TSH IS < .01 AM I OVERMEDICATED?????

[mjacobs1973]

I am being treated for HYPOTHYROIDISM....I went to the ER for dizziness, and they said my TSH is less than .01, and therefore I have HYPERTHYROIDISM!!!!    I told my doctor, and he said when taking synthroid, it lowers the TSH level....IS THIS TRUE?  I need to know what is going on, I feel out of my mind!!!    Thank you.

[laura320]

It's been a couple years now.  So Grey, did you ever get off the synthroid?

[grey06]

Thanks AMG :o)
"You sound like me, feeling fine with the high numbers and horrible when they try to fix them."
Actually I was fine "before" starting this whole Synthroid ride!  My new doc suggested it during a routine check up 'cause she noticed a small goiter (which has been there for at least 15 yrs!)  Everyone who knows me thought it was hilarious that I'd be considered "hypo" when actually I'm very physically active.  Not hyper, but hard working and athletic.  And I don't mean to boast when saying that lol.  Just trying to describe the irony.
On Wednesday, I called to get an appointment to stop it all together, but only got a date for the 31st of August.  Secretary suggested I call at 8:30 am the next day at opening time for an "emergency" check up as the doc saves a couple of spots for special cases.  Obviously phone rang "busy" from 8:25 to 8:34 am.  When I got through no more spots.  Groan.  Fridays she's off.  Tomorrow morning, I'm going in person to line up at the door to book an appointment.  If she's not available, I'm going with another doc.

I just wanted to add that this forum is so good.  I've learned so much more on the internet than from doctors!  Thank you to all for sharing your knwoledge.  :o)  

[AMG3369]

I have had Hashi for years. Thyroid problems for over 50 yrs. The Endo I say back in the 90's put me on Synthriod 150 and I felt great. I started with a new internal medicine Dr. and for my yearly physical checked my thyroid. You guessed it, only THS. It was .00.
She started cutting me back all the way to 112. You are right, I felt awful. 3 years and ending up in bed every day I told her I wanted to go back to 150. She refused and said I should go to an Endo. I did and same story, TSH. She said I was not sick and I said I'll go to Mayo Clinic. Then she did more tests!!My freeT3 was 60 and my Reverse T3 was high. Then she said I had a problem. She would only up me to 137 and that was not enough.She learned to ignore the T4 and TSH. We only worked on the T3. Nothing we tried worked. The only time the T3 changed was when I started Armour. Now I am having trouble again. I think it may be the Armour. You sound like me, feeling fine with the high numbers and horrible when they try to fix them.

[grey06]

LOL!  If I run through the bag at third I'll have to keep going to Home.  Will stick to fade-away slide thanks for the advice.  ;o)
And thank you for the link.  'T was an interesting read.  Actually, it makes sense with what my doctor was probably doing.  She wanted to up my dose even more last time.  (Despite me telling her I was getting these unwarranted rushes of adrenaline at the chest and throat level since she upped it to 0.075.  To a point where it made me cough.  Heart going wacko?  Anxiety?  I asked her if I wasn't becoming hyperthyroid on meds and asked at how much my T4 was.  She had no score for T4 since TSH was in normal range and lab automatically doesn't test.  So I asked if I could go for another blood test that would include T4 and that I'd pay for it so as not to be a burden to the Health sytem lol.  (In Quebec, Canada it's free.)  She agreed, I went and results were TSH 2.55, T4 21.6.  She didn't call back to confirm that we'd up the Synthroid, so I should have continued at 0.075 Synthroid.  But... two days after the test, I was getting those rushes even more intense that I decided to check it out myself.  I started taking only 3/4 of my Synthroid which would make it 0.056 and have been for the last 5 weeks or so.  The rushes mellowed down gradually, but it's starting to come back again, coincidentally at the same time of the month as the other times which has me wondering if T4 levels are much higher at certain times of the month for women.  At one point I was wondering if it wasn't all in my head because of my dislike of meds, but 1 year of feeling like this is pretty long.  To be honest, I'd like to see if I can wean off the Synthroid since I was only subclinical and had no symptoms whatsoever.
I'm going to call today, equipped with all the info you gave me (thanks!)    
So sorry for the venting.  I wish I could rewind time back to before that appointment!    

[gimel]

The reference ranges vary dependent on the lab, and of course the units of measurement.  For example,  my lab results show for Total T4 a range of 4.6 - 12.0 ug/dl.  For free t4 it shows a range of .60 - 1.50 ng/dl, which converts to 10.2 - 19.2 pmol/L.  For free T3 they use 2.3 - 4.2 pg/ml, which converts to  230 - 619 pg/dl, or 3.5 - 7.7 pmol/L.  So you can see why we usually ask for the reference ranges to go with the test results.

So make sure you insist on FT3 and FT4 tests.  Those are the most important.  They ae thyroid hormones and largely regulate metabolism and other body functions.  FT 3 is four times as potent as FT4 and it correlates best with hypo symptoms.  TSH is a pituitary hormone that is affected by many variables and it does not correlate well at all with symptoms.  And symptoms are what it is really all about.  You should also get the antibodies testing done to confirm Hashi's.  Please update us when you get new test data.  

In the interim I think you might benefit from reading this link.  It pretty clearly spells out which tests are important (FT3 and FT4) and which should be relegated to the trash heap (TSH is a good candidate).

http://www.hormonerestoration.com/Thyroid.html  

Also wanted to point out that a head first slide is reportedly slower getting to the bag than just running through the bag without sliding.   A head first slide is also very risky for injuries, especially in your condition.   Best stick to a regular fade-away slide.   LOL

[grey06]

Thanks Gimel,  I'll ask the doc whether it's free or total T4.  I'll also ask to get my Free T3 tested.  I think it's the T4 that should be at 12.0.  Do you know what the "normal" ranges are for T3, Total T4 and Free T4?  

I forgot to add that I'm female and since I've been on this stuff my breasts are bigger and tender at least 2 out of 4 weeks!!!  Not a good thing when you're playing ball and diving for third base!  ;oS

[gimel]

Was that T4 test you mentioned total T4 or free T4?  There's a world of difference.  Also, what was the reference range for that test?  

Just a couple of thoughts from what you've said.  First, I'm surprised that if the doctor suspected Hashi's, that no further testing was done to confirm.  This would be important to take into account in determining your meds.  Second, you really need to have them test you for free T3  (and free T4 if the prior test was total T4).  Free T3 is the most active thyroid hormone.  It is four times as potent as free T4 and it largely regulates metabolism and other body functions.  It also correlates best with hypo symptoms that you will be fighting as your autoimmune sytem slowly kills off your thyroid glands, if you do have Hashi's.  

[grey06]

Oops!  Make that "She upped it to 0.075".  D'oh!  :o)

[grey06]

If your synthroid brings you to a T4 level of 21.6, are you overmedicated?

Last year, I was feeling 100% fine but figured I hadn't been to see a doctor for a check up in a few years and am 43, so was due.  I went in for a check up with a new doctor and she noticed a slight goiter (it's been there for over 20 yrs) and suggested tests.  Ultrasound confirmed goiter, no nodules.  TSH was at 12.5 and T4 at 12.8.  Although it was subclinical hypothyroidism (she assumed Hashi), she suggested Synthroid.  I am so NOT a pill person.  Have hardly ever taken Tylenol!  Took 0.05 for 3 months (had heart burn for a while, anxiety?).  I then tested TSH 5.7, T4 16.2.  She upped it to 0.75 which I took for 9 months.  Tests showed TSH 2.55, T4 21.6.  Problem is, ever since I've been on Synthroid, I've had this ongoing anxiety like feeling.  Kind of like rushes of adrenaline for no reason at all.  Like when you're startled.  BOO!  I've never had this feeling before and it literally started with the Synthroid.  I'm a Phys-Ed teacher, athletic, was always very fit and cut.  I've gained a bit lately (8lbs or so) but figured it was a 40's thing.  This anxiety feeling has lasted for over a  year and I'm now regretting I ever went for a check up.  :o(

[mjacobs1973]

I just saw my doctor, and he cut me back from 200 to 100 mcg....and then I have to see him in 2 weeks for the thyroid testing (all of them, not just TSH).....thank you everybody so far!

[Smilerdeb]

Mine did the same thing Chel at the start (or rather I was in too much of a hurry lol).
I was on a high dose, went hyper and had to start from scratch taking 'baby steps'.
I feel your Doctor should be doing the same.
Get your Free's tested as you may have a high FT3 (drug induced) and that causes massive anxiety in me.
Let us know how you go :)

[chel 81]

I agree- you are probably just on a dose that is to high for you. However, the ER was wrong, just because you have a low TSH does not mean you have hyperthyroidism. Hyperthyroidism is a disease state caused by your body making too much thyroid hormone, you still have Hypothyroidism and probably are just on too high of a dose are therefore still have hypothyroidism but are overdosed. Sometimes these docs are so stupid...

Did you just start on thyroid meds? It sounds like your doctor may have just put you on a little too much & if so and you should talk to them about cutting down based on your symptoms. However, make sure they check your other tests like the Free T3 and Free T4 too because TSH is your pituitary hormone- not thyroid hormone so it's not going to fully tell you the whole story.

[mjacobs1973]

Sorry, I meant 200 MICROGRAMS (.2 MILLIGRAMS), NOT THE OTHER WAY AROUND!   If I was on 200 micrograms, I would REALLY be out of my gourd!!!!!!  LOL!!!!!!

[mjacobs1973]

I am on 200 mg (.2 micrograms).  Yes, I have anxiety, shaking like a leaf, and feel out of my gourd!!!   The ER didn't check the T3 or T4, they only checked the TSH, but maybe they should have checked the others?

[Smilerdeb]

You are on a dose that is too high for you.
What dose are you on?
Synthroid does lower the TSH but to be that low means you are being overmedicated.
usually if the TSH goes that low, the Doctor will cut back your T4 med a fraction or may even tell you to stop your meds for a few days.

You would be experiencing hot sweats, anxiety, fast heart rate etc with a TSH that low.
What was your Free T3 and Free T4?