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Old 07-07-2009, 06:06 PM   #1
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Low TSH but symptoms of hypo not hyper

How can it be that I am cold all the time and have all the symptoms of hypothyroid and yet have a low TSH and was diagnoised as hyperthroid. Has anyone else had this happen to them? What does it mean? I'm getting worried. Thanks for any info or advice you might have for me.

 
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Old 07-08-2009, 08:34 AM   #2
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Re: Low TSH but symptoms of hypo not hyper

Argh, another Dr using the TSH to diagnose !

There are many things that can cause your TSH to be low and Hashimoto's is one of them. If you have hypo symptoms you need to be tested further.

Ask your doctor to order the following tests:

Free T3
Free T4
Antibody tests:
TPO-Ab
TG-Ab
And if he suspects Graves: TR-Ab

When you get your results post them here with the ranges. If your doctor won't order then find a new doctor who will. Good luck!

 
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Old 07-08-2009, 09:33 AM   #3
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Re: Low TSH but symptoms of hypo not hyper

It's hard to use symptoms as a gauge, because hyper symptoms overlap with hypo symptoms---fatigue, hair loss, anxiety can happen with both

That's why it's good to get your other blood levels, such as free t4, to see the hormones that are circulating in your blood. Also, you would need further analysis, such as an uptake scan, if you were truly hyper, or just experiencing "thyroiditis" a flare in hormone.

 
Old 07-08-2009, 01:10 PM   #4
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Re: Low TSH but symptoms of hypo not hyper

Thank you both for the responses. I will be seeing my doctor tomorrow and I am going to ask for further testing if he doesn't order it without my asking. I don't think I can have 8 out of 10 symptoms of hypothyroid and only 2 overlaping symptoms of hyperthyroid and be diagnoised as hyperthyroid. I am 65 years old and for the past 2 years my symptoms have been appearing so I do think I need further testing.

 
Old 07-08-2009, 01:17 PM   #5
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Re: Low TSH but symptoms of hypo not hyper

I am definitely hyper, but I have often felt as though I was experiencing more 'hypo' traits such as weigh gain.. and feeling cold all the time (at times I have hot flashes too but not sure if that is more fertility related).... but, all my tests are showing grave's and most recently toxic multinodular goiter as well.

Good luck getting answers..
__________________
Dx Grave's 10/2005 (High TSI level)
PTU Meds started 1/2007
Dx Toxic multinodular goiter 7/2009
Total Thyroidectomy 7/10/2009 (Benign)

 
Old 07-08-2009, 02:55 PM   #6
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Re: Low TSH but symptoms of hypo not hyper

If you have Hashimoto's you will experience both hypo and hyper symptoms and the TSH will be all over the place. You need to find out the amounts of free thyroid hormones in your system to accurately diagnose. Be sure to get those antibody tests too.

I also recommend you get a saliva cortisol test to check your adrenals.

 
Old 07-10-2009, 01:27 PM   #7
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Re: Low TSH but symptoms of hypo not hyper

My labs are closer to hypo, but my symptoms are hyper, including Graves eye disease which I have. You should have further testing. I have BOTH Hashimotos and Graves and I had all of the recommended tests that someone else recommended.

 
Old 07-10-2009, 04:23 PM   #8
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Re: Low TSH but symptoms of hypo not hyper

Quote:
Originally Posted by gabby1944 View Post
Thank you both for the responses. I will be seeing my doctor tomorrow and I am going to ask for further testing if he doesn't order it without my asking. I don't think I can have 8 out of 10 symptoms of hypothyroid and only 2 overlaping symptoms of hyperthyroid and be diagnoised as hyperthyroid. I am 65 years old and for the past 2 years my symptoms have been appearing so I do think I need further testing.
I'm also a senior, hypo and diabetic. I read somewhere, don't know if it's true, that metformin can make you seem hyper. I'm not sure if it's a false hyper, just on paper, or if you feel hyper, have bulging eyes and some other hyper symptoms. Anyone know anything about this? Does it just give you a confusing mixture of symptoms or numbers or both?

 
Old 07-10-2009, 04:25 PM   #9
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Re: Low TSH but symptoms of hypo not hyper

Quote:
Originally Posted by gabby1944 View Post
Thank you both for the responses. I will be seeing my doctor tomorrow and I am going to ask for further testing if he doesn't order it without my asking. I don't think I can have 8 out of 10 symptoms of hypothyroid and only 2 overlaping symptoms of hyperthyroid and be diagnoised as hyperthyroid. I am 65 years old and for the past 2 years my symptoms have been appearing so I do think I need further testing.
I'm also a senior, hypo and diabetic. Are you diabetic? I read somewhere, don't know if it's true, that metformin can make you seem hyper. I'm not sure if it's a false hyper, just on paper, or if you feel hyper, have bulging eyes and some other hyper symptoms. Anyone know anything about this? Does it just give you a confusing mixture of symptoms or numbers or both?

 
Old 07-10-2009, 04:27 PM   #10
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Re: Low TSH but symptoms of hypo not hyper

Quote:
Originally Posted by AlexaIn2006 View Post
My labs are closer to hypo, but my symptoms are hyper, including Graves eye disease which I have. You should have further testing. I have BOTH Hashimotos and Graves and I had all of the recommended tests that someone else recommended.
So what do the doctors do for you?

 
Old 07-10-2009, 05:03 PM   #11
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Re: Low TSH but symptoms of hypo not hyper

UPDATE: I just got a call from my doctors office with my lab results which to me make no sense at all. I hope someone here can figure it out for me. I do know that he wants to do a ultrasound and then send me to a Endocrinologist. Here are my results from blood drawn yesterday.

TSH: .20
Free T4: .77
Free T3: 3.20

He said my TSH is low - my FT4 is above normal - and my FT3 is normal

What does this mean in terms of a possible diagnoses?

Last edited by gabby1944; 07-10-2009 at 05:23 PM. Reason: forgot a word

 
Old 07-11-2009, 01:33 AM   #12
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Re: Low TSH but symptoms of hypo not hyper

Quote:
Originally Posted by gabby1944 View Post
UPDATE: I just got a call from my doctors office with my lab results which to me make no sense at all. I hope someone here can figure it out for me. I do know that he wants to do a ultrasound and then send me to a Endocrinologist. Here are my results from blood drawn yesterday.

TSH: .20
Free T4: .77
Free T3: 3.20

He said my TSH is low - my FT4 is above normal - and my FT3 is normal

What does this mean in terms of a possible diagnoses?
You are entitled to one hard copy of the lab report, which will contain that particular lab's "normals",a/k/a ranges. We can't tell from your post what they call normal for T4 or T3. TSH ranges change a lot and normal used to be 5 and under (.05? I forget) but then it changed to 3, and now around 1, some places. Sounds like he wants to lower your dose a little. If you take metformin for diabetes, you might want to ask him if that's causing you to look a little hyper. Some inhaled steroids can also lower the TSH, and probably other meds.

Cancer patients' TSH is kept suppressed, so one doctor online says if low TSH doesn't harm them it obviously wouldn't harm anyone else either, but traditions die hard? I'm not sure it's okay to mention his name. He has a lot of sensible information, and a newsletter.

Last edited by Eagle; 07-11-2009 at 01:36 AM.

 
Old 07-11-2009, 03:18 AM   #13
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Re: Low TSH but symptoms of hypo not hyper

Unfortunately a lot of doctors are still diagnosing via TSH results, rather than doing the full thyroid panel and then taking symptoms into account too.

I have Hashimoto's and am hypo, but more of my symptoms appear to come from the hyper list. I'm aware now this is due to having Hashi's your thyroid can swing from hyper to hypo and then sputter into life again and be normal for a a time too, then swing back to either hypo or hyper and on and on. I did have a slow metabolism, but used to think it was super fast as i could eat like a horse and not put on weight. People assume i am hyper if i mention i have a thyroid problem. I've found with my own personal symptoms and reading other people's symptoms that symptoms can vary from person to person. This is due to the fact that it's not just your thyroid which is causing issues (as well as it swinging from hypo to hyper), but generally all things within the entire endocrine system. A lot of people have adrenal issues and are not making sufficient of the hormone cortisol or are making too much. Low/high cortisol symptoms are quite similar to thyroid symptoms. I had the most chronic tiredness with bulging/burning/stinging/painfully tired eyes. It was all connected to my low cortisol levels. Now that my doctor has addressed my adrenals and thyroid it has eased so many of my symptoms, but simply starting adrenal meds eased so many of my symptoms.

In addition to thyroid and adrenals, addressing vitamin/mineral deficiencies eg: ferritin, zinc, iodine, B12, folate and Vitamin D is a must as a lot of people with thyroid problems have deficiencies in various vitamins/minerals.

Thyroid problems also often come along with other hormones imbalance symptoms from having estrogen dominance and progesterone deficiency and also testosterone excess.

A lot of people appear to have gluten intolerance too so that is another thing worth checking. Gluten in particular isn't a friend of auto immune diseases so might be worth easing off the gluten, even if you don't have an actual gluten intolerance.

So basically you need to have the full thyroid panel tested, including your thyroid antibodies and then get all the other above things i mentioned tested too. Not a lot of doctors look at these other areas, but they all go hand in hand with thyroid issues and if you want the best health possible you need to get checked out for everything.

 
Old 07-11-2009, 07:38 AM   #14
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Re: Low TSH but symptoms of hypo not hyper

I definitely second Audrey above. Get that saliva cortisol test (I think Canary Club has best prices) and check the adrenals. They have to be addressed first before the thyroid meds are started.
* Disallowed website and related information removed by hb-mod, moderator * You do need to get those antibody tests but also be aware that there is a high false-negative with them so they aren't the end-all for diagnoisis. I have all the symptoms of Hashi's, including painful dry eyes, periodic weight loss but my antibodies always come back negative. Also Hashi's can cause your test results to be all over the place so it's best to replace your hormones until the symptoms are relieved and definitely throw out that TSH as any kind of guage for treatment success.
Can you provide the ranges for the Free T tests above? It's not whether you're simply in range that matters, it's where in the ranges you fall that's important.

Last edited by hb-mod; 08-23-2009 at 04:29 PM. Reason: Please don't post disallowed websites and products as per Posting Policy. Thanks.

 
Old 07-11-2009, 07:47 AM   #15
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Re: Low TSH but symptoms of hypo not hyper

Your FT4 of .77 would be below range according to every lab standard I've seen. Combined with low TSH, it's suspicious for hypothyroidism due to pituitary disease. This is an uncommon reason for hypoT, which is why so many doctors miss the diagnosis. If none suggests pituitary testing for you, consult as many MDs as it takes to get it.

Bottom line, you're very likely hypothyroid. Let us know what the endo says after you see one.

 
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