Low TSH with low normal T3, T4.

[PegRN]

History of benign thyroid adenoma removal with confirmed biopsy of Hashimoto's.  Still have numerous stable(in size) nodules.  TSH went from1.8 in March, 2009, to 0.185 (0.400 - 5.300) in November, 2009.  Would probable cause be:  (1) new adenoma with hormone secretion (2)  Pituitary problem  (3)  Adrenal insufficiency?????  Symptoms:  bradycardia (56- 60), occasional PVC/PAC's, cold intolerance, irritability, fatigue (physically overwhelming at times), difficulty sleeping, nervousness/depression.  I am only on Climara Patch/postmenopausal however have been under alot of stress in the last six month with family health issues..

[PegRN]

Sorry I didn't give a lot of info.  Absolutely new to this forum thing.  First, I am not on any thyroid medications.  I was dx with a goiter with mult. nodules some years ago and they wanted to just "watch" it.  When I developed difficulty swallowing, and US revealed a very large nodule on lower pole of the left inferior nodule.  A left partial lobectomy on June 2, 2008, resulted in the removal of  2.0cm (at maxium) benign folucular adenoma.  Pathology also confirmed Hashimoto's.  I returned to the ENT several times expressing hypothyroid symptoms.  Labs were always in "low normal" range and she didn't want to start any meds until absolutely necessary.  

Post surgery labs:
6/24/08  TSH    0.763 (0.270 - 4.200) *different lab
             FT4     0.912 (0.932 - 1.710) *
8/6/08    TSH    1.628 (0.400 - 5.300) Hospital lab
             FT4     0.96 (0.80 - 1.76)        "
11/6/08  TSH     1.816 (0.400 - 5.300)  "
             FT4      0.87 (0.80 - 1.76)       "
2/13/09  TSH     0.442 (0.400 - 5.300)  "
             FT4      1.12 (0.80 - 1.76)       "
11/17/09  TSH    0.185 (0.400 - 5.300) "
              FT4     1.07  (0.80 - 1.76)      "
              T3        147  (60 - 200)          "

On my last visit, she stated that she was not too concerned about the low TSH and that there may be low output from my pituitary gland and recommedned I see an Endocrinologist.  In my research, I found that I also have the symptoms of adrenal "fatigue" or even a pituitary turmor.  Of course, with a Hx of an adenoma, I'm concerned about another on my pituitary.  I have been under an enormous stress related to having to take care of other family members with health issues. Before I go to an Endogrinologist, I wanted to see if anyone else had a similar situation. Thanks

[Barb135]

Are you currently on any thyroid med?  If so, what and for how long?  Have you had any tests run other than TSH, like Free T3 and Free T4?  If so, please post the results along with the lab's reference ranges, as that will help members comment more fully.  

I also don't understand your first sentence: "History of benign thyroid adenoma removal with confirmed biopsy of Hashimoto's".  Hashimotos' is not diagnosed by biopsy, it's diagnosed with blood work, showing thyroid antibodies, along with ultra sound showing a goiter (enlarged thyroid).  

Do I understand correctly that your adenoma was removed, not your thyroid?