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Low t4, low total t3, low tsh

I have hashimotos and my tsh has never risen, so I know not to look at it, but it is .01 (.4-4.5). My t4 is 1.1 (.8-1.8, up from .9 when last tested on this dose), total t3 is 89 (76-181..not sure if this result matters, and free t3 is 3.1 (2.3-4.2). I weigh 140 and am on 2.5 grains of natur-throid. I have symptoms of mental exhaustion, especially after several weeks of hard work or studying, and my head often feels "off." These are my main symptoms, along with water retention, need to a bit sleep more than before, and a difficult time losing weight. I do not know if my symptoms are thyroid related or if my results are fine. I do not feel like I could handle a full time job or grad school right now, and need to figure out what is going on before deciding on a career path or course of study, but I do not know if I can blame the thryoid as my results seem ok.
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I sent you a PM with the info.  To access, just click on your name and then from your personal page click on messages.
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I think the best way to answer is to give you this quote from the website of an excellent thyroid doctor.

" in tests done about 24 to 28 hrs after their last daily dose, most people on adequate NDT therapy have a suppressed TSH. They usually have FT4 levels that
are 1 to 1.3ng/dL, and free T3 levels that are rather high in the range or even slightly above the range. The higher FT3 level compensates for the lower FT4 levels on NDT. These patients have no symptoms or signs of hyperthyroidism--if such occur the dose is reduced."

Compared to that info your FT4 and FT3 are still too low, and you are having symptoms.  Also note the suggested time interval since last med dosage before blood draw for tests.  If you took your med the morning of the blood draw, it may have caused somewhat false high results.  At any rate it seems that you need a dose increase. Symptom relief should be all important, not just test results.  

Also, hypo patients are frequently deficient in Vitamin D, B12 and ferritin.  So if not tested for those you need to do so and then supplement as needed to optimize.  D should be at least 50 ng/mL, B12 in the upper end of the range, and ferritin should be at least 100.  All of these can have an effect on symptoms as well.
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3 Comments
Thank you for your response. Can you link the website or tell me the name of the doctor so I can read more/bring this info to my prescribing doctor? For reference, I normally split my dose morning and night. Whenever I plan to get a blood test, I take my night dose with the morning dose that morning, and get the blood test the NEXT morning (so it's about 24 hours since taking meds).

My vitamin D and B12 levels are good, although I'm not sure about ferritin.

I felt best when my free t3 was at 3.6 but haven't been able to get it to this level again. My dose is pretty high for my weight which is why I think my doctor may be hesitant to raise it, along with my very low tsh
Thank you for your reply. I always take my blood test 24 hours after my last dose of medicine, and my b12 and vitamin D levels are good. Not sure about ferritin, although I do take iron with vitamin C. Can you give me the name of the doctor you quoted or post a link so I can read more?
Sorry for the double reply, the first one wasn't displaying so I thought it did not post.
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