low tsh

[maggie106]

Over the last 4 mths my tsh has gone from .10 to .05 with my t-3, t-4, t-free all normal. the dr took me from 100 mcg 7 days a week to 75mcg - 6 days.  i am curious if cobalt (level is 6.6) and chromium (level 1.5)poisoning have anything to do with my the tsh issue.

[lindaed]

  my TSH 0.01 - L
  my T4 FREE 3.0 H
  MY T3 TOTAL 270 H
   my T3 UPTAKE 38 H
   my RED BLOOD CELL COUNT 5.27 H
   please help,Thanks,Linda

[gimel]

I have lots and lots of data supporting the contention that suppressed TSH is not a cause for alarm, unless there are also hyper symptoms due to excessive levels of the biologically active thyroid hormones.  If the active thyroid hormones FT3, and FT4 are actually still within the reference ranges that the doctors use so much, then how can there be a concern with a low TSH?  The doctors have no good answer for that, they just fall back on what they were taught, or what they've read about suppressed TSH being a concern.

This is a link to a lot of references on thyroid issues.  It was put together by a good thyroid doctor.  

http://www.hormonerestoration.com/files/Thyroid.doc

If you read through the link, you'll see these quotes.  "LT4 therapy given at a dose sufficient to reduce TSH to 0.27-0.005 microIU/ml and maintain normal serum values of free triiodothyronine (FT3) and free thyroxine (FT4) did not cause bone loss in pre or post-menopausal women. Appetecchia 2005

"“restoration of serum TSH to the reference range by T4 alone may constitute inadequate hormone replacement.” (Tigas, 2000)"Muscle breakdown occurs only with free T3 and free T4 levels several times upper limit of reference range.  It resolves when treatment raises TSH to 0.01 and lowers free T3 and free T4 to top of ref. range Riis 2005"

"Some patients achieve a sense of wellbeing only if free T4 is slightly elevated and TSH low or undetectable."

" A score of 8 main symptoms of hypothyroidism, serum thyroxine radioimmunoassay (T4-RIA), serum T4-RIA/thyroid binding globulin (TBG), 24 h urine free triiodothyronine (T3) were considered before and after treatment. The score of these 8 main symptoms is a reliable expression of their illness in 97% of hypothyroid patients. 24 h urine free T3 correlates better with the clinical status of hypothyroid patients (R2 = 0.30) than serum T4-RIA (R2 = 0.12), and even better than T4-RIA/TBG (R2 = 0.19). Other investigators were unable to find any correlation between serum thyroid stimulating hormone (TSH) or serum free T4 and thyroid symptoms. The dosage of natural desiccated thyroid (NDT) has a correlation with 24 h urine T3 of R2 = 0.50. Conclusions: In this study symptoms of hypothyroidism correlate best with 24 h urine free T3. (Assumedly, serum free T3 would also correlate better with clinical status than serum free T4 or TSH".-HHL)


If you want to visually see the variability of TSH that inhibits its utility for diagnosing thyroid issues, have a look at Fig. 2 on page 5 of this link.  If you have trouble with the link, let me know.  I had a bit of difficulty with it.

http://optics.merck.de/servlet/PB/show/1809250/Thyroid-Inter-3-2008.pdf










"

[jtlmom1577]

My TSH over the last 3 months has consistently been .02....I was able to convince my GP that I was fine (not hyper) but after the 3rd blood test came back, she consulted a "Thyroid expert" and is freaked about the TSH.

Logically, one would think that the pituitary gland is actually doing its job correctly if the levels of T4 in the blood are accurate.  

What I need is more documentation to present to my doctor that it is OK to have a TSH level of .02.  Can you help.

[maggie106]

Thank you very much for the explanation. I felt better when I was on 100mcg  so I really wished he would not have changed it to 75mcg. I see him in a couple weeks and will talk to him about putting me back where I felt better. Again....thank you for your input and the website you sent me to.

[gimel]

It is a very common occurrence that patients have suppressed TSH when taking significant quantities of meds, especially T4 meds.  This does not mean that you are hyper, unless you have hyper symptoms due to taking excessive amounts of meds.  If your T4 and T3 tests were all "normal", the doctor's decision to reduce your meds is just wrong, unless you came up with hyper symptoms all of a sudden.  For example my TSH has been .05 for over 25 years with never a hyper symptom.  In fact I had lingering hypo symptoms until I learned about the importance of free T3 on this Forum and got my meds changed to include a source of T3.  Now I feel best ever.  

TSH is a pituitary hormone that is affected by so many variables that it is totally inadequate as a diagnostic by which to medicate a patient.  After being put on medication a patient;s TSH is even worse as an indicator, because of the suppression effect.  Unfortunately few doctors really understand this.  I think you will find interesting this quote from the Sept., 1986 British Medical Journal.   "We consider that biochemical tests of thyroid function are of little, if any, value clinically in patients receiving thyroxine
replacement. Most patients are rendered euthyroid by a daily dose
of 100 or 150 ,tg of thyroxine. Further adjustments to the dose
should be made according to the patient's clinical response."

This is consistent with my definition of a good thyroid doctor.  A good thyroid doctor will treat a patient clinically by testing and adjusting levels of the biologically active thyroid hormones, free T3 and free T4, as necessary to relieve symptoms, without being constrained by resultant TSH levels.  Symptom relief should be all important, not test results.  Test results for FT3 and FT4 are most useful as a baseline for monitoring progress toward symptom relief as meds are increased.  

I think you will find what I've said to be consistent with the direction in this form letter.  The letter was written by a good thyroid doctor and sent to the PCP of patients who are consulting with the author from a distance.  It is intended tohelp guide the patient's treatment.  

http://hormonerestoration.com/files/ThyroidPMD.pdf