors mistakenly interpret the low TSH here to mean pituitary trouble.
There's another angle that can be taken based on your test results, too. Since your T3 is lower than your T4, it is possible that you may have some liver problems. The reason I say this is that when T4 is low, someone with a healthy liver will usually have a T3 that is higher in its lab range than the T4 result is.

Why is this? 80% of the T3 in a healthy person's blood comes from the liver where it was converted from T4. If your liver is not up to par for some reason, your T3 will be low. SO, if you have a history of Hepatitis, heavy drinking, or taking tylenol regularly (can damage the liver if taken constantly or taken at high doses), get your liver checked out, too.

My advice and opinion? Get a second, third, fourth...fiteenth opinion if you have to, but get some treatment. The fact that the doctor ignored the T3 being below scale means he doesn't know thyroid from tree-bark and is being negligent in your treatment (my opinion), and further endangering your health.

Meanwhile, do some reading. Here are some books that I recommend:
  • * Solved: The Riddle of Illness by Stephen Langer
    * The Thyroid Solution By Ridha Arem
    * Adrenal Fatigue: 21st Century Stress Syndrome by James Wilson

[This message has been edited by Meep (edited 10-28-2002).]
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I am not a doctor, nor have I ever played one on TV...

 
Old 10-28-2002, 08:47 AM   #6
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Meep,

Do you have any ideas why my numbers are the way they are? I have Hashimoto's and at times my TSH will go up above normal, but I also frequently get test results such as those I posted above. In fact, all my recent troubles started when a (former) doctor kept reducing my synthroid dose based solely on my TSH. However, even though I now have a great doctor who does pay attention to symptoms, I cannot seem to get myself to a place where I feel right. Most of the time I have hypo symptoms but the last time I talked the doctor into upping my dose based on symptoms, I clearly went hyper and had to reduce back down. There doesn't seem to be an in between level where I feel right. Any suggestions?

 
Old 10-28-2002, 10:24 AM   #7
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bunky67 HB User
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Mystreegirl,
Has anyone mentioned finding a compounding pharmacist who can make you an individualized dose of thyroid med.? If you can find one who compounds, then you could try miniscule increases somewhere in between the 2 doses you tried to switch between. It is not always very high cost either. I don't know about price on thyroid meds (I take a regular .1), but another medicine I had to get for my dog who had Addison's disease, costed the same for a 10 day supply (10-.1mg pills of florinef) as I could get compounded for a 3 month's supply.

 
Old 10-28-2002, 11:37 AM   #8
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MystreeGirl,

If you have Hashimoto's, you WILL have fluctuations like that. There ARE options that may help, bue they may or may not be what you want to hear.
  • 1. Continue to treat for the hypo and when you feel yourself going hyper, stop your meds. When the hyper symptoms subside, start back on your meds. You may be off and on your meds for years until Hashimoto kills your thyroid completely, but by carefully monitoring your symptoms and adjusting your meds, you may be able to live ith it more comfortable. Realize that after each hyper episode, you may need more thyroid meds than before because it has killed off a little more of your thyroid gland.

    2. Have your thyroid gland surgically removed, then it will be MUCH easier to stabilize your meds. you will have to rely on meds for life after this, but the stability is worth it. In some people, if any of the gland is missed, it can grow back, but this is rare.

    3. Have I131 treatment to kill your thyroid gland. The radiation is not something that some people want to be subjected to, but it leaves no scars like the surgery does and is fairly reliable. Sometimes you have to do more than one treatment to get the job done.

Also, what may help in the interim is making sure you get enough Selenium in your diet. It might help to supplement with up to 200mcg a day, but many do well at 75-100mcg/day.

[This message has been edited by Meep (edited 10-28-2002).]
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Danny

I am not a doctor, nor have I ever played one on TV...

 
Old 10-30-2002, 09:30 AM   #9
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Thanks, Meep. You have given me a lot to think about. Because I was diagnosed so long ago (over 15 years ago) and because I was so stable for so long (until 3 years ago) I guess I assumed that whatever damage had been done had already happened. I am grateful for this board and at the same time angry that we can't get this kind of information from most of our medical professionals. I wasn't aware of all the fluctuations that went along with having Hashimoto's....you would think some doctor along the way would have explained it to me. Now I wonder if they even understand it. One more question for you-do you think the very low TSH along with the other labs being in the low normal range means I am about to go hyper? Or should I expect my TSH to go up in response to the low normal T3/T4? I still find the discrepancy in the labs hard to understand. Thanks again for all the time you and so may others devote to this board!

 
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