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-   -   low TSH vs low FT3/FT4 question (http://www.healthboards.com/boards/thyroid-disorders/912269-low-tsh-vs-low-ft3-ft4-question.html)

thyroidmess 07-31-2012 01:47 PM

low TSH vs low FT3/FT4 question
 
Thank you in advance for any insight into this question, I haven't been able to find an answer yet. I have low TSH but in normal range. I also have low FT4 and lower FT3 (both lower than 50% mark).

Anyway, my naturopath said yes they're low but normal range and not going to do anything about it because my TSH is low and if medicate for low FT3/4, it will lower TSH and put me into hyperT. Internist said all normal. ENT said I'm fine.

I've been living with nodules for years and I guess nothing needs to be done with them. I imagine they're about filling up my thyroid as some are 2cm, some 1cm and some smaller. I've never had symptoms until recently. Neck/ear pain, thyroid area/some lymph nodes sore and have some swallowing issues as well as some hypo type issues, fatigue, headaches, horrible muscle/joint pain, hair loss and texture change, weight gain etc. Massage therapist said all from tight muscles (computer work 10hrs/day). ENT said all from acid reflux. Internist said I'm fine.

Can anyone tell me if I should continue to try to find an answer from the medical field or do I have my answers = live with it? I'm frustrated and confused. Thank you so much!

sammy64 07-31-2012 01:55 PM

Re: low TSH vs low FT3/FT4 question
 
Sorry you've been dealing with clueless doctors.

Lowering your TSH will not make you hyperthyroid *unless* it also increases your FreeT4 and FreeT3 levels so much that they are over-range and you are dealing with hyper symptoms.

Per thyroid textbooks, healthy people have FreeT4 levels near the high end of the range and FreeT3 levels above mid-range.

It seems that all of the doctors you've seen were sleeping during thyroid class.

"The Autoimmune Epidemic" states that the average person with an autoimmune disease (most cases of thyroid disease are) sees 6 doctors before getting a proper diagnosis/treatment. I know I wound up seeing 5....

These are the suggestions I have to offer re finding a thyroid-savvy doctor:

1. networking
2. check the Top Thyroid Doctors site for a listing in your area
3. ask local pharmacists (not the counter help) for names of doctors that prescribe either Armour or Cytomel. Doctors that Rx either of these tend to be more thyroid-savvy
4. contact the Broda Barnes Foundation and pay ~$18 to get an information packet that includes a list of doctors in your state who follow Dr. Barnes' ideology (Dr. Barnes was the author of "Hypothyroidism - An Unsuspected Illness" and was lightyears ahead of his time)
5. find a doctor that prescribes bioidentical hormones either by checking websites or contacting compounding pharmacies (they are likely to have names of doctors that prescribe Armour which usually means they're more thyroid-savvy)

Idea #1 worked for me....the other ideas have worked for others. I hope one works for you.

ladybud 07-31-2012 01:56 PM

Re: low TSH vs low FT3/FT4 question
 
You can have hypothyroidism with low TSH if the problem stems from the pituitary. Your nodular thyroid sounds suspicious for Hashimoto's thyroiditis, an autoimmune disorder that produces antibodies against your thyroid and eventually destroys it. Have you ever had anti-thyroid antibodies tested? If not, I nwould ask for those, and ask to try some thyroid replacement as a trial to see if you feel better. A pituitary panel (blood test) could be done also to check the other pituitary hormones, like ACTH for adrenals. One must treat the Patient, not the lab results, I want to scream from the rooftops.

sammy64 07-31-2012 02:01 PM

Re: low TSH vs low FT3/FT4 question
 
Another possible cause of hypothyroidism with a lower TSH is the presence of TSH receptor antibodies (that's what's causing mine).

I couldn't agree more with ladybud - doctors should treat the patient, not the lab results. Mismanagement of thyroid disease is pathetically rampant. (sigh)

thyroidmess 07-31-2012 02:29 PM

Re: low TSH vs low FT3/FT4 question
 
Thank you all sooo much for the info. I guess I'll keep trying. I found naturopath via internet search for docs who prescribe natural hormones. Will try another. I had hashi's antibody test in 2006, was negative. So, dunno why the nodules, have had them for years and latest ultrasound (first in years) showed some have doubled in size, some calcified, most are solid, not cystic. ENT said I didn't even need an FNA. I felt so lost and am so grateful for this site and your willingness to share your extensive knowledge. If I hadn't started having all these worsening symptoms, I'd never even check in with docs about nodules as I seriously doubt it's cancer. Thanks again and have a great summer all!

sammy64 07-31-2012 03:06 PM

Re: low TSH vs low FT3/FT4 question
 
Are you near the Seattle area?

If yes, Dr. Robert Murray is quite thyroid-savvy.

sammy64 07-31-2012 03:11 PM

Re: low TSH vs low FT3/FT4 question
 
[QUOTE=thyroidmess;5031309] I had hashi's antibody test in 2006[/QUOTE]

If you only had one antibody test, your doctor did not do comprehensive antibody testing.

Some people will test negative for TPOab's but, positive for TGab's....others will test negative for both of those and test positive for TRab.

Most doctors don't seem to be aware of the role TRab have in causing hypothyroidism.

As I mentioned earlier, TRab is the antibody that can cause a lower TSH in a hypothyroid person.

TRab is "thyrotropin receptor antibody".

Truly, the only definitive test for Hashi's is biopsy. Sometimes, the cellular changes Hashi's can cause in the thyroid are evident during a thyroid ultrasound.

No matter what the cause, hypothyroidism is treated the same so, it will be to your benefit to pursue treatment.

thyroidmess 07-31-2012 07:36 PM

Re: low TSH vs low FT3/FT4 question
 
Thank you Sammy64 and Ladybud, you are a wealth of knowledge. I couldn't find this much info anywhere else. I wrote down the tests needed and other info and called a different naturopath for 2nd opinion. If she doesn't work out, I would drive to Seattle for 2nd opinion from that doc! Thanks again! :)

telus 11-23-2012 07:29 AM

Re: low TSH vs low FT3/FT4 question
 
[QUOTE=sammy64;5031286]Sorry you've been dealing with clueless doctors.


Per thyroid textbooks, healthy people have FreeT4 levels near the high end of the range and FreeT3 levels above mid-range.


[/QUOTE]

Sammy64,

I have been trying to find a discussion or information supporting this concept. It does make sense to me for people being treated with T4 only, because they have to push the FT4 up above the mid-point in order to get the FT3 up to just mid-range. But when people are using T4 plus T3, has someone done a survey of some sort to show that the same concept applies? that's what I am wondering about.
thanks for any comments...

nisreen1811 11-24-2012 10:34 PM

Re: low TSH vs low FT3/FT4 question
 
thanks telus and sammy for this quite helpful info, i need to ask a very insisting question , my son is treated with t4 only , what if tsh is normal range , ft3 high above range, ft4 little above mid range, where did the high ft3 come from? given there is low morning cortisol, how can i help with that, he is on iron supplement?

please excuse me thyroid mess for asking this question in your thread? xoxoxo

nisreen1811 11-24-2012 10:35 PM

Re: low TSH vs low FT3/FT4 question
 
thanks telus and sammy for this quite helpful info, i need to ask a very insisting question , my son is treated with t4 only , what if tsh is normal range , ft3 high above range, ft4 little above mid range, where did the high ft3 come from? given there is low morning cortisol, how can i help with that, he is on iron supplement?

please excuse me thyroid mess for asking this question in your thread? xoxoxo


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