TSH 0.03, low T3 Low T4

[karenhelton]

I have a question about some thyroid lab results.
TSH is 0.03 (range is 0.4 to  4.5 mIU/L).
T3, Free is 2.3 (range is 2.3 to 4.3 pg/mL) and
T4 free is 0.8 (range is 0.8 to 1.9 ng/dL ) .

Is this an indication of a thyroid problem or a pituitary problem or both? These levels have remained constant for over 9 months even after being put on a perscription of Nature Throid and have gone from a 1/4 grain (17 mg) to 3.5 grains (227.5 mg)... with blood work being done every 3 to 4 weeks and still feeling like the walking dead and putting on lots of weight. Been given a diagnosis of Severe Thryroid Disease and Hypothyroidism..but am not getting any better. HELP..what the heck else could it possibly be?

[karenhelton]

Hi Jacjacr,

Thanks for the reply and advice and for making me realize I am not alone. That there is someone that knows..reading what you wrote actually put a smile on my face. I thought Wow are you my twin? are we related??.HA!HA! I swear I have no energy what so ever..I brush my teeth and I feel like I gotta rest cause I just did a massive workout. Getting dressed feels like I just ran a marathon. I ache and am in pain all the time. I'm not good at taking pain pills. Lidoderm patches and ice are my Best Friends.

I have to work full time to support my family and just push myself to get thru it/the day but by the time I get home. I'm absolutely done and running on fumes. I  make a bee line to the couch and collapse cause my body just goes into crash/shut down mode and I literally collapse from exhaustion. I have two children ( a 10 year old & a 13 year old) and feel terrible that I don't have hardly any energy left for them. To go from someone who is very active, energetic, always go-go-go to someone that needs to rest after brushing your hair and teeth is just sad and pathetic and extremely frustrating. Any suggestions are gladly welcomed and so much appreciated.

[karenhelton]

Hi Barb,

Thanks for the reply and advice. I've had a lot of testing done including my hormones which are in the tank too..I'm way in the high post menopausal range. My doc started me on testosterone back in September which has brought it up at least into the range. And she just started me on estrogen and progesterone supplements this week since they were all low/non-existent.

Testosterone Total = 30 ng/dL (range is 2-45 ng/dL)
testosterone Free = 2.0 pg/mL (range is 0.1 to 6.4 pg/mL)
** this is my level now after being on supplements since September..before my levels were below the range. ***

My estradiol  is <15 pg/mL (range is <or =31 post-menopausal)
My progesterone is <0.5 pg/mL (range for post menopausal is <0.5)
My FSH is 91.6 mIU/ml (range for post-menopausal is 23.o to 116.3)
Estrone is 26 (range for postmenopausal is < or = 65 pg/mL)

I do have a Vit D deficiency and am taking supplements and it is still low.
23 ng/mL (range is 30-100 ng/mL). I get out everyday in the sun to try and get my Vitamin D that way as well

My doc has done some other tests too. Not sure if they are adrenal tests thou. She has tested me for homocysteine, hs-CSRP, cortisol, dhea sulfate and ferritin along with a CBC panel and a Comp Metabolic panel. Are these the tests you are referring too? She has not had any Vit B tests run on me. Is there any other tests I should be asking her to run?

Since she just started me on estrogen & progesterone..when is it reasonable for me to begin to start feeling its effects? She keeps telling me "Don't worry..it'll get better." I'm trying to be optimistic but its difficult when you just feel crappy all the time.

[jacrjacr]

I agree with Barb, you need to know what your progesterone, dhea, vit d levels, b12 level, estrogens, testosterone etc.....Like you, I was hypothyroid around the same time as menopause and oddly all my hormones were almost non existent as well so I had to take hormones at the same times since they can have a lot to do with your thyroid as well.....I went to a bio identical dr you knew this and tested everything at once so I was put on bi estrogen, testosterone and progesterone ,vit d3 and b12 and she took me off caffeine, and wanted me to eat healthier..as well as a t3 t4 thyroid medicine..it was almost an immediate improvement....and b4 that, I felt like I was dieing with no energy and I couldn't even muster the energy to argue or raise my voice literally.
Are you positive, your first test before medication showed a low tsh. The reason I ask is my test after the first one came back with suppressed tsh but my dr told me that if you take medication with t3 in it, it will suppress your test results and so she paid little to no attention to the tsh, just the free t3 and free t4 and my symptoms.
I will say get very familiar with thyroid symptoms because I had some that I thought were unrelated to thyroid so I didn't tell her like joint aches and foot pain and I was undermedicated for a while.
EVERYTHING  Barb said is right on target....

[Barb135]

The doctor's forum only accepts so many posts/day, so if you posted there and they couldn't take it, it would get put over here, which is why you have both posts here.  It's not a problem, I just wanted to let you know in case you wondered what happened to one of your posts.

Yes, I can see why you have symptoms of being hypo - because your FT3 and FT4 are on the floor of their ranges.  

Have you had any pituitary tests done?  TSH is a pituitary hormone, produced to stimulate the thyroid, which, then, in turn produces T3 and T4.  If the pituitary is not producing TSH, the thyroid won't know to produce its hormones, so you levels will continue to drop.

The problem could also be with the hypothalamus, which tells the pituitary gland what to do.  

Have you had any other low hormone levels?  You said you're going through menopause.  Do you know what your reproductive hormone levels are?  What about adrenal testing?  

The thyroid, adrenals, reproductive system, pancreas, etc are part of the endocrine system and when either the pituitary or hypothalamus don't give the proper signals, the glands can't make the hormones.

[karenhelton]

Hi Barb,
Thanks for the reply and letting me know about the other post. I was trying to post it in the doctor's forum and didn't realize I had posted it twice to the is one. I'm new to this and this was the first time I posted anything.

As far as my TSH it's been low right along with the other's. I was reading some of the other post and my mouth dropped realizing I have so many symptoms...like hair loss...difficulty swallowing, sleepiness, constipation, high cholesterol which keeps going up every time my blood is drawn. I just got increased to the 3.5 mg yesterday. The one doctor I'm seeing says she will test me again in 1 month and hopefully will see some improvement but I am not holding my breath. I'm so frustrated like what the heck is wrong with me. I started feeling terrible about 2 years ago but attributed it to going thru menopause (I'm in my late 40s).  My primary doctor has referred me over to an Endo..but my appointment is over a month away.  Feel terrible like the walking dead and am looking for some possible answers beside being told .."Don't worry. It'll get better."

[Barb135]

I see you have 2 threads going exactly the same, so I've reported the other one as a duplicate.

Has your TSH always been that low, or did it drop after starting the NatureThroid?