If it's not pituitary, then what's suppressing my tsh?

[Sunshine_67]

My doc today said my tsh isn't low because of pituitary issues since my tsh was 3.7 before I started on thyroid meds. My estrogen and other hormones have always been low, but he said that has nothing to do with it. I disagree, but what else can cause tsh to be a .007 when you're only taking t4 meds and you're not hyper?

[Super_sally888]

Well my tsh is < 0.005.  But my FT3 and ft4 are in upper side of reference range.  This is where I feel good.  So just another example of TSH not being a good indicator, particularly when you are medicated.

[Sunshine_67]

My FT4 was 1.19 and my FT3 was 3.2. I don't have the ranges with me, but both are on the low end, especially the FT4. I've seen 3 endos and all 3 only go by the TSH and totally ignore my symptoms and the FT4 and FT3 levels. I'm done seeing endos. I'm glad you found a good one. None of mine cared how I felt.

[Barb135]

What are your FT3 and FT4 levels?  My TSH stays right around 0.02, but my FT's are both about mid range, so we don't worry about TSH.  I was fortunate to find one of the doctors who looks more at FT's and symptoms.  

My FORMER doctor was pretty much like your -- nothing mattered except the almighty TSH and he kept lowering my med in an effort to bring TSH back up even though my FT4 was below range.  He refused to even test FT3..........I thought he was going to kill me for sure ------ fortunately, I got sent to an ENT for "unrelated" issues, who realized what was going on and sent me on for more testing and an ultrasound.

My ENT couldn't feel nodules or inflammation on my thyroid either, but he sent me for an ultra sound "just in case" there was something he couldn't feel -- that's when it was discovered that I have Hashi's and nodules on my thyroid; whereas my pcp refused to even look beyond the TSH.  My ENT ended up sending me on to an endo and I'm doing much better............

[Sunshine_67]

Yes, I could tell he was getting frustrated with me because I was disagreeing with him. I think I know my own body and how it feels though. He felt my neck and said my thyroid didn't feel inflamed, yet my small pills are getting stuck in my throat.

I understand doctors have to go on trust when a patient tells them they feel bad because they can't see hard evidence of symptoms like they can in a lab, but when a pateint is almost in tears, I doubt they're making these symptoms up.

[gimel]

Yes, you can see the same sort of reaction from doctors in the patient feedback in the above article.  It's almost like lowly you are questioning their superior knowledge and judgment.   And once they have pronounced something, not many will ever reconsider.  So many of us have had to resort to finding a good thyroid doctor that will treat our symptoms by testing and adjusting the "Frees".   The only alternative with your current doctor is to bombard him with articles that are readily found on the net, that spell out the fallacy of relying on TSH, and the importance of treating symptoms.  Lacking success with that, one of our members recommended stopping by the local hardware store and buying a strong chain and a lock and when you go to the doctor chain yourself to the desk and threaten to swallow the key, unless the doc forgets TSH and gives you some medication.  LOL

[Sunshine_67]

Thanks. Yea, this doc didn't care at all about my symptoms. Even after I told him I felt better when my FT4 and FT3 were a lot higher, he still didn't care. All he cared about was that stupid TSH. I thought doctors were supposed to help patients feel better, not treat labs and not even care if the patient never feels better. I was almost in tears telling this doc how bad I was feeling and he was cold as ice.

[gimel]

Taking thyroid meds frequently suppresses TSH level to the low end of the range or below.  This does not mean that you are hyper, unless you also have hyper symptoms.  Symptoms are paramount.  Many patients encounter low TSH while in the process of getting their FT3 and FT4 high enough to alleviate hypo symptoms.  That's why I frequently say that in my opinion the very best way to treat a thyroid patient is to test and adjust FT3 and FT4 levels with whatever medication is required to alleviate symptoms, without being constrained by TSH level.  When you think of the logic of it, how can the absence of a pituitary hormone have any direct effect on metabolism and many other body functions.  Those functions are affected by FT3 and FT4 levels.  I think you might be interested and somewhat entertained by reading patient feedback on this subject.


http://www.altsupportthyroid.org/tsh/tshexp1pr.php