Excerpt from Healthline - T3 test...
"Abnormally low levels of T3 may indicate the following:
long-term illness (T3 levels decrease when you are sick. If you’re sick enough to be hospitalized, your T3 levels are likely to be low. This is one reason that doctors do not routinely use the T3 test as a thyroid test, but usually use it along with the T4 and TSH test to get a more complete picture of how your thyroid is working)
hypothyroidism
starvation"
Excerpt from Wikipedia's article Hypocholesterolemia...
"Possible causes of low cholesterol are:[citation needed]
statins
hyperthyroidism, or an overactive thyroid gland
adrenal insufficiency
liver disease
malabsorption (inadequate absorption of nutrients from the intestines), such as in celiac disease
malnutrition
abetalipoproteinemia - a rare genetic disease that causes cholesterol readings below 50 mg/dl. It is found mostly in Jewish populations.[2]
hypobetalipoproteinemia - a genetic disease that causes cholesterol readings below 50 mg/dl[2]
manganese deficiency
Smith-Lemli-Opitz syndrome
Marfan syndrome
leukemias and other hematological diseases[3]"
Gimel,
Wow. This is such a thorough and helpful answer. Thank you so much. I have read such horrible things about Synthroid and have been so scared of it that I think I just ran away too quickly when things went adverse.
My current doctor is actually really supportive, saying that we treat the symptoms and not the numbers. So far, I am very impressed.
I am a bit shocked that my T3 numbers are lower than what you usually see. I guess I never figured things were that bad (or they felt really bad to me but I assumed I was just a bit off because my TSH was always normal. Happy I found a doc that will test everything.) Do such low numbers mean I will end up on a very high dose of synthroid? Or is that impossible to tell? Any clue of when I might feel even slightly better with the increased dose?
I will look into having those other labs done. I have been taking extra B vitamins and a really good multi-vitamin for awhile, and just started taking extra D as well. I do also take iron (though admittedly not consistent with it). I will make sure to be more consistent and to get those levels tested as soon as I can. Again thank you.
I really appreciate the help and support. It means so much to have some answers when all I have had for so long is fatigue and questions! If you have any other thoughts or advice, I would really appreciate that. I will try the increase of synthroid again tomorrow. I keep questioning it...wondering if something else is better. Again, I think I'm just nervous from the horror stories I've read and then scared off by my bad experience this week.
Last thing, which might be too much to ask, but any thoughts or suggestions for sources of information on treating hypothyroid and fertility? I know that docs pay way too much attention to TSH and that a high TSH is a risk factor in pregnancy. But if TSH isn't really the best indicator, what about the other levels? I ask because my husband and I are about to try to conceive and I wonder if we should wait (I don't want to risk any complications, of course). Last time around, my FT3 was not tested but my other levels (TSH and FT4 looked almost identical: 1.06 TSH and 12 Free T4).
Again, I thank you so much. You have just done such a selfless and wonderful deed by taking the time to help me out. I am so grateful.
You are correct about TSH. At best it is only an indicator, to be considered along with more important indicators such as symptoms, and also levels of the biologically active thyroid hormones, Free T4 and Free T3. The best use of TSH is actually to distinguish between primary hypothyroidism (Hashi's) and central hypothyroidism. Central is due to a dysfunction in the hypothalamus/pituitary system, characterized by relatively low in the range TSH which results in low Free T4 and Free T3.
Your Free T4 is near rock bottom of the range and your Free T3 is below range, which we don't even see too often. So no wonder you have hypo symptoms and feel so bad. Many members say that relief from hypo symptoms required Free t4 at the middle of its range, at minimum and Free T3 in the upper third of its range, or as necessary to relieve symptoms.
A good thyroid doctor will treat a hypothyroid patient clinically by testing and adjusting Free T4 and Free T3 as necessary to relieve symptoms, without being constrained by resultant TSH levels. Symptom relief should be all important, not just test results. You can get some good insight from this link written by a good thyroid doctor.
http://www.hormonerestoration.com/Thyroid.html
Regarding your increase in Synthroid, a couple of possibilities come to mind. One is that you do need to try it again and try to get through any adverse feelings for a few days to give it a chance. Realize that your body has been very low on thyroid hormone and may need time to acclimate to having it again. Another possibility is that patients often find that when starting on thyroid med, their TSH level will be diminished and in turn cause lower output of natural thyroid hormone, with the overall effect of no gain, or even a slight reduction in Free T4 and Free T3 levels. The third possibility that comes to mind is that hypo patients are frequently too low in the ranges for Vitamin D, B12 and ferritin. These need to be optimal to prevent related symptoms. D and ferritin are very important for metabolizing thyroid hormone. If ferritin is too low, starting on T4 thyroid med is reported to sometimes cause reactions.
So, to be sure of your status, I suggest that you should find a way to get your Vitamin d, B12 and ferritin tested. D should be 55-60. b12 in the very upper end fo the range, and ferritin should be 70 minimum.If these are not optimal you can supplement on your own to raise the levels.
I don't think iodine would be a concern. If your iodine was too low for adequate output of thyroid hormone, then I would expect that the TSH would be higher. But rather than discard the thought you can certainly ask for that to be tested also.
So, for now, I think I would stick with the Synthroid and try out the increase again. I would also push to get those additional tests done as soon as possible, so that we can better understand what you need. If you have reservations about your latest doctor being a good thyroid doctor, we can possibly suggest one in your area if you will tell us your location. Since it may take time for an appointment, it is good to get started on that if needed.