TSH of <.004

[nancygif]

Hi, I have been treated for  Hashi's for just over 3 years (June '05).  
I was started on just synthroid then added cytomel  in Dec '06.  Adjustments made at first and things were good until this past Feb when after blood work my doctor said my TSH was too low and he dropped my synthroid.  
Repeat blood work in early May showed TSH still low so another reduction in synthroid.  Blood work at end of June again low TSH = decrease in synthroid.  Late August TSH .12 (.45 - 4.5).  Doctor said T4 and T3 fine each time and lowered synthroid again.  
Got latest labs back yesterday in the mail (a first) and my TSH is <.004 with Free T4 of .64 (.61 - 1.76).   I am taking half the dose of synthroid now (1/2 of a .125 tab a day) then I was back in January (.125 a day).  My cytomel dose through all of this was 15 mcg in morning and 25 mcg at 3pm.  
The hypo symptoms have returned so 2 weeks ago I increased my cytomel to 20 in the morning and 30 at 3pm in hopes of feeling better.  
The biggest bummer is I have gained 9 lbs in the past 8 months after losing 20 lbs 3 years ago and keeping it off.
Another tidbit is I am 51 and had my first bout of hot flashes a month ago.  They were every day for 7 days straight and haven't had any since.  My period is crazy but don't know if its thyroid or peri-menopause.    
I've been researching all of this online and am wondering if I could have adrenal failure and/or estrogen dominance.  
I am expecting my doctor to call as soon as he gets the results.  I did email him and tell him about the weight gain and the return of hypo symptoms but being as he is a family doctor and not a specialist, I assume he will just say to decrease the synthroid again.  
What should I pose to him as a next step in figuring this out.  Is there a medical website he could go to for more info on hypothyroidism that he would trust (even though we all know that this site and others like it is where the real truth is).  Would a total change in meds (armour) help?  What tests should be done?
Thanks for your help.
Nancy

[AR-10]

Bump for another look.

[nancygif]

Thanks for replying with great information.  
I didn't have my free T3 done this time but did in late Aug - don't know the number just that my doctor said my T3 and T4 were both fine. He didn't say "free" but free was on the lab script.  I called today to get copies of all my past labs - should have them by Mon or Tues and will then add them to my tracker.  As far as the amount of cytomel - I just built up to it under the guidance of endo doctor (don't see him anymore) until I felt good and he was happy with my labs.  There are occasional times when it is too much and I will cut back for a few days then build back up.  This whole experience has been one of getting in tune with what my body is telling me, learning by trial and error and reading tons of information online ( which is what led me to this site yesterday).  
Question for anyone else - what is the connection between hypo and estrogen dominance?  
Thanks, Nancy

[AR-10]

Adrenal testing sounds like a good idea.
Estrogen dominance is not something I am familiar with.

When was the last time you had your Free T3 checked? I know you said you have hypo symptoms, but you are taking a LOT of Cytomel, and that could push your Free T3 high, your TSH low, and give you ups and downs every day.

Is your doctor running Free T3 tests or Total T3 tests?
Are you sure the Free T3 level is "ok"(low)?

I can't imagine he would lower your Synthroid again when you are so low on Free T4 now.

Still, your TSH is practically zero, and I think if your Free T3 was through the roof you would feel hyper.

Verify that your Doctor is running a Free T3 and your result is above midline but not pegged out at the top.

If that is the case, then test the adrenals and the pituitary. It may be that your pituitary is not producing TSH as it should. It may be that your adrenals are shot, and they are putting the brakes on, slowing down the thyroid in an attempt to keep up.