# Low TSH, low free T4, low free T3, please help!



## Savestheday (Jun 18, 2011)

Long story short, I've been on thyroid medicine for a little over a year now. I started out on Cytomel only because my labs were all within normal range but the doctor thought I could benefit from some T3. A few months ago I still didnt feel the way I thought I should; could still use more energy and had the weight gain. I was put on 1 grain of Armour and 25 mcg of Cytomel. Well a few months of this and I didn't feel any better so I decided to try a new doctor who is an M.D. but with a more alternative side because I believe I have adrenal fatigue as well and my old doctor didn't believe in that.

The new doctor gave me an IV of dmps for a heavy metal provocation test, and gave me Nature-throid to try (1 grain). The next day (while still on Armour even though I missed a full day's medicine) I had a blood test for my thyroid. There results were:

TSH: .03 (.4-4.5)
Free T4: .5 (.8-1.8) 
Free T3: 1.7 (2.3-4.2)

My heavy metals test showed no heavy metals, and I am still waiting on my saliva cortisol results to show if I have adrenal fatigue. About a week after being on Nature-throid, I started getting symptoms of what I thought were hyper symptoms (lots of anxiety/panic, nervousness, lightheadedness when standing or sitting up too long, some nausea, muscle weakness/fatigue in arms and legs, hypoglycemia symptoms if I don't eat in time etc.) so the next day I reduced both medicines to 1/4 of each pill, and the day after that I stopped the Nature-throid all together.

While having these symptoms on Nature-throid and Cytomel, I went to my general practitioner to see if something else was going on. She did a metabolic panel and some other things which all came out normal except my thyroid results which were:

TSH: <.01 (.4-4.5)
Free T4: .7 (.8-1.8)
(this doctor wouldn't test free T3)

Over the next few days I started to feel better, but now I am feeling very bad again with the anxiety, nervousness, and weakness in arms and legs. I have been reluctantly taking a Xanax to help me sleep until I can get to my original endocrinologist on Tuesday (today is now Saturday).

My question is, does anyone know why all of my levels are so low, and if I should be taking my thyroid medicines? I've been only taking 1/4 of my Cytomel which is 6.25 mcg because I thought these were hyper symptoms, not hypo. I can't stand this anxiety! Please help, any info is greatly appreciated! Sorry for such a long post, thank you!


----------



## Andros (Aug 26, 2009)

Savestheday said:


> Long story short, I've been on thyroid medicine for a little over a year now. I started out on Cytomel only because my labs were all within normal range but the doctor thought I could benefit from some T3. A few months ago I still didnt feel the way I thought I should; could still use more energy and had the weight gain. I was put on 1 grain of Armour and 25 mcg of Cytomel. Well a few months of this and I didn't feel any better so I decided to try a new doctor who is an M.D. but with a more alternative side because I believe I have adrenal fatigue as well and my old doctor didn't believe in that.
> 
> The new doctor gave me an IV of dmps for a heavy metal provocation test, and gave me Nature-throid to try (1 grain). The next day (while still on Armour even though I missed a full day's medicine) I had a blood test for my thyroid. There results were:
> 
> ...


Good grief!!! With all that and your Free T3 is in the basement? We expect FT4 to be low when taking exogenous T3. But.........................if I were you, I would ask your doctor to run rT3 test (reverse T3) because that T3 has got to be going somewhere and I think an antibody is blocking the receptor site for FT3 and causing a conversion to rT3.

Here is info on that.

rT3
http://thyroid-rt3.com/whatis.htm

Reverse triiodothyronine (rT3) is a thyroid hormone produced primarily from monodeiodiation of the inner ring of thyroxin. Approximately 85% of T3 synthesis and nearly all of rT3 production may be attributed to the deiodination of T4 in the periheral tissue rather than by direct secretion by the thyroid gland. Physical, mental and environmental stresses can inhibit the deiodinating enzyme, 5′ - deiodinase, causing less T4 to be converted to T3, thus decreasing the amount of active thyroid hormone available to the cells. More T3 is then shunted towards rT3 causing an elevation in rT3. Once identified, there are several alternative approaches to treatment.

rT3, unlike T3, does not stimulate thyroid hormone receptors. However, rT3 binds to these receptors, thereby blocking the action of T3. Under stress conditions, the adrenal glands produce excess amounts of cortisol. Cortisol inhibits the conversion of T4 to T3, thus shunting T4 conversion from T3 towards rT3. As a consequence, there is a widespread shutdown in T3 binding across the body. This condition is termed Reverse T3 Dominance. It results in reduced body temperature, which slows the action of many enzymes, leading to a clinical syndrome,

Please continue reading here..........
http://en.wikipedia.org/wiki/Reverse_triiodothyronine

And yes, you could have adrenal fatigue but which came first, the cart or the horse.

If I were you, I would request rT3 lab.

And if you have not had any antibodies' tests, I would suggest that you do.

TSI (thyroid stimulating immunoglobulin),TPO (antimicrosomal antibodies) TBII (thyrotropin-binding inhibitory immunoglobulin), Thyroglobulin Ab, ANA (antinuclear antibodies), (thyroid hormone panel) TSH, Free T3, Free T4.

You can look this stuff up here and more.........
http://www.labtestsonline.org/

What was your original diagnosis?

And.......................I can not advise you on your med; only your doctor can do that. Always trust your instincts though; that is a given.


----------



## Savestheday (Jun 18, 2011)

Thank you for your reply. I should have added the results for those other tests:
Reverse T3: 14 (11-32)
Thyroid peroxidase antibodies: 16 (<35)


----------

