Low free T's good?

[cdwarrior]

I was diagnosed mildly hypothyroid this past July. My blood tests:
In July before diagnosis and medication:
TSH ... 4.23 (0.49-2.5)
FT4 ... 1.52 (0.75-1.76)
FT3 ... 3.4 (2.3-4.2)
ANTI-TPO … 33 ( <60)

Labs done last week after 8 weeks on 75 mcg of Levoxyl and 5 mcg Cytomel:
TSH ... 0.67 (0.4-5.0)
FT4 ... 0.9 (0.6-1.6) ... 30%
FT3 ... 2.8 (2.3-4.2) ... 26.32%

First question is, how could I have felt so horrible before dx with my free T’s in the upper half of the range? I had 80% of the symptoms, right down to missing eyebrows.
Second question. My doctor tells me my levels are looking great now. I'm confused. How can lower free T's be better? I was always under the impression they should go higher (within range) for a hypothyroid person to feel better. I asked my doctor to explain how lower could be better and she said something like:
Lower free T's combined with a lower TSH means that more thyroid hormone is being taken up and used by the tissues and less is floating around the blood stream doing nothing. This is why I should be feeling better with lower free T numbers. The lower TSH indicates that the tissues are getting adequate hormone so having lower frees is not worse.
Does that make sense? I can’t seem to find anything about it on the internet. Forum posts all seem to indicate that people feel better when their free T’s are nearer to the upper end of the range. This is frustrating because I still have some symptoms but my doctor says I’m properly medicated now and there’s no need for any more dosage adjustments.

[Mark Lupo, M.D.]

The lower TSH may reflect tissue hormone levels, but I am not sure about the lower T4.  I think the TSH is a better test at this point.  Dosing based on "free T's" is not a standard of care.  

May have been a lab error, different lab or based on timing of dosing -- ie, cytomel may decrease T4 and has a short half life so if lab done before cytomel dose it will make the T3 look low as well.

[lumley801]

Did the testing come from different labs?

[cdwarrior]

Yes, they were done by different labs, which is why the ranges are slightly different. That might explain some differences in the numbers. But the T4 difference in particular is pretty large, especially if you look at it percentage-wise. It's gone from about 75% of the range down to 30%. That seems like a big drop to me. I'm not sure all that can be attributed to different labs. And that still wouldn't explain why my doctor thinks lower is better. I've never heard that before. I always hear people say higher within the range is better.

[marie2]

I feel better and my t3 went down, too, but just a tad. I don't even pay attention to TSH.
I always thought the same, too, higher t3's correspond to better feelings.

And if you still feel bad,  you aren't well, are you? And your doctor should listen to you, shouldn't he?

Why don't you post over at stopthethyroidmadness.com and see what they say? I'm still learning, that's why I'm here. I'd be curious to hear their view, too.

[cdwarrior]

Yeah, I'd like to find a doctor who will listen. Not sure how to find one though. My current doctor just tells me that if I'm still having symptoms it can't be from thyroid any more because my numbers are "perfect."
I find it hard to believe "perfect" is at the low end of the range. Seems "perfect" should at least be in the middle. Why would we use a range that's so far off-center from perfect?

[cdwarrior]

Cytomel was taken about 6 hours before blood was drawn for labs.