Low TSH, Low T3 & T4

[Angela1313]

I just received a call from my Endocrin physicians office regarding my labs. TSH is 0.004 , T3free 2.98 & T4 Free 0.95. I have Hashi disease and the past 3 months I have gained 13 lbs, extremely tired all the time, puffy hands and face in the morning, brain fog, insomnia with headaches. I can't seem to lose any weight dispite my efforts. I am taking a T3/T4 compound 240 mg daily. The only thing he wants to do is lower is slightly to 210mg daily. I still feel like there is something wrong. I have a huge lump in my throat everyday which gets bigger as the day goes on. I had an ultrasound in Aug that only showed a slight enlargement of the thyroid. The nurse told me to wait a few weeks and see if my symptoms go away. Has anyone had this problem before?

[Mark Lupo, M.D.]

We don't use compounding b/c of incosistent results in our experience.
The T3 looks normal -- you did not mention reference ranges.
The TSH is clearly low, so the overall medication needs to be lowered.
If you have a lump, that is enlarging, repeat ultrasound and/or biopsy may be needed - would talk to your endocrinologist about this.

[Angela1313]

I actually had blood work done at a different lab then my Endo docs own lab and my results were as follows: TSH= 0.066 (Ref 0.450-4.500) T4= 0.56 (Ref 0.93-1.71) &  T3=1.8 (Ref 2.0-4.4) My Endo then called and said he wanted the same blood work done at his lab in his office, so I had them done the very next day with these results
TSH=0.004 (Ref 0.4-4.0ulU/ml) T4= 0.95 (Ref 0.8-2.3ng/dL) & T3= 2.98 (Ref 2.2-5.8pg/mL) They told me due to having Hashimoto's syndrome, I will always have that lump in my throat and that I need to take the lower dosage for a few weeks and call if symptoms get worse. I have a long history of autoimmune problems, so I am wondering if I am having some Adrenal Gland fatigue as well.  Thank you for the advice!