# Is this normal?



## bllcy (Nov 10, 2009)

I had my 4th baby in May and started developing signs of a thyroid problem shortly after that. My dr. ran some tests and my TSH and Free T4 both came back low, so she sent me to an endo. He basically said that it was a postpartum thing and that the TSH was only low because it lags behind by a few weeks. He also told me that my numbers were not low enough that they should be causing any symptoms.  He has been monitoring my numbers monthly. Here are the results:

8/18
TSH = .26 (.3-5.0)
Free T4 = .8 (.9-1.8)
Free T3 = 2.9 (2.3-4.2)

9/10
TSH = .586
Free T4 = .8
Free T3 = 3.0

10/9
TSH = .354
Free T4 = 1.0
Free T3 = 3.0

11/9
TSH = .457
Free T4 = .9
Free T3 = 3.2

Do these results seem normal? Is it right for both the TSH and the Free T4 to remain on the lower end? I thought they should be opposite of each other? I am still having a ton of symptoms and very frustrated. Any insight or ideas of what (if anything) is going on here? Is this normal for postpartum thyroiditis? Thank you for any help, I am still so confused about all of this.


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## chopper (Mar 4, 2007)

What are your symptoms?

Your VERY low TSH along with low FT4 is a concern, yes.

If you were not recently pregnant my first thought would be tsh producing pituitary tumor but pregnancy is known to throw thyroid numbers out of line so I just don't know.


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## bllcy (Nov 10, 2009)

Thanks for responding.

Here are some of my symptoms:
- tons of hair falling out (like I said this is my 4th child so I know this is normal, but this is literally by the handful and I can see my scalp now where as I used to have very thick hair)
- hair is also brittle and dry
- very foggy brain, can not find the word I am looking for a lot and stumble over my words when talking, can not remember anything or concentrate
- I lost a lot of weight right after having my baby, but then it stopped and has actually been creeping up even with breastfeeding and watching diet, etc.
- bruising on my legs
- constantly exhausted and run down feeling
- insomnia
- anxiety
- moody :ashamed0001:

I'm sure there are some more that I am not thinking of right now. I just dont know what to do next. It seems pointless to me to keep watching my numbers like this when they are staying pretty much the same. I need to call my endo, but want to know what to ask, what this could mean, etc. before I do that so that I dont just get blown off with a quick "you are fine".


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## Andros (Aug 26, 2009)

bllcy said:


> I had my 4th baby in May and started developing signs of a thyroid problem shortly after that. My dr. ran some tests and my TSH and Free T4 both came back low, so she sent me to an endo. He basically said that it was a postpartum thing and that the TSH was only low because it lags behind by a few weeks. He also told me that my numbers were not low enough that they should be causing any symptoms.  He has been monitoring my numbers monthly. Here are the results:
> 
> 8/18
> TSH = .26 (.3-5.0)
> ...


If you are not taking any T3 thyroid medication, it usually is not normal to see the FT4 so low w/TSH so low. Your FT3 has eased up there but it is still below mid-range (we do like to see it mid-range or a bit higher as this is your active hormone for energy) and now w/ FT4 so low, there is little to call upon for conversion.

Therefore, the best way to get to the bottom of this is to have some antibodies' tests. I personally don't know how the doctor could say this is only a temporary post-partum condition when he/she did not run those antibodies' tests. (I am impressed that you are getting the Frees done though; so many docs won't run them.)

So, request if you will, TPO (antimicrosomal antibodies), TSI (thyroid stimulating immunoglobulin) and Thyroglobulin Ab. This is a good place to start.

By the way, thank you for including the ranges for your lab results and welcome to the board.


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## chopper (Mar 4, 2007)

I would like to add that sometimes in the beginning stages of Hashi's and/or hypothyroid we see the Free T3 sneak up slightly as a preservation mechanism. Mine did but my TSH was also very high too at the time.

Im not a doctor and my theory may not make sense, but this is what I think happens:

As your T4 drops your body starts converting more of what is left of your T4 into T3 which is more active and useable. It does this to keep you functional (and alive) otherwise you would feel really, really tired.

Since your body is not producing enough T4 but has just about enough T3, the T3 may be just enough to send a signal to halt TSH which is why your TSH is so low.

This is the only thing I can think of to justify such a low TSH along with a low FT4, aside from either a pituitary tumor or some form of Grave's disease. If your numbers are wildly fluctuating, there is a slight chance that you just happen to have low TSH for your blood draws, although you've had many at this point.

You certainly need your antibodies checked as Andros mentioned above. I wouldn't be surprised if a pituitary MRI was called for at some point as well, once you find an endo who is familiar with thyroid.


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## bllcy (Nov 10, 2009)

Thank you everyone for the help. I did talk to my dr. (actually his nurse, apparently I wasnt worth his time) and was told that my labs are completely normal. And that I can get them rechecked in 6 months and then yearly or sooner if I develop symptoms that persist for more than 2 weeks.

I explained to her that my symptoms havent gone away, I still have all of them and have for months. She asked what they were and when I mentioned bruising on my legs she told me that wasnt even a symptom of a thyroid problem. (Is this true? I was under the impression that it was?) Then she rattled off a bunch of symptoms to watch for: intolerance to heat, feeling like I just drank 20 cans of soda... Arent these HYPERthyroid symptoms??? I wonder if they even looked at my chart.

I was basically told I have no thyroid problem at all and I should check back with my regular Dr. to see what else might be causing my symptoms. Uuhhhh! I am so frustrated!

Are these numbers completely normal? I'm not sure if I should try to get a second opinion from another endo or if they are right that the numbers are normal? My regular dr. is the one that sent me to the endo when she saw the lab results, so she must have thought they weren't normal, right? I'm so confused how this works... Is there anything else that mimics all of the symptoms of hypothyroidism?


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## Andros (Aug 26, 2009)

bllcy said:


> Thank you everyone for the help. I did talk to my dr. (actually his nurse, apparently I wasnt worth his time) and was told that my labs are completely normal. And that I can get them rechecked in 6 months and then yearly or sooner if I develop symptoms that persist for more than 2 weeks.
> 
> I explained to her that my symptoms havent gone away, I still have all of them and have for months. She asked what they were and when I mentioned bruising on my legs she told me that wasnt even a symptom of a thyroid problem. (Is this true? I was under the impression that it was?) Then she rattled off a bunch of symptoms to watch for: intolerance to heat, feeling like I just drank 20 cans of soda... Arent these HYPERthyroid symptoms??? I wonder if they even looked at my chart.
> 
> ...


Could you please get a copy of your lab tests and post the results and the ranges here? We all could help you better if you could do that.

Also, did the doctor run the suggested antibodies' tests as discussed in previous posts? TPO, TSI, Antithyroglobulin Ab??

I hear your frustration..............


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## bllcy (Nov 10, 2009)

The results are in the first post on this thread.

No, he wouldn't run any more tests. I was blown off and told that nothing is wrong with my thyroid. I dont know if I should believe him or start trying to figure out with my insurance how to get a second opinion....


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## Andros (Aug 26, 2009)

bllcy said:


> The results are in the first post on this thread.
> 
> No, he wouldn't run any more tests. I was blown off and told that nothing is wrong with my thyroid. I dont know if I should believe him or start trying to figure out with my insurance how to get a second opinion....


My mistake, I thought you had another battery of tests done.

It is my humble opinion that you indeed do have thyroid disease and as stated based on your lab tests listed, they don't appear normal as TSH, FT4 and FT3 are all in the basement.

Are these doctors not accountable? He actually told you he would not run antibodies' tests?

I would pay out of pocket then. You need to have TPO (antimicrosomal antibodies), TSI (thyroid stimulating immunoglobulin) and Thyroglobulin Ab.

You definitely need a better doctor. Even a layperson (which is what we are here) can tell your labs are not normal. Combine that with your clinical symptoms as described per you, this is like a no-brainer.

It is very difficult to advocate for yourself when you don't feel well. That is part of why we are here; to give you the courage and the knowledge to do battle w/ the medical establishment.

Hugs,


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