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  • Could .08 TSH ever be ok?

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    Old 10-30-2008, 05:00 PM   #1
    gbb
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    Could .08 TSH ever be ok?

    Hi all. I have been on 75mcg of synthroid and 5mg of tapazole to balance a previously fluctuating thyroid. I have also been diagnosed with graves disease. My levels have been stable for a couple of years with this regimen until my latest labs. My TSH is .08, yet my T3 and T4 are both normal. My endo seemed a little concerned about me going hyperthyroid and wanted to either decrease or take me completely off Synthroid, which I am afraid will make me go very hypo as I was in the past. Moreover, when I was taken off Synthroid 5 years ago my goiter enlarged significantly. I have been vigilant for symptoms of hyperthyroid. I do not have palpitations, and if anything, my blood pressure is on the low side, sometimes ~100/60, and my pulse is in the 70s which is normal for me. I also tend to be very cold, which is contrary to the sweats a truly hyperthyroid person would get. My toes seem to get numb very quickly in the cold.

    Now the vanity concern: I have found it easier than ever to keep my weight down lately, which has been a welcome surprise. I was crushed to find out my TSH and think it might be due to hyperthyroidism. While I know it is irrational to keep myself hyper for the sake of weight loss, with all those other factors considered, I am wondering how hyper I really am and how much I really need to decrease the synthroid. As I said, my T3/4 are both normal. Is TSH alone enough to indicate hyper, or would those numbers have a big impact on diagnosis too?

    I would really appreciate any input anyone may have on my predicament. Thanks!

    Last edited by gbb; 10-30-2008 at 05:16 PM.

     
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    Old 10-30-2008, 10:42 PM   #2
    midwest1
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    Re: Could .08 TSH ever be ok?

    About that T4/T3... There's "normal" and then there's "normal". Exactly what are yours? If they are at the higher end of "normal", they are likely too high for you. Few people need more than 75% of the lab ranges. Only a few people feel well with them at the bottom of the ranges, and only a few can stand them at the top. Just being within range doesn't mean all is "normal".

    Post the numbers and lab ranges, if you have them.

     
    Old 10-31-2008, 05:01 PM   #3
    gbb
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    Re: Could .08 TSH ever be ok?

    Lab ranges are
    T4 (Thyroxine): 4.5-12.5
    T3 Uptake: 22-35
    TSH: .4 - 4.5

    My T4 is 11.3 and my T3 is 30.

    Could you translate that for me? I know everyone feels better at a different range but I've been feeling normal. Do these numbers point to hyperthyroid?

     
    Old 11-01-2008, 08:31 AM   #4
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    Re: Could .08 TSH ever be ok?

    If your T4 (thyroxine) test was the 'free' version instead of the 'total', I could tell you more. However, the error rate inherent in the total test makes it hard to say. One more question... Do you take estrogen-containing birth control or HRT? That would make your TT4 appear higher than it really is. As it stands, your T4 is at the higher end of the range, and may be high enough to squash your TSH... but it's tough to know without the better free T4 test. If your FT4 were proportionately as high as your TT4, it would be very likely too high for you.

    And the "T3" test you list is not a measure of your T3. "T3 uptake" is a useless, unrevealing test that has no bearing at all on the amount of T3 in your system. So, we still don't know your T3 level. I wish MDs knew how stupid that panel of tests is for monitoring dosage.

    Since your case is complicated by the fact that you also take tapazole, I'm at a loss for practical suggestions. The fact that you have no hyper signs/symptoms is important, but my guess is that you won't convince your doc not to lower your dose based on those alone. Depending on how cooperative he is, you might be able to convince him to let you remain on the current dose by stressing how there are no hyper signs. But if that isn't possible, you may just have to agree to a very small reduction in your Synthroid dose and take your chances.

    To answer your original question... A TSH of .08 alone is NOT a reason to lower a dose. My TSH hasn't been higher than .02 for most of the time I've been taking Armour Thyroid, but my free Ts have never been higher than 70% of their ranges, either. That means I am not hyper despite a suppressed TSH. Fortunately, my doc knows that.

     
    Old 11-01-2008, 01:10 PM   #5
    gbb
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    Re: Could .08 TSH ever be ok?

    For T3 total it says 'pending." I actually do see the Free T4 on here as well with T7 in parentheses and forgot to list it before. That range is 1.4-3.8 and mine is 3.4. I am cutting my Synthroid in half for a month and hope it doesnt have any other adverse effects.

     
    Old 11-02-2008, 01:17 AM   #6
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    Re: Could .08 TSH ever be ok?

    Your doctor told you to cut your pill in half for a month?

    I'm asking because usually they tell you do that only once a week.

     
    Old 11-02-2008, 08:59 AM   #7
    gbb
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    Re: Could .08 TSH ever be ok?

    My doctor told me to cut my dosage in half and get labs done in four weeks. So you're saying normal procedure would be to take half a pill one day out of the week, and my regular dose the other six days? I was hesitant to cut it so much too. Do you think I should try cutting it for the one day first and THEN get the labs in four weeks just to see what it is then?

    The part that disturbs me is that he was going to take me off synthroid altogether instead of tapering it first. I had to somewhat convince him that I wanted to try a less drastic reduction. Going by that, I'm doubting I could convince him of an even lesser reduction in the Synthroid. Then again, I adjusted my tapazole to my own discretion before and felt better, and the doctor ended up thinking it was fine.

    On one hand I'm nervous to not heed his advice because I really don't know much about interpreting T3/T4 and how they factor in. On the other I know that doctors aren't always as keen to a patient's total picture as the patient sometimes is, especially with thyroid. That's why I'm really counting on the board and those who may have been through this type of thing before. I'm so scared to go back to hypo

    Last edited by gbb; 11-02-2008 at 09:01 AM.

     
    Old 11-03-2008, 04:14 AM   #8
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    Re: Could .08 TSH ever be ok?

    Glad you're cautious about too-drastic cuts. I was just asking.

    I don't actually claim to know.

     
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