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Low TSH and my DEXA shows Osteoporosis....but my FT3 is great
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Low TSH and my DEXA shows Osteoporosis....but my FT3 is great

I just got a DEXA bone density scan which shows I have osteoporosis and osteopenia. I'm also 59 and post menopausal with very low Vit D levels. Anyway I'm taking supplements. I'm sure this is commonly asked but of course it's now an issue for me.

My FT3 is now to a level it probably has never been. I'm taking 90 mg Armour and have no hyper symptoms. My BP runs about 114/72 with pulse 70-80. My temp is up from 96.4 to 97.6 No hair falling out, no weight loss or increased appetite. No heart arrhythmia.

I guess osteoporosis aside, if the issue is not to go by TSH with a preference to FT3 levels, are there studies that correlate FT3 with risks of osteoporosis instead of TSH. If FT3 is not above range is that not considered "hyper" therefore not likely to further affect bone density? It makes sense and I certainly feel better but for me it's almost an act of faith to believe it if that makes any sense. Just looking for a little direction in this balancing act. In order for me to get a TSH in range my FT3 would likely be in the basement and the FT3 level makes more sense to me than TSH. Your thoughts?


TSH   0.04    (0.45-4.5)
FT4         1.03    (0.82-1.77)
FT3           4.1     (2.0-4.4)
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Avatar_f_tn
You're absolutely right.  Low TSH is only a worry for osteoporosis IF (the big fat IF) it accurately reflects that you are truly hyper.  If your FT3 is in range, and you have no hyper symptoms, then you are not hyper.

Meds with T3 in them (T4 meds can do this, too, but it seems not as often) often suppress TSH so that it no longer reflects accurately if you are hyper or not.

Your numbers look great, and I'll bet your bones don't object to them, either...
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Avatar_m_tn
Totally agree with goolarra.  Plus, I thought you'd like to read this quote from a good thyroid doctor.

"Thyroid hormone does not cause bone loss, it simply increases metabolism and therefore the rate of the current bone formation or loss. Most older women are losing bone due to their combined sex steroid, DHEA, Vitamin D, and growth hormone deficiencies. The solution is not life-long hypothyroidism, but the correction of their other deficiencies."
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649848_tn?1357751184
Totally agree with goolarra and gimel.  My TSH stays at < 0.01 all the time, and I actually rebuilt bone I'd lost to osteopenia, by taking 1200 mg calcium daily and exercising.  If your vitamin D was low, your body would not have been absorbing calcium properly.

You might talk to your doctor about trying a calcium supplement, with magnesium and vitamin D, since both are needed for adequate absorption of calcium.  

Do make sure, though that you don't take vitamins, particularly calcium, within 4 hrs of taking your thyroid med.  
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Avatar_n_tn
I have been taking 8000 u/day D3 and will start calcium and magnesium. My Dr already mentioned she would want me to cut back on meds. I got these labs on my own. She would be horrified at how low my TSH is and would have me on less than 1 gr and ill to get it into range. Not an option but I don't want to be cavalier about it either. It would be great for me to get a correlation between FT3 and density. I feel dense trying to understand the irrelevance of TSH when in range with Frees and asymptomatic. I believe it,  but am having a hard time grasping it.  Since it does have implications I want to get it right. I feel too good to let it go and it's possible to educate my Dr if I can completely understand the mechanism myself.
Oh and thanks guys!
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Avatar_m_tn
You will not find any correlation between bone density and FT3.  FT3 does not cause bone loss.  As described by the doctor, increasing levels of FT3 would only increase the rate of bone loss or formation.  The bone loss or formation is dependent on the other factors listed.  

For info, my TSH has been about .05 or less for over 30 years now, without ever having hyper symptoms, or bone loss.  In fact I continued to have lingering hypo symptoms with that TSH level, until learning about the importance of FT3.  Got mine tested and confirmed as low in the range.  Doctor agreed to switch me to a NDT med.  After some tweaking my FT3 is now 3.9 (range of 2.3 - 4.2) and I feel best ever.

For many patients the FT3 will never get high enough in its range to relieve symptoms without TSH becoming suppressed.  Symptoms are what really matter.  Not TSH level, or even FT3 or FT4 levels.   TSH cannot be shown to correlate well with either FT3 or FT4, much less with symptoms, which are most important.
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Avatar_n_tn
So thyroid replacement will increase the metabolic rate of bones,  not just the loss of bone density.  I think I've got it!  
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Avatar_n_tn
I have an update!  
Back then I had seen an endo who told me I was taking too much Armour and she wanted my TSH around 1. No can do! I would tank so I fired her. I continued to test and adjust my meds.I am happy on 90 mg and my tsh is subclinical hyperthyroid. My worry was osteoporosis. I had a DEXA and I'm happy to report  osteopenia in my lumbar has stabilized and osteoporosis in my femur is now osteopenia! I'm taking vitamine D and calcium and happy as a clam!
Just wanted to share my guinea pig results.
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Avatar_m_tn
Great news.  Thanks for the feedback.  That kind of info is very valuable for members with similar issues and similar doctor responses. Thankfully, we  have learned that much of the dogma those types of doctors  try to feed us is wrong.  
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Avatar_f_tn
Congratulations both on your scan results and on firing your doctor!  Thanks for getting back to us.
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