# High TSH, but good FREEs -- Confused



## Hypoman (Aug 7, 2010)

Hi All,

Back with an update. So my doctor agreed to lower my Synthroid to 137mcgs from 150mcgs. This was three and a half weeks ago.

Just got new lab results:

TSH 3.390 (0.450 - 4.500)

FT4 1.72 (0.82 - 1.77) 
FT3 3.6 (2.0 - 4.4)

My labs before the drop in Synthroid looked like this:

TSH 1.9 (0.450 - 4.500) 
FT4 1.74 (0.82 - 1.77) 
FT3 3.2 (2.0 - 4.4)

My TSH has gone up considerably, but my Free T3 looks pretty great. I've never had my FT3 above a 3.5!

Why would TSH be high, but FREEs look good? Is this a fluke in the test because I didn't wait the full 4 weeks? What do these new labs indicate?

I felt better for a bit, but have since packed on 6 pounds! SO discouraged. I can't seem to get myself feeling better with any combination of meds. Any help would be greatly appreciated. I'm super down.


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## joplin1975 (Jul 21, 2011)

I'm readings along...but don't have a really good answer. So I'm hoping to bump this up so somone else see this.


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## Andros (Aug 26, 2009)

It could have something to do with the thyrotropic feedback loop but this is a question for your doctor. Has he/she commented? Sometimes there are disrupters to the receptor sites.

And also, sometimes there is a lag time between the Free T3 and TSH meaning that the TSH is slow to respond.

Let us know what your doc has to say.


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## Hypoman (Aug 7, 2010)

Thanks Joplin and Andros,

I have an appointment coming up, so I'll definitely be asking. Would the TSH go up, and then come down over time? Because the Frees look rather good.


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## Lovlkn (Dec 20, 2009)

My experience - TSH is directly affected by FT-3 labs and you are not at 3/4 of range.

When you are on replacement medications - your body still has fluctuation in "need" of thyroid hormone. TSH also lag's so in your case on your labs - your medication was reduced - thus the higher TSH and somehow your Free's both went up - which would tell me your body began utilizing more of the hormone you were ingesting. Did you take your replacement the same time the day prior to the test - did you have the lab draw at the same time of day both times?

I'm no doctor - I just speak from my experience and can tell you that after being on replacement medications for 11 years - sometimes labs change and it just does not make any sense. This is why we pay attention to the FT-4 and FT-3.

Your labs look to me like you should ask for a 5mcg dose of Cytomel to try and raise your FT-3 into 3/4 range and lower your Levothyroxine to try and get it into the 3/4 of range rather than top of range. These small changes can make a huge difference.


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## Hypoman (Aug 7, 2010)

Thank you for the response Lovlkn. I'm a little confused -- won't my TSH go up even more if I drop down to 125mcgs?

The irony is, that's where I started this whole journey, and it looks like I'll end up right back at the same dose.


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