Aa
Hypo - TSH, T3 normal...T4 low
Hi,
I am a 44 year old female. About a year ago, blood tests indicated my T3 levels were low, where as my T4 was in the on the low side but within range. My doctor put me on Cytomel in order to increase my T3. My T3 is now at 127, but my T4 has dropped below range at .6 and my TSH is within range. My hypo conditions have improved considerably, but have not gone away completely. I asked my doctor if this could be from my T4 levels being low. She explained that since T4 is inactive she doesn't want to treat it, and instead leave it alone. In my mind, it seems ALL levels should be comfortably within the "range". Should I insist on her treating my low T4? Should I try to get a referral to an endocrinologist? My doctor is specialized in Internal Medicine. Any information is greatly appreciated.
I am a 44 year old female. About a year ago, blood tests indicated my T3 levels were low, where as my T4 was in the on the low side but within range. My doctor put me on Cytomel in order to increase my T3. My T3 is now at 127, but my T4 has dropped below range at .6 and my TSH is within range. My hypo conditions have improved considerably, but have not gone away completely. I asked my doctor if this could be from my T4 levels being low. She explained that since T4 is inactive she doesn't want to treat it, and instead leave it alone. In my mind, it seems ALL levels should be comfortably within the "range". Should I insist on her treating my low T4? Should I try to get a referral to an endocrinologist? My doctor is specialized in Internal Medicine. Any information is greatly appreciated.
COMMUNITY LEADER
I hope you specified FREE T3 and FREE T4, because if you just asked for "T3 and T4", you will get Total and those are outdated and useless. That's why we always type it as "Free" or FT vs just "T"
Will look forward to seeing your results, with reference ranges.
Will look forward to seeing your results, with reference ranges.
Thank you all for the great information. I called and spoke to the nurse at my doctors office on Friday. I asked to have my T3 and T4 levels checked...Friday late afternoon I was at the lab for a FULL Thyroid panel. I will have my results later this week and hopefully some answers.
Thank you again!
Thank you again!
COMMUNITY LEADER
As I said before, Total T3 and Total T4 are basically, useless and are pretty much a waste of money, because you don't really need to know those numbers. You only need to know the amount of the FREE hormones, because the Free T4 is what's converted to T3 and the Free T3 is what's used by the body. Again, that total T3 test of 206, does not give any useful information.
Anyone on a T3 med should have Free T3 tested every time labs are done and in my opinion, a doctor who doesn't order it is not treating you properly. Yes, high levels of T3 can contribute to osteoporosis.
To test for Hashimoto's, you need to get Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TGab) tested.
Anyone on a T3 med should have Free T3 tested every time labs are done and in my opinion, a doctor who doesn't order it is not treating you properly. Yes, high levels of T3 can contribute to osteoporosis.
To test for Hashimoto's, you need to get Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TGab) tested.
I do know that when I was originally put on Cytomel, all of the levels were checked. My T4 and FT4 were within range, but my T3 and T3 free were low, which is why she treated me with only Cytomel and seemed to think my body wasn't converting the T4 properly. I can't see to find the original tests as I would like to post those numbers.
I guess one of my concerns would be "why didn't she retest all levels again?" I would tend to think that all T levels and Free T levels needed to be reviewed for a proper reading.
Also, my concern is "what if my T3 levels get to high? I already suffer from early stages of Osteoparosis. Doesn't high levels of T3 cause one issues? My total T3 this last test was 206, which is considered high according to the "range".
I've never been diagnosed with Hashimotos Thyroid. Are there other tests I should be asking for in regards to my thryroid issue?
I guess one of my concerns would be "why didn't she retest all levels again?" I would tend to think that all T levels and Free T levels needed to be reviewed for a proper reading.
Also, my concern is "what if my T3 levels get to high? I already suffer from early stages of Osteoparosis. Doesn't high levels of T3 cause one issues? My total T3 this last test was 206, which is considered high according to the "range".
I've never been diagnosed with Hashimotos Thyroid. Are there other tests I should be asking for in regards to my thryroid issue?
Thank you for the reply. I was on 25mcg Cytomel. Tests done on 12/6 indicate following:
T3 total 84 <range 76-181
FreeT4 .9 <range .8-1.8
TSH 2.41 <range .4-4.5 (noted as TSH 3rd generation)
No freeT3 tested
Doctor raised Cytomel to 30mcg. Tests repeated on 1/23 below.
T3 total 206 <range 76-181. This sky rocketed
Free T4 .7 <range .8-1.8. This lowered
TSH .51 <range .4-4.5. (doesn't indicate 3rd generation but range is the same as above...if its the same, it dropped dramatically.
No free T3
Since I began the 30mcg, my energy levels have increased and I feel great. However, I still have extremely dry skin, facial skin is still rough looking, foggy head, hair loss and no weight loss.
I hope this helps provide a better picture. The results I posted originally were from the tests a year ago..above are two most recent. Any thoughts?
T3 total 84 <range 76-181
FreeT4 .9 <range .8-1.8
TSH 2.41 <range .4-4.5 (noted as TSH 3rd generation)
No freeT3 tested
Doctor raised Cytomel to 30mcg. Tests repeated on 1/23 below.
T3 total 206 <range 76-181. This sky rocketed
Free T4 .7 <range .8-1.8. This lowered
TSH .51 <range .4-4.5. (doesn't indicate 3rd generation but range is the same as above...if its the same, it dropped dramatically.
No free T3
Since I began the 30mcg, my energy levels have increased and I feel great. However, I still have extremely dry skin, facial skin is still rough looking, foggy head, hair loss and no weight loss.
I hope this helps provide a better picture. The results I posted originally were from the tests a year ago..above are two most recent. Any thoughts?
Hi,
please post your actual results, and the reference range.
I tend to agree with your doctor that T3 is the most important hormone to treat (and you may be lucky that you have a doctor who does treat thsi way).
Have they tested FT3 / FT4, as opposed to just T3/T4. FT3 and 4 reflect actual bioavailable hormones and should give a much better idea of what's going on than just testing t3 and t4.
Please give us some more info also on your syptoms and let's see if we can help.
please post your actual results, and the reference range.
I tend to agree with your doctor that T3 is the most important hormone to treat (and you may be lucky that you have a doctor who does treat thsi way).
Have they tested FT3 / FT4, as opposed to just T3/T4. FT3 and 4 reflect actual bioavailable hormones and should give a much better idea of what's going on than just testing t3 and t4.
Please give us some more info also on your syptoms and let's see if we can help.
Have an Answer?
You are reading content posted in the Thyroid Disorders Community
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.
First off, anyone taking cytomel should ALWAYS get tested for Free T3, since cytomel is a T3 only med. Total T3 is, for all practical purposes, useless, because it shows the amount of ALL the T3 in your blood, including that bound by proteins and unavailable for use. The FREE T3 shows only the unbound amount that's available for immediate use by the individual cells. That's what you need to know.
T4 must be converted to T3 prior to being used. Again, the FREE T4, shows that which is available for conversion. The rest is bound by proteins and not usable. Your lab $ would be much better spent, if you drop the tests for Total T3 and Total 4, and add Free T3.
With your FT4 levels being so low, you have nothing to convert to the usable FT3.........
All of that being said - why is your doctor treating you only with a T3 med? It's very unusual to treat a hypo patient with a just a T3 med. Typically, one would be put on some combination of T4 and T3 med. Or possibly just a T4 med to start with to see if you convert adequately, if not, a T3 component would be added, whether in the form of cytomel, or at desiccated T4/T3 combo.
Do you know if you have Hashimoto's Thyroiditis?