low TSH and low TT3 on meds

[barleypop]

Hi Dr. Lupo,
I have been having a difficult time lately getting my levels in order.  I am 31 yo female, 5.5, 134 lbs, very athletic and active.  Currently on 112 mcg Synthroid since Oct 2008.  Labs done on 12/1
TSH 0.34 (0.34-5.6) - TSH was 2.58 in Oct on 100 mcg synthroid.
TT3 88 (97-219) flagged low
Endo won't run FreeT4 or freeT3.  I am not sure why not though since I am on T4 meds.
Had a CBC at the same time as well and glucose was low at 72 (74-118) and Osmo Serum Calcium low at 274 (275-295).  

Currently I am experiencing excessive hair loss, very quick temper/anger, dizziness, no periods since April 2008.  I have taken Prometrium (200mg/5 days) twice to induce a cycle but only spotted for one day both times.  Does this mean I am low in estrogen?

What should be my course of action?  Is it possible I am not converting T4 to T3 very well?  My labs consistently have my total T3 at the very bottom of the range and have even had a free T3 flagged a low at 1.3 once.  I know my calcium is not too low but should I be concerned.  

Thanks for any help!
Marianne

[Mark Lupo, M.D.]

The TSH levels have been within the target range - the lack of periods needs additional evaluation and cannot be attributed to the thyroid based on what you describe. The most common cause of hair loss is stress, but thyroid problems can contribute.  It may be that taking a slightly lower dose (ie 112mcg 6 1/2 tabs / week rather than 7 / week) may beneift, esp if you are experiencing agitation with the increased dose -- discuss w/ your endo.  T3 therapy (ie using a low dose of cytomel) is usually not very helpful, but exploring this may be worthwhile.

[barleypop]

Wanted to add that I have Hashimoto's and that I will be seeing my endo next week about the labs and I know that I am bordering on my TSH being in hyper range and will likely have to drop to a lower synthroid dose.

Thanks again!