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Low TSH normal T3 & T4 have Hashimoto

I was diagnosed  with type 2 diabetics just 1 year ago. Have had Hashimoto for 36 years have had to adjust synthroid a couple of times over the years but never was there a time that I noticed a change in how I Felt. That changed when I went for my year check up on both thyroid and diabetics all of my blood work came back good except my TSH was 0.09  T4 was 7.94 and T3 was 87. I felt really good and had lost 45 pounds over the past year with most of the weight coming off in the first 6 months. My Dr lowered my dose and with in. Few weeks I started having under active symptoms with fatigue being the worst. I called to have a recheck earlierI then my scheduled follow up appt thinking I would be hypo and that was not the case she now wants to lower the dose again. I really can not handle feeling like this plus now I have gained 7 pounds in the lady 10 weeks. Is there anyone out there who has had this issue? My Endo thinks it was caused by the weight lose.
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I'm quite sure those are total T3 and total T4.  The total tests tell the total amount of the hormone in your blood.  However, much of that is chemically bound by protein and useless to your cells.  The free tests tell what's available.  Your doctor, if she's a good thyroid doctor, should be ordering frees.

At any rate, let's work with the totals.  Your T4 is at 42% of range.  The target for FT4 is about 50% of range.  So, that's a little on the low side.

T3, on the other hand, is VERY low at 6% of range.  The rule of thumb for T3 is upper half of range (50+%).  

The targets for these two are based on where many of us have to be to feel well.  Just being "in range" is seldom enough to relieve symptoms.  Your doctor is reacting to your TSH and nothing else.  She's ignoring T3 and T4 and ignoring your symptoms.  This will keep you not feeling well.  If you had no hyper symptoms on 125 mcg, then you were not hyper and did not need your dose reduced.

As far as the change from Synthroid to levo is concerned, the different manufacturers use different fillers in their tablets.  Fillers can change the absorbability of the meds.  That's why the recommendation is to stick with what works best for you.  Many doctors won't prescribe generic because your pharmacy can change the manufacturer of its generic meds at will and without notifying you.  With a brand name, like Synthroid, the manufacturer is controlled.  

While waiting to see the doctor, if I were you (I'm not a doctor and just speaking as a fellow patient), I certainly would not reduce further.  Cutting out Sundays would reduce your average daily meds down to 96 mcg, which is even bigger than the first reduction.  In fact, if you have enough meds to do it, I'd seriously consider going back to 125 mcg.  Once again, just my opinion as a layperson.  

One of the biggest complaints we hear on this forum is from people whose doctor has reduced their dose in response to a suppressed TSH.  If your doctor is incapable of treating based on T3 and T4 and symptoms, she is simply not a good thyroid doctor.  You can try to educate her, but if that fails, you might have to go shopping for a new doctor.          
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Avatar universal
I have no idea if it is FT3 and FT4. The ranges for TSH 0.50-4.0 mine was 0.09, T4 5.00-12.00 mine was 7.94, T3 80-200 mine was 87. I was on Synthroid 125 MCG and now Levothyroxin 112 MCG. Not sure why she switched to the generic I have always taken Synthroid until this past July when she changed the dose. Since my blood work yesterday still shows my TSH is still low she wants to lower the dose again or I can skip Sundays and keep taking the 112 for 6 days a week. I told the nurse this was unexceptable and I made an appointment to talk with the Dr of course I can't get in for 2 Weeks.
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Avatar universal
What are the reference ranges on your T3 and T4?  Ranges vary lab to lab, so you have to post both together.  Do they say they are FREE T3 (FT3) and FREE T4 (FT4)?

Once on meds, TSH is often suppressed and becomes a virtually useless diagnostic.  Your doctor should be testing FT3 and FT3 and using those, rather than TSH, to adjust your meds.  Your symptoms tell the whole story...you were feeling well until your meds were reduced, and now you are feeling hypo, and the doctor wants to DECREASE your meds?  You can't let her do that.  

What have you been taking and how much did she reduce?
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