Thyroid UK
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LOW TSH. NORMAL T3 and T4. High levels TRABs

Hello. I am new to the site.  I have had low TSH for over a year now,  I have been absolutely exhausted for the past 8  months.  My GP is very supportive in terms of doing bloods but he is not au fait with thyroid problems.  When my TSH went to .01 (range; .4 - 4.5) I saw an endocrinologist who ran more bloods and found T4 had risen to 28.9 (range: 10 - 22).  T3 was slightly above normal at 3.8. Also my VIT D was 14 (range 50 - ?).  My TRABs are at 3.9 (range: 0-.9).  So, I am told I  have Graves Disease.

I was prescribed neomercazole 20mg.  However, after 8 days I was bouncing off the walls and could not sleep.  I had my bloods rechecked and T3 and T4 were back to normal and in mid range.  I was told to reduce the neomercazole to 10mg in a bid to raise TSH.  I have a problem with this as when my TSH was low for the past year no-one seemed to care.  I do not want T3 and T4 to fall and mean that I become hypothyroid.  i have stopped the neomercazole.

Am I right to say that the medication will not have any effect on the antibodies (TRABs)?  As I see it I need to reduce these so that mt TSH starts to rise and influence my T3 and T4 levels NORMALLY. Low TSH means a problem with the pituitary and not the thyroid, is this right?  How do I help to reduce these antibodies?

I just can not understand the meddling with perfectly normal T3 and T4 levels that I have now in an attempt to raise my TSH when low TSH did not matter when my T3 and T4 levels were normal for months and as they are now.

I am still exhausted.  I do not have any other hyperthroid symptoms.  In fact I have the opposite, I am so cold all of the time, slow pulse and haven't the energy to be anxious.  I would really appreciate advice as I am soooooo confused.

4 Replies

Is that TRABs result written correctly? I'd interpret the result as written to say you don't have TRAB antibodies - over 9 would be a positive result.


Sorry that should be TSI levels...are raised at 3 times what they should be and Graves Disease has been diagnosed.


Hi Shinbone,  "The thyroid hormone process begins when the pituitary gland in the brain produces thyroid-stimulating hormone (TSH). TSH then acts upon the thyroid gland to produce thyroid hormones. The two main thyroid hormones produced are thyroxine (T4) and triiodothyronine (T3). Although the thyroid gland produces more T4 (80 percent) compared with T3 (20 percent), T3 is 300 percent more active than T4 and is the thyroid hormone responsible for increasing metabolism. In fact, much of the T4 is converted into the more active T3 inside the cells of the body. Once the brain senses the thyroid gland has produced enough thyroid hormone, it will decrease TSH production. Through this negative feedback loop, the production of the thyroid hormones is slowed."

Sometimes Selenium is supplemented and here is an article about it in this list.  You can also search Graves at this website.



Low TSH is typical for someone with Graves'.  The TSI antibodies stimulate the TSH Receptors so that TSH can be low, even after they remove your thyroid.  

Antithyroid drugs like neomercazole do tend to decrease the antibodies over time, but it's a long-term treatment.  Some people take levothyroxine while taking antithyroid drugs so they can lower their antibodies, but still have enough T4 in them to be functional.  It's called modified block and replace.  They stay on this protocol for years, not days.  If you stopped the neo after only 8 days, I would expect you to become hyper again.  You might benefit from reading this page:

You can have a perfectly functional pituitary gland and have a low TSH, especially if you have Graves'.  Your TSH will remain low until the antibodies decrease significantly.


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