Your T-4 suggest hypo and your TSH suggest hyper. However I would wait a couple (three months) Labs to see if TSH will move up which usually will bring up T-4 as well. However I would like to see a T-3 done with the other two to check if there is a conversion problem with T-4 and T-3.
It is not unusual for hypos to have a Hyper TSH or to be hyper first before going full blown hypo. That might be why your first T-4 reading was hyper high and now hypo low, that is, your T-4 level is finally converting over to hypo. It takes a while for the TSH to catch up, in other words, TSH lags behind the other two. Also hypers can be hypo first before becoming full hyper.
All this considered a few Labs are needed to see what the levels are planning to do. Also switching meds. can give different readings buy certain factors. So they need time to do what they are going to do. That is, levels stabilizing to the new meds.
Even med students have trouble understanding thyroid numbers.
Practice & testing gets it fine tuned. The TSH is compared to
the other T's. If others are normal & TSH is very lo then you
are considered 'subclinical-hyperthyroid or euthyroid' & the
Rx will be (lowered). The lo TSH means your pituitary gland is
balancing this hormone for you so you need 'less' med. It's
sending in troops to help. Hypo is generally over 3.0 on TSH.
The other T's are telling the Dr. what's really going on in a
bigger picture. Synthroid/Armour is used mostly for Hypo but then they back off if TSH stabilizes. Your thyroid hormones control so much that they should be in balance. Heart/hair/
skin, are things that need to be added to equation. Unless you
had a specific problem, most of the time results show up by
doing basic labs. Stress can alter the labs so Dr. wants to ck.
to see if he's getting reliable results from your body. I know,
seems like the lower the # the more med needed but it's just the opposite. Ask Dr. for an opinion but my guess is he's still
trying to fine tune. If nothing else is going on, a year from
now you may be normal & no pills. If a true pattern is there,
meds will be needed for life to keep you healthy. Try to get
Dr. to use generics vs names.
It is important to have the T-3 done as well. All three in how they relate to each other can mean certain thyroid issues.
A low TSH and a low T-4 (with a low T-3 can mean adrenal fatigue and depending how the T-3 relates to T-4) can also mean hypothyroidism due to low pituitary function. Or other problems such as Allergies, hormonal imbalance, yeast.
False T4 levels also can be produced by severe nonthyroid illness is another possibility.
I'd wait to see what the next test shows and hopefully you will get all three done.
There might be thyroid issues other than the matter of just being hypo or hyper.
I'd have the three done and then take the wait and see approach.
I just new you'd ask that! Easiest is to just look at the TSH.
0 to .3 = Hyper. If TSH goes over 3.0 it's Hypo. While on meds,
working w/ (your own) hormones the body makes, you are actually
Euthroid or in the middle but more towards Hyperthyroidism. At
.25 TSH you were Hyper. Still Hyper at .01. Many Dr's use just the TSH. Yours is making sure nothing else throwing the #'s off.
I'd say you are Euthroid, meaning borderline for thyroidism.
The trial meds & tests will either-way decide. You have to know
what ea. 'T' does & one will suppress or alter the other number.
Most Dr's try to get TSH at 3. It's like being borderline
diabetic. Food intake balances your insulin. If body can no
longer work w/ that, you need shots. Something is changing the
TSH #'s. Trust your doc. There may be something w/ other bloodwk
confusing your pituitary. I don't do labs. Just know why the
meds are given & dosages are altered. That's why the docs get
the bucks. Gd-luck.
My understanding is it is important to check the free T3 + T4 levels as well. I am hypothyroid and have had strange readings such as exactly what you described. I just make sure they check ALL thyroid (and they have checked parathyroid) functions. As for keeping a patient at 3.0 for the TSH, I thought those numbers were substantially lowered? Anyone?
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