No thyroid, TSH too low, T3&T4 in the range

[AgnessaM]

Hi, I had total thyroidectomy in April 2017 because of papillary carcinoma.

I am on a synthetic T3 and T4 combo (Novothyral) + levothyroxine. Recently I am feeling restless, many thoughts in my head, hard to concentrate and focus, difficult to stand still, always feeling I should do something, very emotional etc.

The results of my analyses are:

fT4 13,6 (norm 12-22)

fT3 4,5 (3,1-6,8)

TSH 0,06 (norm 0,30-4,20) - it is taken today, in Dec it was 0,07

So the TSH shows kind of that I am hyperthyroid but how is it possible when the levels of my hormones are not high, especially T4? What could cause it? Or is this TSH value a problem at all?

There is not much use of my endo, she said I should take less meds. But if I take less meds my hormone levels get too low, isn`t it? I would be very thankful for your opinion what can cause this kind of a low level of TSH. Thank you in advance.

[Nanaedake]

I believe that TSH is often suppressed when a patient is taking T3/T4 combination. You need to judge dose according to FT3 level which in your case is not particularly high. People more expert on combo therapy will hopefully comment.

The other thing you should check is your vitamin D level, B12, foliate and ferritin. If any of these are low it may cause symptoms.

[silverfox7]

When taking anything with T3 in it then TSH should be suppressed, FT4 can fall in its range but FT3 should be high in its range but never over. Can't give you a link but it's what my Endo explained to me when restarted taking NDT.