Very Low TSH With Low T4

[G2G2]

Your knowledge please for my 90 year old mother. Her thyroid labs show suppressed TSH 0.07 (0.45-4.50) & low T4 6.3 (4.5-12). She takes 45 mg Armour & 5 mcg Cytomel. Yes, too low of a dose.

Though FT4 was requested by me, lab report is listed as T4, not total, not free, just T4. I have no idea what this means. FT3 was also requested, but "quantity insufficient for analysis."

The doctor wants to discontinue Cytomel. I'm out of my mind for T3 to be stopped when the idiot doctor doesn't even know what her T3 level is & my mother shows no symptoms of being overmedicated. She's ice cold all the time, hair loss to wearing a wig, horrible fatigue--classic.

I'll speak with the doctor. Fear it will do no good explaining the uselessness of TSH as an indicator because we've all been down that road. These are the first labs by this doctor. Her previous doctor retired & I don't have former labs.

Why is TSH suppressed when T4 is low? Could it be her T3 is actually high despite only taking 5 mcg?

Thanks for your help.

[mistydog]

T4 will be suppressed if taking T3 and Armour also contains T3. It looks like a FT4 result but you'll need to check. Insufficient material often means they've "dropped" the vial because they don't want to do the test.

Have you considered a private test, it would be good to test Vit D, B12 folate and ferritin along with TPO and TgAb antibodies? Also I assume you know the stuff about testing first thing in the morning and fasting and only drinking water. If they drop the T3 then she'll need an increase in Armour. Have they tested for the DIO2 gene?

[G2G2 in reply to mistydog]

Thanks! Oh, that means they didn't want to do the test. We're in the US & I haven't seen that before. Vit D, B12, folate were tested & were good. I'll have to check about ferritin with her hematologist. Good idea to check DIO2 gene.

[mistydog in reply to G2G2]

If you have any other results it's a good idea to post them with the ranges. Just being in range isn't good enough, your mum needs to be optimal.

[G2G2 in reply to mistydog]

You're right, thanks.

[Marymary7]

Tricky with an older person but good advice from mistydog . If you are not going to private test there is no harm in getting some ' Better You' B 12 Boost daily vitamin oral spray for under the tongue as a lot of elderly folk are short of this and it's even been proven to help Alzheimers and Parkinson's. Also vitamin D but you should know what level that is as you can overdose as it's stored in the fat I believe. Iron level is of importance too as previous answer. Need to get all those levels optimal.

Other experts will answer I hope but yes I would think more NDT should help in theory also you can buy T3 yourself.

[G2G2 in reply to Marymary7]

Thanks, Mary. Doubtful her doctor will increase NDT, but that would help,

[danym]

i've noticed that for me ft4 is low with ndt and t3 meds, maybe she would need to take t4 med with the ndt instead of t3, you should test her ft3 and rt3 as well

[mistydog in reply to danym]

But when you're on T3 or an NDT T4 doesn't really matter.

[G2G2 in reply to danym]

Thanks. Appreciate everyone's suggestions.

[000ggg]

Hi G2G2, my tsh has been lower and t4 is low but t3 is a bit high now. I remember you telling me t4 goes down when you take t3 and t3 goes up. I don’t think my tsh is suppressed but it is a lot lower at the low wnd of the range. If her t3 is not high it could be a pitiutary problem. Anyway I hope you figured this out. Did she have the DIO2 gene test?