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  • VERY Low TSH

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    Old 05-05-2013, 07:23 PM   #1
    JennaN61
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    VERY Low TSH

    Hello my name is Jenna and I am new to this forum. So far I am learning a lot about a condition I've had since age 23. I am now 52 and realize I still don't understand my thyroid health.

    At 23 (after the birth of my second child) I was told my immune attacked my thyroid gland and it stopped functioning. Over the years I have had several adjustments in my medication.

    I am four years post menopausal and have had some issues with controlling my thyroid symptoms. I see an internist for my thyroid and mentioned to him at one appointment that I felt my thyroid was cycling between high and low. I am not sure he fully understood what I mean. As time went on the symptoms of hypo thyroid were winning over, even though I was told that I was actually hyperthyroid because of the medication dose I am on. I was on .175 mcg.

    I started having intolerable cold hands and feet, sleepiness, sluggish bowels, just the normal hypo symptoms. My doctor decided to boost my meds BEFORE he checked my blood levels. These are my results BEFORE he raised my dose to .200 mcg.

    TSH 0.02 STANDARD RANGE 0.47 - 4.68
    T4 FREE 2.21 STANDARD RANGE 0.8 - 2.2 NG/DL
    T3 FREE 3.56
    Thyroid Antibody 20.4 Reference Range 35.0

    I have been on the NEW dose of .200 mcg for 8 days now and have not noticed any hyperthyroid issues yet. (It may be too early)

    My question is are these numbers too out of whack? My doctor sent a message stating these numbers were higher than he wanted to see them, yet I am feeling ok as of now.

    I am very confused. I have had a history of nodules when they have tried to lower my dose below. .175 mcg. Nodule disappeared once the dose was increased. Yet because I started out hypo and now considered hyper.. I wonder if this is dangerous for me to stay on this dose?

    Ive been taking my morning pulse and it ranges in the mid to high 70's so my heart does not seem to be acting up again the higher dose.. My question is, is it dangerous staying on this dose with those lab values??

    I hope this was not too confusing, but I would really appreciate of anyone has feedback on this. My doctor does not seem comfortable with my new dose after these labs. Thank you in advance of any answers that might come this way..

    Jenna

     
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    Old 05-08-2013, 10:35 AM   #2
    FinnMaid
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    Re: VERY Low TSH

    Hello! Do you have the reference range for FT3? Your FT4 was a bit on the high side but I wouldn't be too worried about it if you had no hyperthyroid symptoms. Increasing the dose after these results does sound strange but there are people that need to have their freeTs above range to feel well. There have been times when I've needed to have my free Ts around 95-110% of the range in order to feel well - and there have been times when I've had hyperT symptoms with "bottom of the range FT3", it's crazy .

    I think your new dose will prove to be too much and it would be wise to return on the original dose or even try a lower dose. HyperT symptoms can sometimes be similar to hypoT symptoms and finding the right dose is a matter of trial and error. Your body's need for thyroid hormone can change over time too.

    Last edited by FinnMaid; 05-08-2013 at 10:37 AM.

     
    Old 05-08-2013, 06:42 PM   #3
    JennaN61
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    Re: VERY Low TSH

    Hello FinnMaid, first off thank you for your reply. I saw my doctor on Tuesday and he didn't really like my number range but said as long as I am feeling ok he said he would just leave my dose at .200 mcg. He also said they like to treat nodules a little more aggressively. Energy wise I am feeling good, I feel more normal. I have one complaint and that is I am feeling slightly more anxious, but I have a long history of panic attacks too.

    I found the reference for the FT3 you asked about:T3 FREE 3.56 Reference range: 1.7 to 3.7

    I am confused by all these ranges. I will give this new dose time and see what happens. But certainly wont stay on it if I feel too hype.. Right now I am feeling really good, aside from the anxiety.. but maybe my body is just adjusting to the changes??

     
    Old 05-08-2013, 11:27 PM   #4
    FinnMaid
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    Re: VERY Low TSH

    Quote:
    Originally Posted by JennaN61 View Post
    Right now I am feeling really good, aside from the anxiety.. but maybe my body is just adjusting to the changes??
    Could be. It'll take a few weeks to see the full effects of your new dose. I see you're converting your T4 very well so that's good Good luck

     
    Old 05-09-2013, 05:02 AM   #5
    JennaN61
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    Smile Re: VERY Low TSH

    Thank you!

     
    Old 05-11-2013, 10:08 AM   #6
    telus
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    Re: VERY Low TSH

    Jenna

    My history is very similar to yours - on synthroid for a very long time, then something goes wrong, start to research and learn a lot of things. Based on my own experience, this is what I think of your situation.

    If your doctor is setting your medication dose to control nodules - at the expense of you not feeling very good - then maybe he is succeeding. If this is not the case, then I believe that you are dealing with 3 problems:
    1. You are taking too much synthroid.
    2. Your adrenal glands are probably somewhat out-of-whack.
    3. Your doctor is not giving you much help.

    Too much Synthroid (T4): A normal person's thyroid produces around 100 mcg of T4 daily. When you take T4 meds like synthroid, your body absorbs around 80% of the medicine. So using a little common sense, you need to take about 125 mcg T4 meds to get the 100 mcg like a normal person. So it is no coincidence that most adults end up taking 100 to 125 mcg Synthroid!

    Now looking at your lab results. Your Free T4 is 2.21, which is twice as high as the median value for normal women of 1.1. Your Free T3 is 3.56, which is 122% of the median value for normal women of 2.9. So it is no wonder that your TSH is very low.

    Now at this point you may be asking - "If I am taking too much T4 and my labs are high, then why the heck am I feeling HYPOthyroid??? Very good question (and it would seem your doctor does not know the answer). The answer is REVERSE T3. If your T4 dose becomes higher than what your body needs, your body's built-in defense system against hyperthyroidism will kick-in. Your body does not want to be hyperthyroid. In self-defense the excess T4 gets converted to Reverse T3 (RT3). RT3 acts as a block to the proper functioning of your FT3 by occupying spaces in your cells that normally are occupied by FT3. This is the defense against going hyper. If you keep increasing your dose, you get into a spiral - more T4, more RT3, the less your FT3 works. So in fact you end up feeling as crappy/hypo as when you started, because the RT3 overtakes the FT3.

    Now you may be thinking "that's a great theory, but how can I prove it?" Well, the answer for you is to go get a lab test for Reverse T3. If it is way above normal, you will know that is the problem. For reference, the median value for RT3 is around 21.5 ng/dL. For info, I pushed up to 150 mcg synthroid before I discovered there was such a thing as RT3. I got a RT3 lab and it was over two times normal! I am now taking 100 mcg T4 plus 15 mcg T3.

    If you cannot get your doctor to order the test, then go to a private lab and pay for the test yourself. You should also get TSH, FT3 and FT4 labs at the same time.

    Adrenal glands: you may have already discovered in your research that your thyroid and adrenal glands work very closely together. When you go hypothyroid your adrenal glands try to compensate, but after some time they can no longer handle the strain and then supposedly you have "adrenal fatigue". It's a pretty good bet that your adrenal glands are somewhere along that road. So the upshot is that you have to restore your adrenal function to normal, as well as getting your thyroid hormones back to normal.

    As this post is getting rather long, I am going to stop. Feel free to ask questions...

     
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    Old 05-15-2013, 08:47 AM   #7
    JennaN61
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    Re: VERY Low TSH

    Hello Telus, that was a lot of information to absorb. I don't quite understand what most of these lab values mean. It can be quite confusing but I am trying to understand. Thank you for the break down of tests and lab results.

    I do understand there are issues with adrenal gland function in correlation to thyroid. When I was first diagnosed with hypothyroidism I had to go though testing on my adrenal gland and it was not functioning properly either. They didn't treat me at that time either. No one has said a word to me since that time so I am assuming everything is ok.

    I've been on the new dose .200 mcg. for 18 days now and things seem to be ok. I feel good but my anxiety level is a little higher and someone mentioned it could be the dose change in medication and it may even out at some point. Some of the complaints that I had seem to be resolving for the most part. I understand it is still early and there could be problems the longer I am on this dose. My heart rate is staying under 100 bpm as he was concerned about.

    I will definitely ask if any questions come up, thank you so much!!

     
    Old 06-07-2013, 07:28 PM   #8
    JennaN61
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    Re: VERY Low TSH

    Just wanted to post an update to this post. I have now been on my .200mcg Levothyroxine. A bump up from.175mcg. I am feeling really good (normal) again. Cold hands and feet gone along with some other bothersome symptoms. My heart rate is staying below 100 bpm which my doctor wanted it to be. I just feel all around really well and happy again. I don't seem so fixated on my health now. My doctor said they treat nodules a little more aggressively and for me this seems to be working. Although I am pretty sure my TSH is probably 0.00 now. I hope as long as I am feeling this good it is safe to be on the higher dose. My body seems to be tolerating it quite well.

    Just wanted to share this update since I am in my fifth week in... )

     
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