High Free T3, and TSH question

[Isabelle1427]

Dr. Lupo,

I was diagnosed with hashimato's hypothryroiditis a year and a half ago.  I have been taking 75 mcg of Synthroid with an extra half pill a week, which has not changed since June.  The only other thing I regularly take is birth control pills.  My recent test results have me confused.

Sept.
TSH        2.54    (0.38-4.70)
Free T4   0.74    (0.59-1.17)
Free T3   4.21    (1.8-4.2)

Nov.
TSH        3.63    (0.38-4.70)
Free T4   0.79    (0.59-1.17)
Free T3   4.27    (1.8-4.2)

My doctor is concerned that the Free T3 is high and is afraid I could be getting too much Synthroid.  I am concerned with the TSH going higher and have started to feel more of the hypothyroid symptoms (dry skin, tired, hair falling out).  So part of my question is related to what could cause these odd test results?  Also which test is a better indicator of thyroid function?  Is a slightly high Free T3 bad?

Any information you could give me would be helpful.  I have not been able to get these questions answered at this point.

Thanks.

[Mark Lupo, M.D.]

would not worry much about the slightly high free T3 in this situation.  would base on the tsh which is a little high and consider a dose increase in synthroid.  there is likely a bit of extra conversion from t4 in your case.  

[cheshire]

There are two possibilities:

T4 is converting to T3 like mad to conpensate for low thyroid status

OR

Low cortisol/adrenal disfunction. AD often accompanies hypo and gives low T4 with much higher t3: Free t3 is pooling in the blood unable to reach cells due to low cortisol. A saliva four-point cortisol test can confirm this, from the Canary Club, or your internist can run it. Beware of endos and other lab obsessed drs as they tend to look only for Cushings and Addisons (AKA you have be on your deathbed before they stand up and notice). It's worth doing some research as this subject is not well understood by most MDs but affects most thyroid patients.

[Exbenzo]

The same thing happened to me. How can T-3 and sh contradict one another?
The answer may be that we have  secondary thyroid problems. The pituitary isn't able to send the right signal to the thyroid.

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