# QUESTIONS ABOUT NEW LAB RESULTS- suppressed TSH



## loretta (Nov 18, 2010)

Hi,

My daughter just came back with lab results after being on 60 mg of armor for six weeks. Her doctor tested her FT3 and TSH and said that he was not comfortable with her TSH being as low as it is. she does not feel anything not better and not hyper, however, he feels that since her TSH has gone from 1.89 to 0.29 that she is now going into to a hyper state even though she doesn't have any hyper like symptoms. she basically thinks that she feels the same with no real changes to her energy through out all of this. We have an appointment with a new doctor in a few days and until then, he recommends that we half her dose, which we will do.

Here is my question: After reading tons of testimonials from people who has a suppressed TSH and feel great yet complain that even though they best at their present dose their doctors want to lower their dose because their TSH is below range. these folks are refusing to lower their dose because they are symptom free and don't have any hyper like symptoms. 
I am wondering what is the right way to be viewing this? As I said we are going to see another doctor in a few days and we will get his take on it.

The difference between my daughter and these other folks who say that they feel good at their present dose even though their tsh is suppressed and her is that my daughter still has symptoms of low energy, etc., and doesn't feel any better. Is it possibly to be hyper and not have any hyper like symptoms? Does anyone have any thoughts on this? BTW, he did not test her FT4.
Thank you!

Here are her labs past and present:

Her new labs TSH-0.29
FT3-3.7
did not test FT4 this time

Old Results
TSH- 1.89
ft4 - 1.21 
ft3 - 3.3.
Rt3-302
cholesterol is high @ 210 ref range-<199
triglicerides 71 (ref range <149
HDL 64 (ref r. -40-59
LDL 132- high (ref range-<=99)
B12 is good 
Adrenals tested normal
thyroglobulin antibody-<20 range 0-40
thyroid peroxidase ab-<10 range 0-35

Reference ranges
FT3-2.3-4.2
FT4- 0.75-2.00
RT3-90-350
THS-0.30-4.70
ferritin-10-291
iron-40-150


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## lainey (Aug 26, 2010)

Fatigue is a cross over symptom for both hyper and hypothyroid. Many people mistakenly believe that because their TSH is lower, they will automatically have more energy--the hyperthyroid state, because the body is always "on", can be exhausting too.

Armour, by it's nature, will suppress TSH because it contains an unnaturally high amount of T3 relative to what is produced by the body. When a doctor who prescribes this knows this, they are not disturbed by the suppressed TSH but instead use the Free T3 as the gauge for medication levels.

Your daughter's free T3 is approaching the top of the range, and likely she should not change her dose at this time.

Has ferritin and vitamin D been tested? Low levels of these can give symptoms of hypothyroidism.


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## Andros (Aug 26, 2009)

loretta said:


> Hi,
> 
> My daughter just came back with lab results after being on 60 mg of armor for six weeks. Her doctor tested her FT3 and TSH and said that he was not comfortable with her TSH being as low as it is. she does not feel anything not better and not hyper, however, he feels that since her TSH has gone from 1.89 to 0.29 that she is now going into to a hyper state even though she doesn't have any hyper like symptoms. she basically thinks that she feels the same with no real changes to her energy through out all of this. We have an appointment with a new doctor in a few days and until then, he recommends that we half her dose, which we will do.
> 
> ...


Hi there and welcome. It is not good when a doc treats by TSH alone although I am impressed that he runs the FT3 and FT4 but beyond that, he apparently does not know what to do with the results.

Your daughter's FT3 (most recent) is exactly where it should, that being slightly above the mid-range of 3.2 of the range furnished by your lab. When taking Armour, it is "expected" that the FT4 will be lower than the mid-range and this is as it should be for T3 is the active hormone.

Actually, the doc should be doing labs about every 8 weeks and continue the titration process if needed until your daughter feels great as all daughters should.

How old is your daughter?

What is her ferritin? I see the reference ranges there. Also noting that rT3 is awfully high.
You may benefit from reading this.
http://thyroid-rt3.com/whatis.htm

Also, your daughter does have what I call a "smattering" of antibodies so something is afoot. Antibodies wax and wane and it is hard to catch them at play but sooner or later, they will be on the rise.

Anyway, my answer to your question is that I think that you need to find a doc to treat by the whole picture, not just TSH.

Welcome to the board!


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## loretta (Nov 18, 2010)

hi back to both of you. this is my third thread and and i'm not quite sure if it is confusing tho start a new post when some time goes between posts or to just continue with the old post since so much of the information has been previously laid out. Both of you have been helping us work through her issues since joining. 
daughter is 17. when we first began this process about last august her tsh was over 4., like 4.25 or so.

her ferritin last we checked in sept. was 29 with (ref range [ 10-291] )&#8230;so low.
her vitamin d was 24.5 with range [ 4.8-52.8]
And yes, andros, her RT3 has always been high. I have since read that material about the RT3 distance that you recommended.

This doctor is a ND and is experienced in treating people with thyroid and he has tested her for many things including adrenals which were normal.
his main point now though is now that she has been 60mg this long and because of the fact that she did not feel any boost to her energy level that she and I just might assume that she doesn't need to be on thyroid at all, especially since her THS was 1.69 before she was on any armour at all. (It went down by itself), although it had been at the top of the range at 4.32 when we first started down this road. However, I wonder if its possible that she has not felt better because she still isn't on enough Or maybe she is getting too much T3 from the armor formula and that need to change?? I don't know. maybe after all of this she just has low iron . Again, I don't know. I just hate abandon tis armour approach if she isn't getting better because she still hasn't hit on the right dose.

We haven't actually lowered her dose back down yet. Her new doctor's appointment is 5 days and since she isn't having any bad/hyper like symptoms @ 60mg. that maybe we should just leave well enough alone until we get to the new doctor.
I'm confused about where her symptoms are coming from and where to go from here... there is some history of thyroid problems in our family and I would hate to abandon this approach now only to find out later that she goes into full blown hypo land. thanks again


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## Andros (Aug 26, 2009)

loretta said:


> hi back to both of you. this is my third thread and and i'm not quite sure if it is confusing tho start a new post when some time goes between posts or to just continue with the old post since so much of the information has been previously laid out. Both of you have been helping us work through her issues since joining.
> daughter is 17. when we first began this process about last august her tsh was over 4., like 4.25 or so.
> 
> her ferritin last we checked in sept. was 29 with (ref range [ 10-291] )&#8230;so low.
> ...


Ferritin could be playing a huge negative role here. Ideally it should be 50 to 100; the closer to 100, the better

Liquid Floradix is good for fast asorption and all iron supplements should be taken 4 to 5 hours away from the Armour.

I agree w/leaving well enough alone.

It probably is better for those of us who respond for the poster to stay in the same thread as that way we have the "history" handy.

There is some "wiggle" room there w/the Armour. FT3 could be a bit higher but I have to tell you that low ferritin really impedes the efficacy of any thyroxine replacement.

Glad you are seeing the new doc in 5 days and we will be standing by. Please let us know.


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## lainey (Aug 26, 2010)

You have a doctor that ran most of the right tests and was willing to trial your daughter on Armour when she had normal labs to start with.

In my experience, that is pretty extraordinary. Most doctors would have sent you out the door with no medication at all.

If I may be so bold, what are you expecting out of a new doctor that you don't already have?


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## Jaimee (Aug 18, 2010)

I don't know what the "right" thing to do is... but my TSH is being suppressed because of cancer as well. My last lab it was 0.525 and he wanted it lower so we increased my synthroid again. This time my TSH was 0.07, and while he said it is hyper-thyroid at this point, he would like to keep me there for the first year so that while any leftover cells are continuing to be killed off by the RAI, they are not tempted in the slightest to become active again and cause a problem. After a year and another clean scan and neck ultrasound, we can let the TSH go up to the bottom of the range (0.45 or so).


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## loretta (Nov 18, 2010)

Lainey, A fair question. The answer is Health Insurance. We are going to try a new doctor who was recommended at our local compound pharmacy because he is covered by our insurance. we have paid out of pocket thus far many hundreds of dollars for the open mindedness of a naturopath. However as I mentioned he also recommends that we take her off of Armour and look elsewhere which may or may not be our best option. we may be find ourselves returning to the old doctor if this new doctor doesn't fit the bill. 
Thank you also to Jaimee for your input. It's all very helpful.


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