# Normal TSH,low ft4?



## lonniep (Apr 27, 2010)

I was diagnosed with Hypo last spring after a routine blood test.I was put on .50 mcg of generic levo but switched to the natural porcine med in december due to having hyper symptoms(Anxiety,mood swings,racing heart,imsomnia) even though my numbers were normal.I went to the doctor today and she increased my med from 30 mg to 90 mg.I noticed after I left that my TSH is in the normal range but my t4 was low.I got out some old lab results from last year and noticed that my TSH has always been normal and the ft4 has been the only one to be low(or normal on meds).I got her to draw more blood today to check the antibodies and ft3.With my TSH normal and my ft4 low does this mean I might have a pituitary gland problem?Here are the numbers from this weeks labs.Thanks.

FT4 .814 (.9-1.9)
TSH .846 (.270-4.200)


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## Lovlkn (Dec 20, 2009)

lonniep said:


> I was diagnosed with Hypo last spring after a routine blood test.I was put on .50 mcg of generic levo but switched to the natural porcine med in december due to having hyper symptoms(Anxiety,mood swings,racing heart,imsomnia) even though my numbers were normal.I went to the doctor today and she increased my med from 30 mg to 90 mg.I noticed after I left that my TSH is in the normal range but my t4 was low.I got out some old lab results from last year and noticed that my TSH has always been normal and the ft4 has been the only one to be low(or normal on meds).I got her to draw more blood today to check the antibodies and ft3.With my TSH normal and my ft4 low does this mean I might have a pituitary gland problem?Here are the numbers from this weeks labs.Thanks.
> 
> FT4 .814 (.9-1.9)
> TSH .846 (.270-4.200)


Hi lonniep and welcome.

Why don't we wait until the lab tests come back.

How long do your lab tests usually take before you get a report?


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## GD Women (Mar 5, 2007)

lonniep said:


> normal and my ft4 low does this mean I might have a pituitary gland problem?Here are the numbers from this weeks labs.Thanks.
> 
> FT4 .814 (.9-1.9)
> TSH .846 (.270-4.200)


Not necessarily. There could be a few other reasons for low T4.

Like Lovlkn suggested - to wait until the lab tests come back.

Need to see all three levels, done at the same draw with Labs reference range. Post them as soon as you get them.


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## lonniep (Apr 27, 2010)

Thanks for the replies.Labs should be back by monday.


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## Phoenix (Mar 20, 2010)

Hi Lonniep,

Do you know if they ran a FT3?

When you are taking a T3/T4 combination med, your FT4 will almost always be low, so they really need to run the FT3 as well to get a better picture of what your levels are like. The FT3 is important so they don't send you hyper.

The TSH can actually dip below the normal range, as long as the FT3 and FT4 are within the normal ranges. My TSH runs around 0.075 to 0.10, but my FT4 is on the lower side of the range, and my FT3 is just above midrange.

Phoenix


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## Andros (Aug 26, 2009)

lonniep said:


> I was diagnosed with Hypo last spring after a routine blood test.I was put on .50 mcg of generic levo but switched to the natural porcine med in december due to having hyper symptoms(Anxiety,mood swings,racing heart,imsomnia) even though my numbers were normal.I went to the doctor today and she increased my med from 30 mg to 90 mg.I noticed after I left that my TSH is in the normal range but my t4 was low.I got out some old lab results from last year and noticed that my TSH has always been normal and the ft4 has been the only one to be low(or normal on meds).I got her to draw more blood today to check the antibodies and ft3.With my TSH normal and my ft4 low does this mean I might have a pituitary gland problem?Here are the numbers from this weeks labs.Thanks.
> 
> FT4 .814 (.9-1.9)
> TSH .846 (.270-4.200)


If you are on natural porcine thyroid which contains T4 and T3, it is natural to see the FT4 below mid-range. However, yours is so low that I do suspect that you are still undermedicated. FT3 would be ever so helpful in this situation. And you can see why because it is your active hormone. See if you can get that test run.

Then we can take it from there. I personally need 3 3/4 grains of Armour to sustain my euthyroid status. I am also very active.

By the way; that was a big jump on the increase. The usual titration protocul is 1/4 to 1/2 grain, not a whole grain. So, I will be anxious to know how you are feeling as you continue to take the 90mgs. (1 1/4 grain)


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## lonniep (Apr 27, 2010)

This will be the first time there checking the ft3.Even when I was taking the synthetic t4 only meds the ft4 was low normal with nomal tsh numbers.I hope the increase in meds makes me feel better because I've had very little energy lately.There going to do a 24 urine test to check my cortisol levels too.I failed the flashlight in the mirror test.


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## Andros (Aug 26, 2009)

lonniep said:


> This will be the first time there checking the ft3.Even when I was taking the synthetic t4 only meds the ft4 was low normal with nomal tsh numbers.I hope the increase in meds makes me feel better because I've had very little energy lately.There going to do a 24 urine test to check my cortisol levels too.I failed the flashlight in the mirror test.


Thank you for clarifying that about only taking the T4 at the time of these labs. That's a whole different ball game then.

Hmmmmmmmmmmm; will you keep us informed on this? FT3 will be most helpful when you get it so if you want, please post results and ranges here!


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## lonniep (Apr 27, 2010)

Andros said:


> Thank you for clarifying that about only taking the T4 at the time of these labs. That's a whole different ball game then.
> 
> Hmmmmmmmmmmm; will you keep us informed on this? FT3 will be most helpful when you get it so if you want, please post results and ranges here!


The lab numbers on my first post were with me taking 30 mgs of Armour.Last years numbers were pretty close to that when I was on t4 only med.I should have the results early next week.


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## lonniep (Apr 27, 2010)

Well I finally got my lab results and somebody has screwed up.No ft3 or thyroid antibody test were made even though they were ordered.My NP hasn't called me back yet.
TSH .715 (.270-4.200)
FT4 >.825 (.900-.1900)
Prolactin 6.190 (2.700-16.900)
Testosterone 212(250-1100)
%of free Testosterone 2.72%(1.50-2.20)
ANA Positive
ANA Titer 1:80

My cholesterol and blood sugar have also been elevated.
Since I tested positive on the ANA test do you think I have hashi's?Is it possible to have hashi's with a normal TSH?
Another thing I don't understand is that I've always had some hyper symptoms such as a fast heart rate(85-115)resting,a tremor,and heat intolerance.


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## GD Women (Mar 5, 2007)

Are you scheduled for further test? And/or a repeat test perhaps adding FT-3 and antibodies along with other test.

Maybe your symptoms are from something else going on. Your levels might suggest so, but hard to relate without the FT-3. Have you been sick lately, stressed mentally or physically, on any other type of medications.

If you are not scheduled for more test, I'd call the doctors office and find out why. Your FT-4 is out of Labs and you'd want to know why...right?


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## lonniep (Apr 27, 2010)

I just talked to my NP and she said the t3 and antibodies were checked.They were on a different paper that the receptionist didn't give me.She's going to mail it to me.She didn't tell me the numbers but said my t3 levels were good and the antibodies were very low.She also is refering me to an endo.
She called the lab and they said since the titer was so low that it was probably nothing,but to recheck it in again in a couple of weeks.


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## GD Women (Mar 5, 2007)

Sounds like a good follow up.

Let us know how it turns out for you.


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## peaches (Sep 29, 2009)

I have tested normal on TSH many times with Hashi's. I have also had many symtoms of hyper along with feeling hypo most of the time. I think I get rushes of hormones that swing me hyper when my sad little thyroid trys like choo choo train to work. It says: I think I can, I think I can, I think I can, then floods my body with thyroid hormones and sends me hyper really quick. Now that I am on meds it happens less often and less violently though. I think I am definitely in a hypo stage right now though because my FT4 is not where it should be even though my TSH is .93.


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## Andros (Aug 26, 2009)

lonniep said:


> I was diagnosed with Hypo last spring after a routine blood test.I was put on .50 mcg of generic levo but switched to the natural porcine med in december due to having hyper symptoms(Anxiety,mood swings,racing heart,imsomnia) even though my numbers were normal.I went to the doctor today and she increased my med from 30 mg to 90 mg.I noticed after I left that my TSH is in the normal range but my t4 was low.I got out some old lab results from last year and noticed that my TSH has always been normal and the ft4 has been the only one to be low(or normal on meds).I got her to draw more blood today to check the antibodies and ft3.With my TSH normal and my ft4 low does this mean I might have a pituitary gland problem?Here are the numbers from this weeks labs.Thanks.
> 
> FT4 .814 (.9-1.9)
> TSH .846 (.270-4.200)


If you are taking dessicated porcine thyroid which has T3 in it (or if you are taking any T3), it is normal for the FT4 to be low. After all, T3 is your "active" hormone.

Not to worry.

How are you feeling right now this minute? Have you started the 90 mg. yet? That is a huge leap. Usually the titration is by 1/2 grain (30 mg.)

Somewhere along the line you will want to get a FREE T3 lab test. This will tell you exactly where you are at in regards to further titration and whether you are euthyroid or not. (euthyroid means normal; feeling good)


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