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Thyroid Cancer, Nodules & Hyperthyroidism (Expert Forum)
Critically Low TSH BUT normal T3 & T4 Levels???
Answered by
Mark Lupo, M.D. - Thyroid Nodules, Thyroid Cancer, hyperthyroidism, hypothyroidism, Thyroid Ultrasound
Thyroid & Endocrine Center of Florida
Sarasota - FL
Questions in the Thyroid forum are answered by Mark Lupo, MD. Topics covered include Goiter, Graves Disease, Hyperthyroid, Parathyroid/Calcium Problems, Thyroid Cancer, Thyroid Nodules/Cysts, Thyroiditis, Thyroid & Pregnancy, Thyroid Stimulating Hormone (TSH), Thyroid Tests, and Thyroid Surgery.
Critically Low TSH BUT normal T3 & T4 Levels???
by gpm, Jul 12, 2007 12:00AM
OK i have been undergoing fertility treatments for over a year now! with 2 failed attempts at IVF one ending in m/c and about to go into another in a couple of months we did a huge hormone panel AGAIN to see what going on . well i have gotten my thyroid checked about three times since jan! about a month and a half ago i got b/w done by both of my DRs, my RE only measures and goes by TSH and my endocrin (who i have been going to for over 10yrs treating my hypothyrodism) goes by T3 & T4.. SO i just got my results back from a month ago and my TSH level is critically LOW (.0?)and my T3 & T4 levels were low but in range... so she upped my Armour (that i have been on this whole time) to about 5.5 grains...SO....after all that being said i am not sure what to do or what to believe and need help cause one DR says the other is wrong and with about to go into another cycle i want this to be under control! and my endocr. DR says she might have to switch me to another med depending on my current b/w results(which i will find out on monday)...!!
all i know is that my RE says i am on too much thyroid and my other DR says i am not on enough and have absorbtion issues????
so ?'s
1. who and what do i believe about what is my right level?? and who is right?? please explain?
2. what will happen when or if i switch to another med?
thanks for any other insight that anyone can give me as to what is right!???
all i know is that my RE says i am on too much thyroid and my other DR says i am not on enough and have absorbtion issues????
so ?'s
1. who and what do i believe about what is my right level?? and who is right?? please explain?
2. what will happen when or if i switch to another med?
thanks for any other insight that anyone can give me as to what is right!???
Doctor's Answer
by Mark Lupo, M.D., Jul 15, 2007 12:00AM
, Jul 15, 2007 12:00AM
You are likely on too much based on the low TSH. Armour will cause a lowish T4 but usually a high-normal T3. I would be inclined to convert to straight T4 (levothyroxine) while trying to conceive, as the levels tend to be more stable. The thyroid may have nothing to do with the infertility issues, but since you are hypo, this needs consistent control (ie, keep TSH around 1.0). Thyroid antibodies may increase miscarriage rates, but consistent therapy is the best option in this case as well.
T3 uptake - 31
T4 free - 1.0
T4 total - 5.9
Free T4 index(T7) - 1.8