Low TSH high average free T4 post surgery but sluggish

[farmgirl429]

I have had a low TSH (0.02) for about 3 years.  After tests, Hashimoto's and nodule were found.  Dr. never put me on andy meds since I didn't have classic hyperthyroidism. I  had surgery 4 months ago to remove thyroid.  Now I am on Synthroid and the Dr. keeps lowering the dose since my TSH is low (0.05) and Free T4 is high normal.  I am sluggish, gaining weight and confused about why he thinks he needs to keep lowering my dosage.  I don't have any Hyperthyroid symptoms.  Does anyone have any ideas on what I should recommend to have my Dr. check.
  

[gimel]

To support my statement re. low TSH, I found the following info-------- "in view of  the rapidly evolving body of evidence linking osteoporosis with excess thyroid hormone, it seems reasonable to keep an open mind about the possible but not invariable link between osteoporosis and thyroid status in individual patients. Even in patients with thyroid cancer who need to take higher than normal doses of thyroxine for decades, there is little convincing evidence that the risk of osteoporosis is significantly increased."  I'm sure there are opposing views, however,  clearly there is no consensus about this concern and bone density can surely be monitored periodically to assure no changes.  To me, the unquantified low risk of any long term effect on the bones was far more than offset by the daily benefit from relief of my symptoms.

[gimel]

I confess I am confused as to why TSH in that range is considered hyperthyroid and something to be avoided, as long as T4 and T3 are still within  the normal range.  I have been that same way for many years and feel great and have no overt symptoms of hyperthyroidism.  The main reasons I have been told to be concerned with low TSH readings are  heart palpitation, and some concern for bone loss.  My blood press. is good, no heart palpitation, and normal pulse rate.  I also saw a study that concluded that they could not confirm that low TSH caused any  bone related problems, yet we keep hearing of that as a concern.  I think that this is a subject on which we should ask Dr. Lupo for some references.  Also, I would like to suggest that you read the last couple of comments I made to another poster ( mananda ) on the subject of basal body temperature.    

[Mark Lupo, M.D.]

I don't see the indication for the synthroid if the baseline TSH was .02 - this is hyperthyroid and synthroid should not be used.  Would consider and endocrine eval (or second opinion) to re-establish a definite diagnosis (ie graves vs hashi vs functioning nodule).