# Very LOW TSH with low/normal Free T4 and T3



## LDRT

I have been on synthroid for about 20 yrs and cytomel for 2. My TSH has become very low yet my Free T4/T3 are in the low end of the "normal" range. What does this mean? My doc won't change my dose because he said he can't justify it with the low TSH even though T4/3 are lower than I normally feel well at.


----------



## Andros

LDRT said:


> I have been on synthroid for about 20 yrs and cytomel for 2. My TSH has become very low yet my Free T4/T3 are in the low end of the "normal" range. What does this mean? My doc won't change my dose because he said he can't justify it with the low TSH even though T4/3 are lower than I normally feel well at.


Hello and welcome. Do you have actual lab results we can see? If so, we need that plus the ranges as different labs use different ranges.

How much Synthroid are you taking and how much Cytomel? Sounds to me like you are undermedicated but need to see the labs.

Keep my TSH @ 0.03 and no way am I hyper. Actually, I am euthyroid (normal as in feeling good.)

Do you have a thyroid gland? What is your diagnosis besides being hypothyroid?


----------



## LDRT

I take 88 mcg of Synthroid and 12.5 of Cytomel. I feel like my energy could be better. Doc is concerned about the long term effects of low TSH and not comfortable with raising dosages at this point.

TSH 
0.014 uIU/mL; Range is 0.450-4.500

T4 Free, Direct, 
0.86 ng/dL Range is 0.82-1.7

T3
119 ng/dL Range is 71-180


----------



## Andros

LDRT said:


> I take 88 mcg of Synthroid and 12.5 of Cytomel. I feel like my energy could be better. Doc is concerned about the long term effects of low TSH and not comfortable with raising dosages at this point.
> 
> TSH
> 0.014 uIU/mL; Range is 0.450-4.500
> 
> T4 Free, Direct,
> 0.86 ng/dL Range is 0.82-1.7
> 
> T3
> 119 ng/dL Range is 71-180


Has the doctor clarified what the long-term effects might be? Is your doctor aware of the long-term effects of keeping a patient undermedicated?

It is quite obvious that you could use a bit more Cytomel. I recommend (per doc of course) 2.5 mcgs. increase for 8 weeks, get labs and if still not sufficient go up to the 5mcg. level on the increase and see where that takes you in another 8 weeks.

I am actually on about 33 mcgs. of T3 because I take 3 1/2 grains of Armour and each grain had 9 mcgs. of T3. I am not hyper. I get my Frees done every 3 months or so. So we know I am definitely not hyper.

My TSH is kept @ 0.03 and I am T-totally fine. I happen to take Armour but had to wing it for about 18 months on Cytomel so I am familiar w/both.

If your doctor won't relent, find one that will. Life is waaaaaaaaaaaaaaaaaay too short. I am 68 and have no long-term effects from a nearly suppressed TSH. That is all poppycock in my humble opinion. I know, I know.................they say bone density and all of that. So, big deal. You get the bone density test and if need be, you take the calcium/mag.

You deserve to live.


----------



## LDRT

He cited the bone issue as well as heart. I will talk to him about it again. When I first went on cytomel I took 12.5 twice/day but that made me really shaky and jittery, racy heart etc so we cut back and the effects went away.
I was surprised my T4 was that low, it had been more mid range last year. I get checked every 6 months.


----------



## LDRT

I should add that he is a very renowned thyroid expert, not just here but internationally and not one of those docs who just throws synthroid at you and tests only TSH so I am inclined to trust his word...
this stuff is all so confusing.


----------



## Andros

LDRT said:


> He cited the bone issue as well as heart. I will talk to him about it again. When I first went on cytomel I took 12.5 twice/day but that made me really shaky and jittery, racy heart etc so we cut back and the effects went away.
> I was surprised my T4 was that low, it had been more mid range last year. I get checked every 6 months.


T4 is suppressed when taking T3. And that is as it should be. Being undermedicated is just as hard on the heart. Do your research before you talk to your doctor.


----------

