# FT4 still seems a little low...



## Scanders (Sep 9, 2015)

My prior labs on 1.25mg MMI were TSH .23 (.2-4.5), FT4 .9 (.5-1.7), FT3 2.5 (1.7-3.7). She agreed to a trial off MMI, and after 6 weeks my labs were: TSH .03, FT4 1.0, FT3 2.9 (same ranges.) I was a little surprised FT4 didn't rise a little more without methimzaole to tamp it down. I think I feel OK, and certainly better than I did even a few months ago. But I'm still not sure I feel as well as I could. I would really like to have a better thermostat, and for my ears to stop ringing so loudly. And my husband said I'm nuts if I think I'm "normal". Apparently I'm not quite back to being myself yet..., but to be honest, I'm not sure I remember what that is. (I suppose "nuts" goes with graves?)

Does this FT4 seem a little low? Would you think my FT4 might just continue to rise, even though it was a pretty minimal rise over the past 6 weeks? I know there's no way to tell what might happen here, but I think I'm looking for experience of others after stopping MMI. My endo has (finally) said as long the hormone numbers are normal and I feel well she won't worry about the low TSH.

Any insight? Thanks!


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## Lovlkn (Dec 20, 2009)

Yes - your FT-4 and FT-3 are both on the low side. Somewhere between 1/2 - 3/4 of range would be a good goal.

Antibodies really can skew results and in your case, you apparently have your fair share with such a low TSH.

Is anyone really ever "normal" after dealing with thyroid disease?


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## Scanders (Sep 9, 2015)

Any ideas how to boost those a bit? Any supplements? I think I've done what I can with diet and exercise, and there aren't any meds to tweak. Or, most likely, I just have to ride it out and see what happens in the next 6 weeks?

Thanks!


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## Lovlkn (Dec 20, 2009)

I see the issue as a doctor taking a hyper person and making them completely hypo.

Hopefully just being not medicated on any anti thyroid meds will help raise it. The only other option would be block and replace - most doctors are not experienced or confident enough to try this approach.

Did your eyes get worst since going hypo? MMI can actually have a calming effect on TED, however it you do not have labs to support taking ti then it's not an option.

I feel the key to helping manage your TED is to NOT be kept hypo and to ignore the TSH and focus on FT-4 and FT-3. In your case your FT-4 was not high to begin and it was your FT-3 causing the majority of hyper in your case.

Have you had an ultrasound of your thyroid?

Are you considering any "permanent" option such as surgery to remove your thyroid?


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## Scanders (Sep 9, 2015)

Actually, my eyes feel all right just now. I do think the hormone levels directly affect how my eyes feel. Lately, it seems that FT4 lower than .9 brings eye discomfort, and uncomfortable menopause symtpoms.

At least my endo has given up on raising TSH with MMI. But you're correct that she isn't comfortable with block and replace. As far as she's concerned, these hormone numbers are very good. We'll recheck labs in 6 weeks. She's talked about TT in the past, but hasn't brought it up in a while, maybe because I hadn't been especially receptive. I think I'm a little more open now. I still find it surprising that just small fluctuations can affect me so much. But again, I don't feel so horrible as I did a few months ago. (I just wonder if I can feel even better.)

And for now I guess I just have to wait and see what happens next--no way to coax things along.


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## Lovlkn (Dec 20, 2009)

Your endo needs th focus on your FT-4 and FT-3 levels.


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## Jolanta (Aug 21, 2016)

Scanders said:


> My prior labs on 1.25mg MMI were TSH .23 (.2-4.5), FT4 .9 (.5-1.7), FT3 2.5 (1.7-3.7). She agreed to a trial off MMI, and after 6 weeks my labs were: TSH .03, FT4 1.0, FT3 2.9 (same ranges.) I was a little surprised FT4 didn't rise a little more without methimzaole to tamp it down. I think I feel OK, and certainly better than I did even a few months ago. But I'm still not sure I feel as well as I could. I would really like to have a better thermostat, and for my ears to stop ringing so loudly. And my husband said I'm nuts if I think I'm "normal". Apparently I'm not quite back to being myself yet..., but to be honest, I'm not sure I remember what that is. (I suppose "nuts" goes with graves?)
> 
> Does this FT4 seem a little low? Would you think my FT4 might just continue to rise, even though it was a pretty minimal rise over the past 6 weeks? I know there's no way to tell what might happen here, but I think I'm looking for experience of others after stopping MMI. My endo has (finally) said as long the hormone numbers are normal and I feel well she won't worry about the low TSH.
> 
> Any insight? Thanks!


Hi, it is beneficial to look at the antibodies levels before stopping MMI. No test can predict remission but it is usually determined by looking at TSI levels. The remission occurs when a person stops producing TSI and has a stable and normal TSH levels for six months. It is difficult to know if your FT4 levels start rising again but you can help the situations by following some other holistic approaches. MMI takes about 6 weeks to work.

Wishing you the best of health


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## Scanders (Sep 9, 2015)

Thanks. My last labs in early August were nearly identical to the labs from June. My endo did not test Trab. She said she could tell by my low TSH that there are still antibodies at play. She said she was still OK with the low TSH for now as long as my thyroid hormone levels were normal, and was OK with remaining off the MMI..

Were you referring to holistic approaches to raising FT4, or were you talking about holistic approaches to treat hyperthyroid in general? I feel about the same as I did in June, although one week I'm pretty convinced that I'm becoming hypo, and the next I wonder if I'm becoming hyper. I expect this is just my vivid imagination...


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