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normal TSH, , normal T3, low T4 . . . a problem utilizing T3??

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Old 09-23-2008, 02:24 AM   #1
Join Date: Sep 2008
Location: claremont california
Posts: 3
maxhofa HB User
normal TSH, , normal T3, low T4 . . . a problem utilizing T3??

hello all, trying to sort something out.

my wife has had refractory (drug/therapy resistant) depression ever since the birth of our child. 12 terrible years now. she's been on just about every SSRI and a good handful of norepinepherin anti-D's. wellbutrin (working on dopamine receptors) has been marginally helpful. but as for everything else, nothing.

she's also had a slough of other vague hypothyroid-linked symptoms (aside from depression), including anxiety, lethargy, very irregular menstrual cycles, weight gain, mild hair loss, constipation, odd dry patches on her skin, etc.

two thyroid hormone checks 5 years apart, on both her TSH was normal (low normal) and her T4 was low. but T3, the active version of TH, was normal. i've thought, given the onset of symptoms and the date of her pregnancy, that hashimoto's is a possibility for some time now.

but something doesn't add up . . .

my question is how can her T3 be normal when her T4 is low, given that T3 has a much shorter half-life than T4 does?

if T4 is low, shouldn't T3 also be low as a rule? let's say i'm baking cookies and there is a group of hungry people in my kitchen. the dough is my T4, the cookies are my T3. if everything is working right i've got enough cookie dough to keep those cookies coming out of my oven regularly and can keep pace with all of those hungry people in my kitchen. everything is normal. but if i start to run out of dough, and the number of hungery people (T3 receptors) remains constant, shouldn't i also run out of cookies? shouldn't the amount of free cookies on my countertop run low as well?

it would seem to me, a non-physician, that this would possibly indicate that she isn't able to utilize the T3 she's already producing, which keep her TSH artificially low and knocks her T4 below the normal value.

if someone could explain this to me, or point me in the right direction, i would greatly appreciate it.

ps: she's just started taking synthroid for her low T4 this week.

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Old 10-13-2008, 12:55 AM   #2
Join Date: Oct 2008
Location: California
Posts: 3
MissRed48 HB User
Thumbs up Re: normal TSH, , normal T3, low T4 . . . a problem utilizing T3??

I hope you soon get an answer! I just found a nodule and had a biopsy with an indeterminate result. My TSH is below 1 (considered normal) but my T4 is below normal. My doc wants to wait 4-6 months to redo the biopsy. I don't think I can wait one more week! This has all changed for me very rapidly. I am not me and I need to be! I would like to hear what a reply you recive.

You have a lucky wife to have your wonderful support and bravo on being an awesome advocate for her!


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