Confusing lab results

[jambo11]

I'm on armour thyroid, just got a lab test back:
tsh .01
t4 1.1

T4 seems normal, tsh way low.  Over time, tsh levels have dropped significantly from normal range, whereas t4 has moved up into an average range.  Should I change my dosage?

[flyingfool]

As gimel points out TSH can be suppressed by Thyroid medication.  This seems especially true if taking a T3 medication or one with a T3 component which Armour is.

This is just further evidence as to why TSH should never be used by itself.

Please post your FT4 and FT3 levels.

In my opinion if you are being treated with a T3 med or Natural Thyroid like Armour, you Dr should be sued for malpractice if he/she is not testing for FT3.  It is absolutely essential!

[gimel]

Forgot this link.

http://hormonerestoration.com/files/ThyroidPMD.pdf

[gimel]

TSH is a pituitary hormone that is affected by so many variables that it is totally inadequate as the sole diagnostic for thyroid issues.  At best it is an indicator too be considered along with more important indicators such as symptoms and also levels of the biologically active thyroid hormones Free T3 and Free T4.  Free T3 is the most important because it largely regulates metabolism and many other body functions.  Scientific studies have also shown that Free T3 correlated best with hypo symptoms, while Free T4 and TSH did not correlate.  

When taking significant dosages of thyroid meds, TSH is often suppressed below the reference range.  That does not mean that you have become hyper, unless you also have hyper symptoms due to excessive levels of FT3 and FT4.  My own TSH has been about .05 for well over 25 years without ever having hyper symptoms.  In fact I had lingering hypo symptoms due to inadequate conversion of T4 to T3.  When I found out on this Forum about the importance of FT3, I got mine tested and it was confirmed as low in the range.  Switched to Armour thyroid and now my FT3 is 3.9 (range 2.3 - 4.2), and I feel best ever.  

The decision to change your dosage should be based on how you feel.  Do you still have hypo symptoms?  Also, you should get tested for Free T3 and Free T4, and TSH each time you go to the doctor for tests.  As the old saying goes, "If it ain't broke, don't fix it".  If you are feeling good, there should be no need to change med dosage, and your TSH test result should not even enter into the decision.

Clinical treatment for hypo patients is the most effective.  This link is to a letter written by a good thyroid doctor for patients that he sometimes consults with from a distance.  The letter is sent to the PCP of the patient to help guide treatment.  I think it will give you some insight into clinical treatment and ease any concern you have about the TSH result.