Aa
Aa
A
A
A
Close
1303649 tn?1274500506

Low TSH, lower Free T4

I am confused by my labs, hoping for clarification.  I have hashimoto's and my TSH is 0.31 (0.34-5.60) and my Free T4 is 0.62 (0.58-1.64).  I take 90 mg of armour thyroid daily.  The endocrinologist I am seeing is not very communicative.  I started seeing him about 6 months ago.  He insisted I did not have hashi's and my original labwork was an error and every doctor I had seen since just went along and gave me thyroid meds for a disease I did not have (he did a thyroid ultrasound and said I had the best looking thyroid he had seen).  So he insisted on another test (I think it was the anti tpo) which of course came back showing I had hashimotos.  Sooo, he acts like this is the first I am hearing I have hashi's (have had it 10 years-ish) and that I would have to take a little pill every day for the rest of my life.  UGG!  Anyways, can somebody please explain what a low tsh and a free t4 on the lower end indicate?  
Thank you!
8 Responses
Sort by: Helpful Oldest Newest
Avatar universal
You are taking Armour, which has both T3 and T4 in it.  The thyroid of the pig has a lot more T3 in it than our normally functioning thyroids would have.  So, Armour is heavy on T3.

Did your doctor test FT3?  If so, please post that as well.  As far as I'm concerned, there is little excuse not to test FT3 anyway, but once you are on meds with T3 in them, it becomes irresponsible not to test FT3.

Many times, once we are on meds (especially eds containing T3) TSH is suppressed by the meds and becomes useless.

How do you feel?  If you are feeling well, it's probably because your FT3 is high enough from the Armour to keep your symptoms at bay.  Any fluctuation in how you feel during the course of the day?
Helpful - 0
1303649 tn?1274500506
He did not test the FT3 and I feel like crap.  Totally exhausted, cannot stay awake, sleep every spare minute I can.  Total bags/puffy under eyes.  I'm just afraid he will take me off the armour because of the low TSH, when I think I need my thryoid medication increased.
Helpful - 0
Avatar universal
We very often see people on meds, especially meds with T3 in them, having their TSH suppressed, sometimes down to close to zero before hypO symptoms are relieved.

Your FT4 is right above the floor of the range.  Rule of thumb for FT4 is midrange,so you have a long way to go to get there.

You're absolutely right that you need an increase.  

Your doctor should test FT3 as well.  I'd request he test FT3, FT4 and TSH all in the same blood draw.  Point out your dismal FT4 to him.  Make sure he knows how bad you feel...sometimes doctors don't understand this unless you're VERY adamant..  If he doesn't respond to that, you may need a new doctor...this one will keep you sick.  Don't let him lower your meds, it will only get worse.  Trust your instincts.  
Helpful - 0
1303649 tn?1274500506
Frustrated!  I asked the dr to increase my armour and he said no.  He states I am hyper!  I said I am having a bunch of hypo symptoms, he didn't care.  He didn't even want to hear what they were and stated they were due to some other reason!  He implied that next time if my tsh is not up (6 months) he will lower my armour.  I was in tears yesterday because I have been so exhausted and unable to stay awake for any length of time (have to take meds at work to get through the day, come home and crash).  My skin and hair are very dry and I continue as always to gain weight.
This is like my 5th endocrinologist and there are just no other options.  Left me very depressed today!  I also have rheum. arthritis and that doctor listens to me, considers my opinions regarding MY OWN BODY and works with me.  I cannot stand being treated like I am a 5 year old child and need to do what I am told.  I had also wanted to ask if he could write me an rx for b12 injections (my previous endocrinologist had prescribed), but I realized there was no point.  He didn't listen and didn't care.  
Helpful - 0
Avatar universal
I have been collecting names of member recommended thyroid doctors.  If you will give us your location, I will let you know if I have a name for you.
Helpful - 0
Avatar universal
I'm so sorry to hear your doctor was such an oaf.

If gimel doesn't have a name for you, have you ever considered asking your rheumy if he'd manage your thyroid condition?  You seem to have a good rapport with him.  You don't have to be an endo to prescribe thyroid meds.  I have a heart arrhythmia, and my endo now prescribes my heart meds along with my thyroid meds.

I assume you also have prenicious anemia if you have been prescribed B12 injections in the past.  PA can mimic thyroid symptoms.  Your PCP could prescribe those as well.
Helpful - 0
1303649 tn?1274500506
I am in Reno, NV.  Although I love my rheumy, he handles just that one thing, my hashimotos would be out of his area of experience and he wouldn't do it.  I would have my pcp manage it, but she is very anti armour thyroid and tried switching me to synthroid or levothroid 2 years ago and when I refused her response was I would have to sooner or later (due to the shortage).  Kinda stuck between a rock and a hard place.
Helpful - 0
Avatar universal
Sorry to say that I don't have a recommendation for Reno.  Sending a PM with best info I can provide.
Helpful - 0
Have an Answer?

You are reading content posted in the Thyroid Disorders Community

Top Thyroid Answerers
649848 tn?1534633700
FL
Avatar universal
MI
1756321 tn?1547095325
Queensland, Australia
Learn About Top Answerers
Didn't find the answer you were looking for?
Ask a question
Popular Resources
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
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.
Condoms are the most effective way to prevent HIV and STDs.