# TSH below zero! Now what!?



## jeffbursens (Mar 24, 2014)

Dear companions,

I have an important question. 
My last blood work from one mouth ago revealed a TSH of - 0.16. (ranges 0.3-4.5) 
Though my levels of free T3 & T4 were midrange and maybe even slightly lower than they should be. 
FT3: 3.30 (ranges 2.1-4.2) 
FT4: 1.02 (ranges 0.7-1.8)

I'm on 112,5 levothyroxine and 12,5 cytomel daily dose. 
Is it safe to have a TSH that low? 
Can I even upgrade my meds to 125 levo a day? I still feel hypo and under medicated. 
I did hear about the 'optimal' values between the ranges were a lot of people are on their best in their 'sweet spots'. 
If the rule of thumb is that FT4 has to be 50% of the range and FT3 upper half to upper third, i's logical that I'm still hypo. This all being said, will my TSH drop even more when I go to 125?

I don't understand the link between TSH and the FT3 & FT4 results. How can I have such a low TSH and still not reach the recommended levels?

Thanks everyone and shoot back if you feel like! 
Jeff Bursens


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## Andros (Aug 26, 2009)

When taking exogenous T3 (your Cytomel), this is normal. Also, it would not be wise to add more T4 to the mix.

You could use a tad more of Cytomel; like say 2.5 mcgs. and see if your FT3 gets a little higher which for most of us would be a good thing.

The ratio should be 4 to1. 4 being your T4 (Levoxyl) and 1 being your T3 (Cytomel.) If you add more T4, you probably won't feel too well.

Humble opinion based on a world of experience.

And it is safe so far as any of us know. Mine is like that always as I take 3 1/2 grains of Armour Thyroid daily.

Do you have a thyroid? If so, it does not appear to be putting out Thyroid Stimulating Hormone which is probably the reason you are on Thyroid replacement medication?


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## Lovlkn (Dec 20, 2009)

jeffbursens said:


> Dear companions,
> 
> I have an important question.
> My last blood work from one mouth ago revealed a TSH of - 0.16. (ranges 0.3-4.5)
> ...


Jeff,

How do you "feel" physically/mentally?

3/4 of range for your FT-3 is 3.68 and your level is 3.3

3/4 of range for your FT-4 is 1.53 and your level is 1.02

I for one do not run any or very little TSH - my most recent labs done last week...

FT-4, 1.42 (.82 -1.77) FT-3, 3.4 (2.0-4.4) 125mcg +12.5mcg Cytomel

FT-4 mid 1.295 ¾ 1.53, FT-3 mid 3.2 ¾ 3.8

TSH 024 (.40-4.0)

I ALWAYS have little to NO TSH yet my Free labs are either at or slightly above or below mid to 3/4 of range.

Most doctors do not know what to do other than reduce replacement medications with the lack of TSH to cover themselves due to the low TSH and osteoperosis connection. Several years back I asked my doctor at the time to run a TBII antibody test which I understood as the "stimulating antibodies" test. Mine was high and over high range so she accepted that for about 8 months then got concerned about my TSH again so I found a new doctor - rather than reduce my medications because at the time my FT-3 was still well below range and prior to my adding Cytomel. Once I added Cytomel my TSH completely disappeared and is always below low range.

Because you appear to not run a TSH when medicated to mid range - you will have to be vigilant in keeping on your doctor to NOT lower your dose. I for one feel you might stand a slight increase in your T-4 medication. Alternating 112 and 125 for the first lab draw would be a better idea than going to the full 125 in my opinion.



> I'm on 112,5 levothyroxine and 12,5 cytomel daily dose.


How long have you been on this dose?


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