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New labs - just gets more confusing

I have Hashimoto's and about 6 weeks ago my doctor started me on thyroid meds. My labs at the time (on no meds):
TSH = 0.72 (0.40-4.0)
FT4 = 1.10 (0.80-1.90)
FT3 = 4.1 (1.8-4.2)
I was started on 25mcg synthroid and 10mcg T3. About 10 days after starting the meds many of my symptoms improved. For about 2 weeks I felt better than I have for a long time. Then some of the symptoms started to return. Some symptoms came back only slightly, others came back full force. My recent recheck bloodwork (on meds):
TSH = 0.57 (0.34-5.60)
FT4 = 0.77 (0.28-1.64)
FT3 = 3.96 (2.39-6.79)
Unfortunately different labs were used with different reference ranges so it is difficult to really compare. However, in both cases the TSH and FT4 are low in the ranges. The FT3 went from top of the range on no meds to low in the range on meds - what???
My doctor's explanation: the first lab results were a "Hashimoto's aberration." Those of us with Hashi's are hypo most of the time, becoming more and more so over time. However, as the thyroid is slowly destroyed there are periods when thyroid hormones are dumped in the blood, making our labwork appear normal or even borderline hyper. The doctor's instincts told him this was the case so he started me on the thyroid meds. He says my follow-up bloodwork shows that his instincts were right. My follow-up bloodwork is also more in line with how I am feeling - hypo. He is having me slowly raise my T3 meds by increments of 2.5mcg every 5 days. He suspects that I am going to need anywhere from 20-30mcg.
Another thing that does not make sense is my TSH. I have had it tested many times, and in most cases it was the only thyroid test done. It has always been low. Now that I found a doctor to test all of the thyroid hormones it appears that my TSH is low regardless of what the FT4 and FT3 are doing. Doctor says my TSH is "suppressed." He explained it but got a bit too technical - not sure I could repeat the explanation.
For those of you with experience and a lot of knowledge about thyroid, does this all make sense? If so, it is the perfect example of why you can't just test TSH and why with Hashi's you need to treat based on symptoms and not labs. Any thoughts?
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Avatar universal
Would you also please click on my name and send a PM with the doctor's name?  Thanks.
Helpful - 0
Avatar universal
Makes sense, and you are lucky to have a doctor that is willing to treat clinically, by adjusting Free T3 and free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  TSH is a pituitary hormone that supposedly accurately reflects levels of the actual thyroid hormones; however, in reality TSH cannot be shown to correlate well with either Free T3 or Free T4 (the biologically active thyroid hormones), much less correlate with symptoms, which are the mos important consideration.  

Further, when taking significant doses of thyroid meds, scientific studies have shown that TSH frequently becomes suppressed.  That does not mean you are hyper, unless you  have hyper symptoms, due to excessive levels of Free T3 and Free T4, which you do not have.
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