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Hyperthyroid??? TSH Low .046; Free T4 and free T3 normal range

I'm hoping someone can help me understand my recent labs. My PCP called and said I'm hyperthyroid but my symptoms feel like hypo. Although when I look up symptoms for both...they often look similar! Im tired all the time!
My TSH was 0.046 with ref range of .450-4.50
T4 free(direct) 1.58 ref range 0.82-1.77
T3 free 3.2 ref range 2.0-4.4
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Avatar universal
Before further discussion, we need to know if you have been diagnosed hypothyroid previously and are taking thyroid med?  
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Yes I have been hypothyroid for 15 years been taking 60mg Armour. This spring my PCP called and said my labs showed the 60mg wasn't working so she rx'd 90mg Armour. Rechecked me 6 weeks later and labs showed I was over corrected so she switched me to 100mg synthroid with 10mg cytomel . Labs 6 weeks after the synthroid and cytomel are what I posted above. Hope this makes sense.  
Avatar universal
Your doctor is making the usual mistake of deciding you are over-medicated and hyperthyroid just because your TSH is suppressed below range.   This is totally wrong because in the untreated state our bodies have a continuous low flow of thyroid hormone from the gland.   Each individual has an equilibrium among TSH, Free T4 and Free T3.   When you take a significant dose of thyroid med once or twice a day, it affects the equilibrium and TSH becomes suppressed for an extended period.    So, when taking thyroid medication, a suppressed TSH does not mean you are hyperthyroid unless you have hyper symptoms due to excessive levels of Free T4 and Free T3, which is not your case.  There are even scientific studies that show TSH usually becomes suppressed when  taking thyroid medication adequate to relieve hypo symptoms.  If you want to confirm what I say click on my name and then scroll down to my Journal and read at least the one page Overview of a paper on Diagnosis and Treatment of Hypothyroidism: A Patient's Perspective.  

So you need to get your doctor to understand this and continue to increase your thyroid med dosages as needed to relieve your hypo symptoms.   If you expect difficulty in getting this done, then give the doctor a copy of the paper and ask him to read and reconsider.   If you do not succeed with that, then you will need to find a good thyroid  doctor that will do so.  

Also a couple of other things.  Hypo thyroid patients are frequently deficient in Vitamin D, B12 and ferritin, so you need to get those tested and then supplement as needed to optimize.  D should be at least 50 ng/mL, B12 in the upper end of its range, and ferritin should be at least 100. all are important for you.  Also, to avoid false high test results for Free T4 and Free T3, you should defer your morning thyroid med dose until after the blood draw.  
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