# TSH and Hashi's



## artms (Jul 23, 2011)

So as I understand it the focus for those with Hashi's should be on FT3 and FT4. The TSH will likely go down with medication. Is there a low range in which a low TSH is acceptable and not alarming?


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## Andros (Aug 26, 2009)

artms said:


> So as I understand it the focus for those with Hashi's should be on FT3 and FT4. The TSH will likely go down with medication. Is there a low range in which a low TSH is acceptable and not alarming?


My TSH is always at 0.03 which is very low. What is important is where the FREES are.

Free T3 and Free T4 are the only accurate measurement of the actual active thyroid hormone levels in the body. This is the hormone that is actually free and exerting effect on the cells. These are the thyroid hormones that count.

http://www.drlam.com/articles/hypothyroidism.asp?page=2#diagnosis: standard laboratory test


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## northernlite (Oct 28, 2010)

Many many doctors do not believe in letting you run with a TSH low in the range. It is the more progressive doctors that get that it is ok.

Mine is one of the ones that I fight. I got my TSH down to 0.82 and she said "no lower". My brother who is also Hashi, had his TSH at 0.14 felt wonderful and his doctor wouldn't let him stay down there and lowered his levothyroxine. He hasn't felt well since.

For FT4 and FT3 - the wisdom of the people says we need to be above the 50%ile in our range, many shoot for the 75%ile. I am trying to figure out how that works for me.

I've been at this a year and FT4 is a useless number for me. Mine has always been in range and does not correlate with how I feel at all. In May when I felt terrible, my FT4 was in the 80%ile. After my medication increase and a significant improvement in my symptoms, I am at the 60%ile

FT3 is a number I am trying to figure out what it means for me. My dr didn't do them until the last two blood draws. May when I felt terrible: 10%ile. August after my medication increase and significant improvements in my symptoms...now don't laugh...13%ile.

Since the August, I have been trying to figure out how I really feel now and my thought is pretty good. I have energy, make it through my work day well, my mood is decent, I walk my dogs a couple times a day, my hair has grown back in thick and silver (it was light brown when it fell out!). I feel slightly under medicated because I run out of gas each evening usually by 7-9:00 but that is really my only symptom right now. When my TSH was at its lowest (0.82) 6 months ago, I didn't have the crash in the evening issue. Right now I am at TSH=1.8 and go back in January and am going to push for another little increase in medication.

So the whole point is I think you need to find what is right for you. For me, TSH seems to be my best indicator of how I feel. FT4 seems useless for me. I can't figure out how I can feel decent at a FT3 of 13%ile but I do so I am not sure the conventional wisdom of FT3 fits me well.


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## Lovlkn (Dec 20, 2009)

I have left 2 endo's and 2 GP's due to them not basing my replacement med's on the FT-4 and FT-3. They would let me keep my TSH low for about 1 year then begin reducing my replacement med's.

I now see a DO who has for 2 years let my TSH be undetectable and treats me by my FT-4 and FT- and have never felt better. I thought he understood but after reading my medical file he called my treatment "unconventional" by taking Unithroid and Cytomel. As long as he ignores my TSH I'll keep seeing him even if he thinks my treatment is "unconventional".

Keep looking, there are doctors out there but it may take awhile to find one.


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## Gwen1 (Sep 3, 2011)

That just shows how different we all are. No two alike!


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