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in range t4 and t3 low tsh and on tyroid meds
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in range t4 and t3 low tsh and on tyroid meds

I am 41 and diagnosed with hypothroydism.  I have been on 137 mcj of trinostint for 5 months and my labs came back t4-1.28 t3 125 and tsh .0332 (out of range).  What could be the deal?  I am also taking tegretol which affects thyroid and my levels there are low (out of range).  Weight loss has been non-existent.
Avatar_m_tn
It would be very helpful if you gave us the reference ranges for the T3 and T4 tests, as shown on the lab report.  Since results, and thus ranges, will vary from one lab to another, it is important to be able to evaluate where results fall within their ranges.

I expect that your Free T4 level is adequate, since you are taking a T4 med.  Unfortunately many hypo patients find that their body does not adequately convert the T4 to T3.  This will result in continuing to have hypo symptoms, until Free T3 level is increased high enough in its range to provide relief.  Many members, myself included, say that symptom relief required Free T3 adjustment into the upper third of its range and Free T4 adjustment to around the middle of its range.  

Also, I expect that your T3 test was for Total T3, which is somewhat outdated and not nearly as useful as a Free T3 test.  You should always insist on being tested for Free T3 and Free T4 each time you go for testing.  In addition, since hypo patients are often deficient in other areas, you should also test for Vitamin D, B12 and ferritin.

Free T3 largely regulates metabolism and many other body functions.  Scientific studies have shown that Free T3 correlated best with hypo symptoms, while Free T4 and TSH did not correlate at all.  

A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  Symptom relief should be all important, not just test results.  You can get some good insight from this letter written by a good thyroid doctor for patients that he sometimes consults with from a distance, after an initial first hand evaluation and testing.  The letter is then sent to the participating PCP to help guide treatment.  

http://hormonerestoration.com/files/ThyroidPMD.pdfh

I mention not being constrained by TSH levels because hypo patients taking significant doses of thyroid meds often find that their TSH becomes suppressed in order to achieve symptom relief.  A suppressed TSH does not mean that you are automatically hyperthyroid, unless you have hyper symptoms, due to excessive levels of Free T3 and Free T4.  
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