norm tsh and low ft4

[Sandy2803]

First of all,  i have been told i have fybromyalgia.  Cynbalta isnt working as well anymore. Im also tired allllll the time but dr said its cuz of fybro.  I also have weight gain and constipation.  Well I work in a lab and noticed drs always ordering free t4 with tsh.  So i had dr to check those...my tsh is 3.15 and free t4 is .70...tthe drs at work ssaid that i need to go to endo but my dr isnt concerned.  What r ur thoughts?

[Woodsyone2]

Don't know if it will help but I've had constant joint pain, extreme fatigue and weight gain. Turns out my TSH was high and my FT3 was so low was abnormal. Thank goodness my Dr. decided to listen and loweredy synthroid and added a T3 medicine. Joint pain is gone. Not as fatigued. Feeling much better..Wishing ya luck in finding a good Dr. And one that listens.

[gimel]

You have a number of symptoms that frequently are related to being hypothyroid.  Fibromyalgia is often related to being hypothyroid.  Your Free T4 and TSH results are further indicators of the possibility of needing thyroid medication.  You also need to test for Free T3.  Scientific studies have shown that Free T3 correlated best with hypo symptoms, while Free T4 and TSH did not correlate at all.

So, it appears you do need to find a good thyroid doctor.  That does not always mean an Endo.  Many of them specialize in diabetes, not thyroid.  Frequently they have the "Immaculate TSH Belief" and only pay attention to TSH.  That doesn't work.  If they test beyond beyond TSH and test Free T4, then they will use "reference Range endocrinology" and tell you that a test that falls anywhere within the range is adequate.  That is also very wrong.  

A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms without being constrained by resultant TSH levels.  Symptom relief should be all important, not just test results, and especially not just TSH results.  You can get some good insight from this link written by a good thyroid doctor.

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

In trying to find a good thyroid doctor there are two main questions.  Will the doctor treat a hypo patient clinically as described?  And will the doctor prescribe T3 type meds, such as Armour and Cytomel?  If either answer is no, then you need to keep on looking.

Whenever you go back for testing you should always request to be tested for Free T3 and Free T4.  Insist on it.  Also, since hypo patients are frequently too low in the ranges for Vitamin D, B12 and ferritin, you should test those as well.