My thyroid was completely removed so why are my tsh levels being tested. My doctor lowered my dose (armour thyroid) because my tsh was .05 (0.34 - 4.82). My FT4 was 1.19 ( 0.45-1.63). They did not test FT3. Isn't my FT4 reading more important? I have no thyroid gland so what is the TSH regulating?
The TSH comes from your pituitary gland, so they test it to see if the conversion is still happening. If your body does not stimulate the TSH even without your thyroid getting the message, then your body will not know to trigger the T4 into your body to convert it to T3. Only a small percent is made in the thyroid, the rest of the T3 being converted in your kidneys, liver and elsewhere.
So it is still important to know what is taking place. Your doctor probably felt you were starting to go a bit hyper and brought your level down to counter that.
TSH is a pituitary hormone that is affected by many variables, so that it is inadequate as a diagnostic, by which to determine dosage of medication. When you are on thyroid meds, very frequently the TSH is suppressed to the low end of the range or below. This does not mean that you are hyper, necessitating reduced medication. Many doctors misunderstand this. You are hyper only if you have hyper symptoms from excessive FT3 and FT4 levels. Your FT4 is not excessive, and you don't really know the most important test, FT3.
You did not indicate whether you still have hypo symptoms or not. If you do , in my opinion the best way to treat a thyroid patient is to test and adjust the actual biologically active thyroid hormones, FT3 and FT4, with whatever meds are required to alleviate symptoms, without being constrained by resultant TSH levels. Frequently this requires that FT3 be adjusted into the upper part of its range and FT4 to at least midpoint of its range. The most difficult part of this is finding a doctor that will agree to treat your symptoms this way without being constrained by TSH results.
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