Hi all, I have been arguing with my Endo for the past two years, I recently asked her where all my thyroid hormone is going, since my FT 3 & FT4 are consistently low in. range. She insists that i’m over medicated and that the excess synthroid & T3 are going to my pituitary. Does this make sense? I would think i’m not getting enough or i’m not absorbing very well. All my vitamins are optimal, but i’m still feeling unwell. Tsh: 0.07 (0.32-4.00) FT4: 12 (9-12) FT3: 3.0 (2.6-5.8). I know i’m under medicated and have increased my T3. I was on 100mcg synthroid + 7.5 mcg Cytomel. I increased Cytomel to 10 mcg. I know I will run out of Cytomel eventually, but I will cross the bridge when I get to it. Is my Endo an idiot, or is there any truth to what she said about my meds going to my pituitary. It makes no sense to me. Can all you knowledgeable folks weigh in on this. Thanks in advance.
Does thyroid hormone go to the pituitary?? - Thyroid UK
Does thyroid hormone go to the pituitary??
The pituitary is a tiny gland - usually said to be about the size of a pea. Might weigh about half a gram.
Thyroid hormone in the bloodstream does reach the pituitary. The amount that reaches the pituitary is what determines how much TSH is produced. The more that is in the bloodstream, the less TSH the pituitary makes. And vice versa.
But the way you refer to "excess synthroid & T3 are going to my pituitary" really doesn't make much sense to me. (Yes, I realise you are quoting your endocrinologist.)
Excess thyroid hormone can be handled in several ways by the body including excreting it.
As the thyroid hormone has to go through the blood to get to the pituitary, it would obviously show up in a blood test. It doesn't get tele-transported from the stomach to the pituitary, I'm sure she would agree with that, and there's not an 'under-ground' tunnel that goes through the lungs, up the neck and into the pituitary so the hormone doesn't get into the blood. I think your endo misunderstood one or two things in med school - assuming, of course, that she did go to med school, and didn't bunk-off every afternoon. However did she get through her finals.
Thanks greygoose!! I don’t think she graduated medical school, not to mention completing her specialty. She said some other weird things that make me question her credentials. She told me that ACTH is not a pituitary hormone. She’s so disgusted with me challenging her in matters relating to my thyroid treatment. She tries every which way she can not to admit that i’m under medicated. She’s very condescending towards me. She wants to know where I get my knowledge about thyroid. I proudly told her that I’m a student at the Thyroid U.K med school. Thanks to everyone on this forum who donate their precious time in the efforts of helping total strangers, even when they too are struggling with their own thyroid journey. I wish everyone great success and a good quality of life. I have learned so much, i’m slowly improving each day, more good days than bad ones. Many thanks to all.
By the way, this Endo is an associate professor of our to university here in Canada. What an atrocity!!!!!
Not much hope for humanity, is there! 
Get a new Endo! After my 3 yr battle I fire them as soon as they start acting dumb I'm tired of wasting my health on people who claim to care about my health but destroy it at every turn.
luv that - well put !
Good grief and I thought things were bad in the UK?! Time for a change of endo if that is even possible - good luck!
JaneCx
Thank you. 
Thyroid hormone suppresses the TSH. However, if the TSH has been suppressed for a long time the pituitary can fail to produce sufficient TSH, there is a ‘down-regulated axis’. This could have happened to you if you had high hormone levels during your thyroid cancer or were prescribed high dose levothyroxine for a while. In this case the TSH does not reflect your thyroid status, your dose has to be titrated according to your symptoms and fT3, fT4.
Thanks for taking the time to reply. I agree with you. I’m not sure if I had high levels prior to going low. I was very ill for two years, constant trips to the emergency room: sweating excessively, no sleep, lost 30 lbs in three months, aches and pains in every joint, no appetite, nausea, anxiety, brain fog, ear & eye infections and many more. They never once checked my thyroids. I had several nodules, some of which were calcified. I only got diagnosed once I started gaining a lot of weight and was literally bedridden with fatigue and pain. I think by then I had become hypothyroid. I was hypothyroid for a year or so. Even when I was severely hypothyroid my tsh never became high, so diagnosis was difficult. Very strange.
Clearly your TSH is not reflecting your thyroid status, you need to make your endocrinologist understand this. Maybe if you can get hold of your result when you were very hypo with mildly elevated TSH you can use these to convince him. Otherwise insist of a second opinion.
Rosebud1955.....Your story is very simular to mine. I had and currently have calcified lymph nodes in my neck and upper chest and chronic pains after I lost thyroid to pap cancer 3 yrs ago.
My TSH has never been good along with the rest of my levels but that never mattered to my Endos they would constantly mess with my meds as my health plummeted and I developed one health issue after another.
I'm getting ready to do full body scan with Radioactive Iodine to see if my calcified lymph nodes are thyroid cancer spread....I'm confident it's not I developed Psoriatic Arthritis brought on by thyroidectomy and believe my calcified lymph nodes are from chronic inflammation.
I think this has happened to me! Do you know where I can get evidence to support this theory such as a research paper on the subject please?
Please remember!
Q. What's the difference between God and an Endo?
A. God doesn't think he's an Endo!!
Well said!!
Hi,
Based on your results, your TSH is suppressed, which means that it signals your thyroid to produce less since you already have high levels. Did you try to reduce your meds? How does that make you feel? Although we have a blood range of "normal" i think each person has their own optimum levels. The bottomline is how you feel. In my case, I have Grave"s disease, and what I saw as a trend, is that my body pegs the value at T4: 14 (when i was taking neomercazole for blocking) and the TSH increases to signal that i need to produce more T4, hence means that i need to reduce my meds that blocks the production. In your case, based on your result is that I see that your body does not want to go beyond T4:12, so it suppresses TSH to prevent the thyroid to produce more.
Yes, the problem seems likely to be downregulation, as jimh111 said
Sorry, my mistake. FT4: 12 (9-19)
I had TT 2017, had papillary carcinoma. My FT4: 12 (9-19) FT3: 3.0 (2.6-5.8), so I increased my Cytomel from 7.5 to 10mcg. That’s an interesting point regarding blocking in order to stop production. Does that mean I should not increase meds? Unfortunately, I do not have ranges prior to my thyroidectomy. Are you suggesting that FT3 3.0 might be normal for me? What would you suggest. It’s very confusing for me. Since I have no thyroid, I can only rely on the synthetic hormone. Would the blocking still be the same without a thyroid?
Thanks for your time.
My treatment plan was block and replace. I take neomercazole to block the production (since I have Grave's) and i take levothyroxine as a replacement for T4. In your case, you don't need to block since you don't have a thyroid anymore. What you only need is the synthetic hormone to supply your body of T4 and/or T3. I am afraid to say that you should do this or that bec I don't want to mess you up more. But in my personal experience, the bottomline is how the dosage makes you feel. First, you need to find a doctor that is very supportive and understanding. My endo is also a professor at the university and he treated me like a statistics. I didn't like him so i worked more with my GP. We tried to find the correct dosage for me. In your case, in principle, it shows that you are overmedicated due to suppressed TSH (or downregulated) so it means you need to take less meds. But these you need to work with your doctor. The bottom line is your dosage should make you feel good. And when changing the dosage it should be little by little not abrupt. I really hope that you feel better soon. This illness is not easy.
You may also find this helpful -
bmcendocrdisord.biomedcentr...
"Thyroid UK med school".....perfect description!
I wish the "idiots" out there would open their tightly closed little minds and realise what rubbish they spout, remember their oath to "first do no harm".....and take cognisance of the harm current protocols are doing to patients.
Good luck.
Checked up on ACTH and she is definitely wrong! Probably confused it with CRH which is produced by the hypothalamus and stimulates releasing of ACTH from the pituitary
en.wikipedia.org/wiki/Adren...
Their ignorance is unforgivable....reliable information is out there. They just don't make the effort.... then they ridicule people who do!
"CRH which is produced by the hypothalamus …"
Just as TRH (thyrotropin releasing hormone) causes release of TSH (aka thyrotropin).
She does need to go back to school. Anyone can check that information in seconds these days.
Problem is, that she apparently feels threatened by your knowledge and the more you show you know, the more resistant she becomes. You definitely need a second opinion with someone who isn't so defensive and is humble enough to be willing to learn - even from a "Mere" patient!.
A while back someone posted this video.
I saved it because it is extremely interesting. It is very good at explaining the way the thyroid works, making it easy to understand.
Rosebud1955, strangely, doctors do love to make up fairy tales and believe all these silly myths. This is the first I'm hearing of this one the pituitary sucks hormone out of the blood?
Looking at the results you've posted, your TSH is very low, your freeT4 is very high in range (but I wonder if you've made a mistake w the range, usually its more like 12-22), and the freeT3 is very low in range.
The freeT3 is the most important number, it shows how much active hormone you have a most closely reflects symptoms. Yours is very low, so I expect you are feeling pretty rubbish. The rough goal of hormone replacement is to raise this number. Definitely you should continue raising T3 until you get this higher in range and keep seeing how you feel. Most people need it in the top third to feel well.
If your freeT4 really is high, you're a very bad converter and really need T3. I suspect from the context it may actually be low. If this is the case your TSH doesn't match your free hormones at all, as its very low. This suggests your pituitary is not doing its job and raising TSH to call out for more hormone, which would be central hypothyroid. Ignore what I've said here if the freeT4 reference range is correct.
Sorry, my mistake. FT4: 12 (9-19)
Hi Rose, do you understand conversion? Your Synthroid is supposed to convert from T4 to either FT3 or Reverse T3. What is stopping your high T4 from doing that since your FT3 is low? Several things can be going wrong. Estrogen for one. High cortisol or low ferritin for another. If any of this rings a bell you could tried to correct those. Often we are estrogen dominant and insulin resistant.
She's wrong. The Active Thyroid Hormone (and I'm not medically qualified in any way) is T3 (liothyronine) which is needed in all of our millions of T3 receptor cells and the brain and heart need the most.
Levo (t4) being inactive should convert to T3 and we have millions of T3 receptor cells and all need T3.
T3 then has to 'saturate' all of the T3 receptor cells and then its work begins by sending out 'waves' throughout the day.
Your endocrinologist is another who hasn't ONE clue about the function of thyriod hormones or where they should go in human bodies to restore the health and well-being.
No wonder thousands of mainly women who get no sympathy at all as familes don't quite understand - after all we're taking a daily dose of pills - that we keep complaining and some have to give up work as brains/bodies don't function as they should.
The fact too, that hormones can be removed from being prescribed by decisions set by those who don't have a problem with their thyroid glands and are completely insensitive to pain/suffering that many continue ruining lives and relationships.
If someone has a 'resistance' to thyroid hormones means that they have to take larger doses of T3 than would be 'normal' to enable them to function normally.
New labs. Any one want to touch this?
switching to armour thyroid
Medications for increasing Free T3 and side effects?
