Doc's don't agree!

[2908bon]

My Free T4 is high normal and Free T3 is midrange.  My TSH is >.01 MIU/I.0  I was told that my high T3 with midranges of Free T3 means an increase in protein binding due to my previous high free estradiol lab report. I have two MDs that completely disagree with each other. One says I don't need synthroid, the other says to lower synthroid and although I take 2 mg. estradiol/day, I need to add another form of estradiol such as a cream.  I don't know which doctor is correct, or if either doctor is correct.  One doctor checked my free estradiol &  Free T4, Free T3 & TSH lab reports to treat.  The other doctor uses TSH reports only to treat.  I'm so confused!! Who do I listen to?

[Mark Lupo, M.D.]

TSH is the main guide to adjusting the synthroid.  If you are on synthroid you are on too much (low TSH).  The high total T3 may well have been due to the estrogens.  Your thyroid can easily be treated independent of what you choose to do regarding the estrogen replacement.  If T4/T3 levels are followed in patients on estrogen then they should be "free".  

Target TSH is around 1.0.

Good luck.

[GravesLady]

My doctor does all three. My T-4 and T-3 is just about in the same place as yours with a low TSH.  However I am not on any hormonal treatment for my post menopause (don't believe in them (for me) and I am doing wonderful,one of the best things that ever happened to me). So I don't have any suggestions on that issue. You can make your own decision on which doctor to listen to by the following information that I have learned for myself.

TSH relates to whether a person is hypo or hyper.
F/T-4s test TELLS whether the thyroid is performing properly.
A total or free F/T-3 test DETERMINES whether the thyroid is performing properly.
F/T-4 and F/T-3 show's whether there is a conversion problem which is rare because the body controls its need by conversion of the more plentiful but less active T4 into T3.  
T4 and T3 are controlled mainly by the TSH.