Overmedicated?

[nickknackk22]

Hi,
I have suffered from symptoms of hypothroidism for 12 years. I am pretty sure that I have been under medicated my whole diagnosis. I have recently felt the best I ever have, but my TSH is quite low.
TSH 0.035,  0.450-4.500uIU/mL
Triiodothyronine,Free,Serum 3.7, 2.0-4.4pg/mL
T4,Free(Direct) 1.05, 0.82-1.77ng/dL

My endocrinologist wants me to take less medication but I have no signs of overmedication and my body temperature is higher than it has ever been.  Do you have any suggestions?

[nickknackk22]

Thank you very much for the information. I greatly appreciate it.

[gimel]

Yes, I suggest that you acquaint your doctor that patients taking thyroid meds frequently report that their TSH is suppressed.  This does not mean that you are hyper, unless you have hyper symptoms caused by excessive thyroid hormone levels, which you do not.  

Unfortunately many doctors believe in TSH so much that they tend to ignore the actual, biologically active thyroid hormones, free T3 and free T4.  TSH is only the hypothalamus/pituitary reaction to levels of mainly FT4.  TSH causes no symptoms.  TSH is affected by so many variables that it is inadequate as a diagnostic by which to medicate a patient.  

I have yet to see a statistically valid study that shows a strong correlation of TSH to FT4, much less FT3 or symptoms.  On the other hand studies have shown that FT3 correlates best with hypo symptoms, while TSH and FT4 did not correlate.  Here is a link to such a study.  

http://www.ingentaconnect.com/content/routledg/cjne/2000/00000010/00000002/art00002

Since symptom relief is all important, I suggest that you don't accept your doctor's intent to reduce your meds.  You may have to battle it out with him, but at least some of the above info will give you some arguing points to do so.  If all else fails, then you will need to find a good thyroid doctor that will treat you clinically by adjusting FT3 and FT4  as necessary to relieve symptoms, without being constrained by resultant TSH levels.  

This link is a good article, written by a doctor, that will help support what I have said.  Giving your doctor a copy might also help change his mind.  Note specifically the info about the fallacy of overreacting to low TSH, when FT3 and FT4 levels are in range.

http://www.hormonerestoration.com/Thyroid.html