Aa
Aa
A
A
A
Close
Avatar universal

low tsh but still low free t3 and t4

i was diag for hypothyroidism. after several docs and issues i ended up with a doc who feels its also adreanal, i supplement adreanal fatigue and take naturthroid (like armour) 3 grains. but my ths is .08 which could be considered hyper but my free t3 and t4 are still way low. any ideas÷experience?
5 Responses
Sort by: Helpful Oldest Newest
Avatar universal
I have central hypothyroidism, which is a  form of hypopituitarism. with this condition TSH SHOULD be very low.  I also have secondary adrenal insufficiency. I take replacement cortisol---natural adrenal support won't do the job.  it sounds like you need to see an endocrinologist and have proper testing done to see if your adrenals are functioning properly.  If you try to treat the thyroid before the adrenals are working right---you will feel worse.  The last time my TSH was tested, it was .00????  can't remember the rest of the numbers.    My husband has hashimoto's , and his TSH can also not be trusted to regulate his thyroid medication.          I once had a doctor try to normalize my TSH---even though my FT4 was low, also.  He kept dropping my thyroid medication until he got my TSH where he wanted it---and by then my hair was falling out.  It took about a year for my hair to recover from that doctor's lack of knowledge.  It should have been apparent that a test showing low TSH and low FT4 is an abnormal test result and indicates pituitary problems.  I had already been diagnosed with central hypothyroidism, by and endocrinologist.  I can't even remember why this guy was messing with my thyroid, because he was not my doc, just another doc in the psych office.
Helpful - 0
Avatar universal
Low tsh along with low ft3 and low ft4 are signs of central hypothyroid.  So u may want to have dr check out other pituitary functions.  If u are truly central hypo your dr needs to ignore tsh and focus on ft4 and ft3 numbers.  Best advise is to read up on central or secondary hypothyroid which is often accompanied by adrenal issues.
Helpful - 0
1530171 tn?1448129593
With adrenal fatigue, usually a minimum dose of desiccated thyroid while treating the adrenal fatigue is a sensible approach, as long as the RT3 is low.

Methylation issues with mthfr gene defect are numerous.

In regards to hypothyroidism, it can raise your copper levels which automatically reduce your zinc levels and high copper also interferes with iron and ferittin, all very important for healthy thyroid function .
Avoid foods rich in copper, take extra zinc. Vitamin C helps detox copper.
Avoid folic acid as the body can't use it when you have this gene defect.
Folate is OK though.
You must refer to  methylocobalmin for B12 and methyl form of B6-I forget what it's called.
It will be great to find out what type of defect you have.
There many different combinations.
Which place are you using and how many methyl polymorphisms do they test for, do you know?
It can simplify your life a lot, as you'll be able to fine-tune your approach to better heath-well with the help of a good practitioner.
Holistic Health International, has one of the best tests for it, but probably the most expensive. But please check out just for reference purposes.

I hear good things about MSM for MTHFR defect issues, from another
forum, if you want to research it.
I personally take oral MSM  daily for maintenance and DMSO for treating acute  intense pain (does not happen often) topically with a 30% solution below neckline and 10% above neckline.

What type of doctor are you seeing?
It is refreshing to see this, as most members have nothing but bad experiences with their doctors and their treatments.
Can you tell me more about your adrenal fatigue treatment?
I hope I'm not asking too much. Lol!

Yes the biggest concerns are the long term effects of low thyroid function on the heart and cardiovascular system.
Unfortunately you cannot rush the thyroid regulation, while having low adrenal function and this is something which takes up to 2 years with a comprehensive treatment plan, depending the extend of adrenal fatigue. It is likely to backfire, if you treat the thyroid aggressively and I'm sure you already found out the hard way.

Please post anytime again to ask questions, answer mine and to comment.

These are rather complex health matters and I commend you for your
perseverance and determination to do what it takes in order to improve your health status.

Blessings.
Niko



  
Helpful - 0
Avatar universal
thaks so much for your input and concern. most of your assumptions are correct. Yes i am dealing with adreanal fatique. i spent a year on t3 only and it did not resolve anything and in fact i was worse many ways. I switched docs and went to desecant thyroid. but my rt3 is not bad as it ws before. we keep the dose of thyroid low so as not to supress tsh. my doc seems ok with numbers but i think we can do beter. er have also established that i am not or rather dramatically undermetholating. doc does not think the reason is important but i have sent off genetic testing to see if it is mthfr defect. it seems like it could make some sence to symptoms. the meth b's are helping but i feel like the longer i am hypo the more long term damage i could be doing to cardio and such. any ideas?
Helpful - 0
1530171 tn?1448129593
HI jjojo63.

Each grain of Nature Throid contains 38 mcg of T4 and 9 mcg of T3

A likely scenario is that due to the fact that in adrenal fatigue,
the adrenals down-regulate thyroid function (secondary hypothyroidism)
for adrenal recovery, possibly by converting T4 to reverse T3, thus your low free T3 and T4. (Reverse T3 originates from T4).
By increasing your dose , if this is indeed the case, it not going to help much, if you do the math and take into account the fact that a good precentage of the remaining T3 is bound by proteins in the serum.

So a couple things can be done.
1. A trial of Cytomel which is only T3, while the adrenals are recovering, with constant monitoring and dose tweaking.
Eventually the body will remove the  excess rT3

2. Get testing for Reverse T3 ( rT3 )as well, since the fT3/rT3 ratio is probably the most reliable marker for low cellular thyroid function.
Look for a ratio of over 20 for healthy thyroid function. (divide Free T3 by reverse T3, but make sure you are in the same unit measurement for both.)

Your adrenals are probably dysregulated, the reason for low fT3/rT3 ratio.  One of the  causes is high cortisol.
Paradoxically low cortisol (which is the next phase after unresolved chronic high cortisol-could be up to years, before the body cannot sustain the elevated cortisol production, resulting in diminished cortisol production!) is another cause for a low fT3/rT3 ratio.
This would be likely more consistent with your situation.
I don't know any particulars in your case, so I'm addressing different possibilities.
So again, while treating the adrenals, a trial of Cytomel as above, using
the fT3/rT3 ratio AND symptom changes, for dosing purposes, might be
a more precise but obviously also more complicated  way to regulate thyroid function.

Iron status, selenium, iodine, zinc, Vitamin A (and cortisol, which  is being addressed as you mentioned) levels  must be checked , as these are all factors in Thyroid function.

I hope this helps, but please note that my comments are not intended as a replacement for medical advice.

Best wishes.
Niko

Helpful - 0
Have an Answer?

You are reading content posted in the Adrenal Insufficiency Community

Top Thyroid Answerers
Avatar universal
MI
Avatar universal
Northern, NJ
Learn About Top Answerers
Didn't find the answer you were looking for?
Ask a question
Popular Resources
We tapped the CDC for information on what you need to know about radiation exposure
Endocrinologist Mark Lupo, MD, answers 10 questions about thyroid disorders and how to treat them
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
STIs are the most common cause of genital sores.