Thyroid Disorders Community
LOW TSH but cant loose weight
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This patient support community is for discussions relating to thyroid issues, goiter, Graves disease, Hashimoto's Thyroiditis, Human Growth Hormone (HGH), hyperthyroid, hypothyroid, metabolism, parathyroid, pituitary gland, thyroiditis, and thyroid Stimulating Hormone (TSH).

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LOW TSH but cant loose weight

So my latest test results are

TSH 0.28
T4 FREE 0.97
T3 105

I have been working out regularly and dieting and i cant loose the weight. I have had my TSH go from 0.1 to normal for the past 4 years. I dont take the meds for hyper cause i am allergic. Lat year had a thyroid scan and they found a hot nod but it was really small and they wernt worried about it. Whats the deal, should i not worry cause t3 and t4 are in the norm range?

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14 Comments Post a Comment
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915219_tn?1300207488
Time for a second opinion. TSH is a pituitary hormone and should NOT be used to treat a person with thyroid hormone. I see no FT3 was ordered, either. Shame. Treating the frees and symptoms is the best way. Are you on a T3 med or just a T4 med like Synthroid? Many of us do not feel well and can't lose weight without a T3 drug added to the mix and our levels at the top 1/3.

I don't know your FT3 levels or your T3 ranges, but your FT4 is low end. Mine is a 1.5. My FT3 is closer to 400. I'm a 37 year old female. My mom, who is 75 with a heart condition, keeps her FT4 around 1.2 and her FT3 in the middle.

BTW - Why  are you on thryoid meds? Hashimoto's? Antibodies tested? People with Hashi and low thyroid commonly have adrenal fatigue, which also makes it difficult to lose weight. The 24 hour saliva test is the best test for adrenal fatigue. If you get the blood cortisol test, it may not be as accurate. A good doc can treat those adrenals and help you get your body back into shape.

See below website for thyroid docs recommended by patients. Call the nurse ahead of time and ask if the doc tests for adrenal fatigue with the 24 hour saliva and if the doc treats frees and symptoms.

http://www.thyroid-info.com/topdrs/

:) Tamra
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Avatar_m_tn
no i dont take meds at all. I just have this fluctuating TSH thing. What do you think that can be with normal levels. I had antibody tests a year ago and they were normal.
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875426_tn?1325532016
Are they monitoring the hot nodule by imaging?  Your TSH is like a thermostat, responding to what your thyroid is doing.  If it's sluggish, it increases.  If the thyroid hormones are very active given your hot nodule, TSH decreases.   If your TSH is not responding appropriately to what your thyroid is doing, ask your doctor for a dynamic MRI with and without contrast of your pituitary gland.
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Avatar_m_tn
ok i just check my records and it was a cold nodule only 1 mm so he wasnt worried about it. Im so confused, i just dont know why i have this overactive TSH all the time and doctors dont seem worried about but cant give an explanation why it is that way.  
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Avatar_m_tn
i forgot to ad he biopsy the nod and it was ok.
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915219_tn?1300207488
Get repeat antibody tests: TGab and TPOab

Sometimes, doctors only test one of the antibodies. Sometimes, they fluctuate and can give false negatives.

Post those FT4/FT3 results, please.

I think this TSH roller coaster and this nodule may be caused by Hashimoto's auto-immune disease.  Any other symptoms? Fatigue, dry skin, hair loss, constipation, leg and foot cramping, brain fog???

:) Tamra
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915219_tn?1300207488
Ooops, I made a typo. I meant to say post the reference ranges for your T3 levels. :) Tamra
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Avatar_m_tn
First, you are not hyper just because of a low TSH reading.  You are hyper only if you have high FT3 and FT4 levels and associated hyper symptoms.  Symptoms are really what defines being hyper, not TSH, because TSH is a pituitary hormone that is affected by so many variables that it is inadequate as a diagnostic.  At best it is only an indicator, to be considered along with more important indicators, like symptoms and also FT3 and FT4 levels. Have you noticed symptoms other than the weight issue?
    
Although you are missing test results for the most active thyroid hormone, FT3, your tests for FT4 and total T3 are more often associated with being hypo, than hyper.  So your test results so far do not preclude your being hypo.  You really need to be tested for FT3 and FT4 (not total T3 and total T4), along with TSH.  Many of our members report that their symptoms were relieved only when FT3 is in the upper part of its range and FT4 is at least at midpoint.  If your FT3 and FT4 are in the low end of their ranges, with that TSH level, then you may need to have your pituitary function checked as well.

Tamra also gave you some good info regarding adrenal issues, which you should also consider.

So I suggest that you start by insisting on being tested for both FT3 and FT4, along with TSH, then get a copy of the lab report and post results and reference ranges so that members can provide feedback.  The doctor is required to provide  you a copy upon your request.

  

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875426_tn?1325532016
You are thinking your TSH or thyroid stimulating hormone is overactive, but it's not.  You are listing that you have below normal to normal TSH levels.  

When your TSH is lower than normal, are you always getting tested for T 3 and T 4  (or at least one of the two) at the same time?  And if so, are those results on the upper end of the range or higher than normal range, mid range, or are they on lower end of the normal range or even below normal?  

You need to know what your thyroid is doing to know if your TSH is acting as the normal thermostat it is supposed to.  If your thyroid is emitting plenty of its hormone, your thyroid stimulating hormone (TSH) would not need to be offering a lot of stimulation to the thyroid, because your thyroid is already active enough.  

But if your TSH (coming from a little gland in your brain known as the pituitary) is low at the same time your thyroid (in your throat) has only low amounts of its hormones circulating in your blood, you should get your pituitary checked out.    
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Avatar_m_tn
yea i will see if i can get those tests, i have kaiser so....

Also i usually get symptoms of hyper the longer my levels are down, like slowly over the corse of a few months, my hair falls out, i will start to loose a little weight, i get muscle twitches, burst of energy (which i have now) but that happens like i said after a few months of low levels then after awhile, it just goes away.
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Avatar_m_tn
I sent my labs to the endo to see his thoughts and he said the following (see below)  but the thing that makes me mad is when i saw in last summer i had all the symptoms he said that are "asymptomatic" now, when i saw him last summer i had sever anxiety and all he mentioned below and he said "well that isnt coming from your thyroid"....but it must be cause i never had these issues until my thyroid got jacked up 3 years ago after pregnancy... its really disheartening to know that at the time i said i had those symptoms he denied it being thyroid and now he is saying if i had those now it would be an issue ( which i dont)

"I reviewed your lab results and yes, you do have a slightly suppressed TSH but this is stable.  This is not indicative of a pituitary problem.  Since there is no hot nodule seen on the uptake scan, and you are asymptomatic (tremors, weight loss, sweating, diarrhea, anxiety), there is no need to treat.  The nodule was thought to be a cold nodule on the uptake scan you had done.  Please follow up with me 1 year after your last biopsy.  "
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875426_tn?1325532016
So, you have suppressed TSH, which is coming from your pituitary- suppressed by what?  Not a cold nodule on your thyroid sending a message to the pituitary not to emit TSH right?  This man, who it seems has ordered no imaging of your pituitary,  does he feel he can somehow divinely determine without any verification that you have no pituitary problem causing this suppression?  Or can he explain why he is so sure it couldn't possibly be a pituitary problem causing the TSH suppression?  Is he willing to stake his license on it, I wonder?

I got my pituitary MRI (where a tumor was found) ordered by an internal med. doctor (not Kaiser, though when I was with them, I had a very good intern med doctor) after one abnormal pituitary hormone reading.  Maybe your Kaiser primary care doctor would be willing to order the MRI for you, given your abnormal TSH numbers.  

Also, if you seek another opinion from a different endocrinologist within Kaiser, I do not recommend Dr. Kunitake at Baldwin Park, CA (saw her on an unrelated matter while I was with Kaiser).
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Avatar_m_tn
SURGIMENOPAUSE, WHAT was your levels on the TSH, T3 AND FREET4 WHEN YOU FOUND THAT TUMOR????
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875426_tn?1325532016
Actually the pituitary hormone that came back outside normal range on me (though it was skued high due to interfering factors) was prolactin.  But having a tumor on the pituitary has potential to suppress output of hormones.  Not saying that's your problem, but I'd rule out that or any other pituitary problem if it was even a possibility, especially since they say one in five has a pituitary tumor.
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