Low TSH Causing my Hypothyroid and Occasional Hyper Symptoms!!

[Ali1101]

I'm struggling with hypothyroidism since 3 years now and when finally discovered it is a thyroid due to low TSH (despite normal, mid-range T3/T4), supplementing T4 didn't resolve the issue completely. However, I observed the followings:

- Low TSH makes very ill during the day till noon. Afternoons, is when I feel better usually, that is the time of the day TSH start to rise slightly and peaks at night which is the time I feel the best.

- When TSH rose occasionally, due to skipping T4 and/or caffeine interference, I will get hyper like symptoms for one day or so! TSH rise for missing the usual dose of T4 but this also causes a lot of stored T4 to be converted to T3 causing hyper symptoms.

- The is some scientific evidence that the higher TSH, the higher the conversion will be:

ncbi.nlm.nih.gov/pubmed/405...

So, this proves to me that Low TSH is causing my hypothyroidism, and I wonder what will be the best solution for low TSH? is it T3 supplement?

[Angel_of_the_North]

How do you know that your TSH is the opposite way round from the usual? (It is usually lowest around midnight and rises through the day, then starts to fall again in the evening) Did you have multiple blood tests on the same day?

Low TSH can, I think, cause conversion problems (T4 to T3), but low TSH plus normal or low normal FT4 and FT3 is often cause by a problem in the pituitary or hypothalamus (central hypothyroid) so you need to get that investigated, as they may be a lack of other hormones as well. If you are on meds, your TSH should be lower as you are getting your thyroid hormones from pills, not your own thyroid, so TSH isn't needed.

Your symptoms sounds a bit like inappropriate cortisol levels, or Hashi flares (alternate hyper and hypo symptoms) or just poor conversion or under medication.

If you post your latest blood results with ranges, I'm sure someone with more knowledge will be able to help.

[helvella in reply to Angel_of_the_North]

Have a look at this post:

healthunlocked.com/thyroidu...

The usual pattern seems to be that it is highest at midnight. Slowly falls to around 10 a.m. Stays low until about 9.00 p.m.

[Angel_of_the_North in reply to helvella]

Of course! I'm an idiot, getting it back to front.

[Ali1101 in reply to Angel_of_the_North]

Hi angel, I didn't mean my tsh is opposite to normal people. Tsh is high at night and low in the morning. Tsh is negatively correlated to cortisol. Yes pituitary gland needs to be investigated.

My blood results look normal except TSH almost always suppressed even before medication with t3/t4 in range.

[Angel_of_the_North in reply to Ali1101]

My TSH isn't suppressed, but is always well under 1 even when T3 is bottom of range (might be under range if I had it tested in the afternoon). I have secondary hypo and take T3 only.

Have you tried T3?

[Ali1101 in reply to Angel_of_the_North]

T3 is my next step to try. I didn't get so much from T4.

How do you feel with T3? How bad symptoms can be if you missed your daily dose? I heard it is dangerous to miss any dose.

[Angel_of_the_North in reply to Ali1101]

I'm not the best person to ask as I'm not very hypo. I take it twice a day and can miss the second dose and not really notice it.

[greygoose in reply to Ali1101]

Ali, not dangerous at all. I missed 6 months of doses, and I'm still here to tell the tale! And I Don't have much of a thyroid gland, either.

I Don't recommend missing doses, of course, but one here and there won't kill you.

[Glynisrose]

Do you still have a thyroid gland? I don't, when I askedmy endo why I would need TSH he got very annoyed. Not that I cared, but why do I need a stimulating hormone when there is nothing to stimulate?

[Ali1101 in reply to Glynisrose]

I do have it, not sure why, but you never know if it has other functions. We do know it effects thyroid but we don't know for sure if it doesn't affect other organs.

[greygoose]

Ali, TSH doesn't make you feel anything. It is the means of communication between the pituitary and the thyroid gland. Yes, it has a bit of an effect on conversion. But if your TSH is consistantly low, it's due to a pituitary problem. So, it is the pituitary causing your hypo, not the TSH itself.

But, if your TSH rises when you miss a dose, then it isn't a pituitary problem - although I do Wonder how you know the TSH has risen? You can't feel it.

Taking T3 will lower your TSH even more - it will suppress it. But as low TSH isn't a problem for anyone, if you're taking supplementary T3, it doesn't matter. The higher T3 level will make you feel better.

[Ali1101 in reply to greygoose]

Hi greygoose,

I was not sure if missing the dose or having caffeine caused me to have a temporary (one day) hyper symptoms. Now I think it is not missing the dose, it is for sure the caffeine.

My hypo symptoms are not consistent, I do have one or two days where I will not feel the hypo symptoms. My TSH was suppressed (for at least two months with normal t3/t4) when I first discovered all my issues are related to thyroid. Once I started Levo, it went slightly over range with t3/t4 slightly under range, but later went back to suppression mode.

I'm really confused! I just ordered my T3 from Greece, I will give it a try!!

[greygoose in reply to Ali1101]

Well, exactly, you can but try. Nobody can know in advance.