28 y/o F Low levels across the board for TSH, T3, and T4

[Allthethyme]

Hi I was wondering if anyone has ever had experience having very low TSH, T3, and T4. My doctor said he was stumped because TSH shows being “hyperthyroid” but my T3 & T4 levels are dangerously though and right now I have severe Hypothyroid diagnosed at 13 y/o with Hashimoto’s. He switched me to being on armoured and increased the dosing. If it doesn’t improve I have to go see another specialist. Does anyone have experience or knowledge on this? Cheers! xx

[tattybogle]

Hi Allthethyme welcome to the forum.

If you can add your actual results people can comment better ( when they wake up lol )

eg. what dose you were taking for 6 weeks before the last test

TSH/ fT4 / fT3 results [ lab ranges ]

time of test / time of last dose.

+ Any results you have for Vit B12 / Vit D / folate / ferritin

[Allthethyme in reply to tattybogle]

Thank you tattybogle! I am happy to be here and thankful to the community. 🤍 dosage 6 weeks was synthroid 25 mcg my last dose was this past Friday and the test was done on Tuesday. I was fasting for it to test A1c levels and metabolic panel. Have a great night/morning!

Thyroid test

[tattybogle in reply to Allthethyme]

Hi... so as you've now been put on 2 grains armour . hopefully you'll start to feel better. ( as long as starting on 2 gr. isn't too high a dose ...)

How come you ended up on such a low dose of Levo ? ( presumably you previously took more than 25mcg) ... was it just because someone looked at a low TSH and said it meant hyper and reduced your dose ?

Those fT4 / Total T3 results are very low . BUT if you took your last dose levo on Friday and this test was Tuesday ? then the explanation for the low T4/T3 levels is the 4 days without levo . so you can ignore these fT4 / TT3 results as they are not a true reflection of your levels.

(if i've understood your reply correctly ? ... can you clarify why no levo for 4 days ?)

[radd]

Allthethyme,

Welcome to our forum,

TSH will be low if medicating Armour, and if FT4 & FT3 are low it would indicate you are under-medicated.

Be aware no thyroid meds work well with the iron/nutrient deficiencies commonly caused by hypothyroidism, or high low-grade autoimmune Hashi inflammation.

How much Amour are you medicating?

Have you had iron and nutrients tested recently?

[Allthethyme in reply to radd]

Hi radd thank you so much! I haven’t been on armoured for 4 years I moved and could only find doctors who prescribed synthetic. I had to go back home to my original doctor to get armoured thyroid and he put me on two grain once a day. and iron supplement x2 every other day with vitamin c. He told me to come back in two months to see how the dosing is and if the TSH is still low I have to go see an endocrinologist. My iron was tested this time but no other nutrients they gave me a b12 shot. My last nutrient testing was in the past year with my OBGYN and all levels were in normal range besides TSH. She wrote I had hyperthyroid without testing t3/t4. Sorry for the long reply! xx

[radd in reply to Allthethyme]

Allthethyme,

No, you are not hypERthyroid if you have a need for replacement thyroid hormone regardless of where TSH lies.

It would be good to have folate and Vit D tested also, as they are other common deficiencies. Are you gluten free?

[Allthethyme in reply to radd]

I was on AIP (autoimmune protocol diet) and OMAD for intermittent fasting. So technically gluten free. I will ask for them to test folate and vitamin d to compare with the previous year. I have been gaining weight like crazy no matter how active I am and super low energy in every department. Thanks so much for your help Radd! 😊

[Allthethyme]

also I was told to not do OMAD and to add low fat dairy products and whole wheat/nutrient dense bread.

[Jaydee1507 Administrator in reply to Allthethyme]

The reason your blood results look like they do is the calory restriction/OMAD. It pushes TSH down and is why you were told not to do do OMAD.

If you have Hashi's then many need to eliminate gluten/wheat.

[Allthethyme in reply to Jaydee1507]

yes I am gluten free I had the celiac test done in I believe 2017.

[pennyannie in reply to Allthethyme]

So did you test positive for celiac ?

[pennyannie]

Hello Allthethyme and welcome to the forum :

Just goes to show that once on any form of thyroid hormone replacement you must be dosed and monitored on your Free T3 and Free T4 blood test results and ranges.

At least, hopefully, this doctor may now question his/her understanding of what they have been taught to believe, as the rules and guidelines, in reality, are not fit for purpose.

The TSH was originally introduced as a diagnostic tool to help confirm a diagnosis of hypothyroidism and was never intended to be used as a monitoring or dosing measure once diagnosed and on medication.

On Armour your TSH will be low suppressed and this is to be expected as Armour is a brand of Natural Desiccated Thyroid and contains both T3 and T4 and any form of thyroid hormone replacement containing T3 results in a low suppressed TSH.

On any brand of NDT the blood test results will not ' present ' in the same way as if you were on Big Pharma's synthetic T3 and T4 treatment options :

On NDT you dose to the relief of symptoms and not a blood test and be prepared for a low suppressed TSH - and likely a lower T4 but a higher T3 reading than when on synthetics.

No thyroid hormone replacement works well until your core strength vitamins and minerals are up and maintained at optimal levels :

I now aim for a ferritin at around 100 : folate at 20 : active B12 around 75++ ( serum B12 500 ++ ) and vitamin D around 100.

For Hashimoto's I read the following website is well recommended - thyroidpharmacist.com

[tattybogle in reply to pennyannie]

* note* pennyannie see reply above ~the TSH seems to have been supressed while on 25mcg levo for at least 6 weeks before test..i think armour has only just been re-introduced after this test ( previously on it 4yrs ago)

sounds like some muppet has been adjusting levo dose based just on TSH though ....

[pennyannie in reply to tattybogle]

Yes, I did see that :

This highlights so well the stupidity of the TSH yearly thyroid function test.

We must not accept dose reductions / adjustments based solely on a TSH readings.

Which is what most of us get within the NHS system and why to be well we are being forced out the system, and needing to pay for our own blood test results and then only to face a battle with most doctors not accepting private blood tests results and being refused T3 testing by laboratories.

The situation is totally ridiculous :

Interested to know is this doctor is private or NHS - as to even get Armour prescribed on the NHS is mission impossible throughout most of the country and we are forced to buy it ourselves through the internet.

[tattybogle in reply to pennyannie]

i'm assuming USA or somewhere.. not UK ? ....due to 'synthroid' instead of 'Levo'

[pennyannie in reply to tattybogle]

Well spotted !

[Allthethyme in reply to pennyannie]

thank you so much for your input I am having to pay out of pocket I went to my original doctor sadly I found my chance from my mother who suffers from Hashimoto’s. He is not in network before that I went to endocrinologist who either dismissed me/cancelled appointment because of my age and saying it wasn’t a “emergency.” Previously I was told I was just depressed by a GP when I told him my hair was balding and I was sleeping way too much etc. I went to a naturopath who helped but it was out of pocket and she charged too much and it was a low dose from a compound pharmacy. I then found a doctor where I live but he unfortunately retired. I haven’t been on armoured for 7 years.

[pennyannie in reply to Allthethyme]

Where do you live ?

Many of us are self medicating - yes- out of own pocket - but we have our lives back ?

You were once on 2 grains Armour - were you then relatively well - compared to now ?

[Allthethyme in reply to pennyannie]

I live in California. I’ve gotten medication here, New York, and Thailand. I was tempted to order online from Mexico but my mom did that and her blood test is only slightly better than mine with the TSH/T3/T4 so I feel like it wasn’t legitimate Cynomel.

[pennyannie in reply to Allthethyme]

There is no point comparing yourself to anyone else, even your mother.

You have options to purchase all the thyroid hormone treatment options -

Just remember none of these work well until your ferritin, folate, B12 and vitamin D are up and maintained at optimal levels.

I self medicate NDT from Thailand - it's cheaper than importing from the USA :

I think the NDT suited you best and once you build back up to around 2 grains, as before, I think you'll also find your mental and psychological issues eased as it is low T3 that causes these symptoms.

You have Hashimoto's - an auto immune disease that systematically disables your thyroid so you are likely to experience " erratic swings " in both symptoms and T3 and T4 levels ' ,

Ultimately when this swing, swings back, you are left with less thyroid function and will be more hypothyroid - as this AI disease systematically fully destroys your thyroid gland and you will likely need increases in which ever thyroid hormone replacement you choose to take.

For all things Hashimoto's AI Disease - Dr Izabella Wentz - thyroidpharmacist.com

[Allthethyme in reply to pennyannie]

Also before I fall asleep and forget I was told by a nurse if I didn’t do well on synthetic to say I had a allergy to something in it to be put on natural thyroid. I never got the chance to test it though because most doctors I’ve seen these past 3 years till now have said I’m having a thyroid storm.

[Allthethyme in reply to tattybogle]

yes I got admitted to a hospital in 2020 because they said I was severely hyperthyroid coming in for a head injury/concussion. They took me off all my thyroid medication just for the TSH test results when I told them I had Hashimoto’s and said I needed to be put on lithium. It was a nightmare! The nurses told me people abuse thyroid for weightlifting and I need to “get off of it” acting like I was addicted to it and suspicious of my prescription from California since I was out of town when the concussion happened. I had no previous history of psychiatric disorders, depression, mood swings, hallucinations, or suicidal thoughts. Welcome to America.

[humanbean]

I notice your T4 and T3 have been tested as Total T4 and Total T3. It would have been much better and more informative if your doctor had tested Free T4 (FT4) and Free T3 (FT3).

The Total levels tell you what your body can produce which is nice to know.

The Free levels tell you what your body can actually make use of.

The vast majority of one's thyroid hormones are being carried around your bloodstream attached to transport proteins, but the body can't make use of any hormone still attached to its transport proteins.

What the body can make use of is the very small amounts of Free T4 and Free T3 which are found in the bloodstream unattached to transport proteins. The Free hormones can get into the cells of the body and do whatever they are supposed to do.

The Total levels might be nice to know. But the Free levels are the really important things.

Look at the section on "Plasma Transport" at this link :

en.wikipedia.org/wiki/Thyro...

I think the percentages given for Free T4 and Free T3 on that link might have been switched in the table. When I've had my own Free T3 and Free T4 measured, they have the same units of measurement and the Free T4 is many times higher than the Free T3.

At some point the body has to detach Free T4 from Total T4, and Free T3 from Total T3 and although I don't know how the process of detachment actually works (I'm not a doctor or a scientist) I'm very certain that minerals and vitamins must be vital to the process.

...

I notice your iron was under range at 31 with a range of 40 - 190 mcg/dL. Do you have a result for ferritin (iron stores)? Or transferrin saturation percentage?

Your MCV (Mean Cell Volume) is under range at 78 with a range of 80 - 100 fL.

The MCV tells you the average size of red blood cells. Yours are too small, and this is commonly found in people who are very short of iron.

When patients have high MCV i.e. red blood cells are too large, this suggests that levels of B12 and/or folate are very low.

When patients have low iron AND low B12 AND low folate the results for MCV are likely to be uninformative and unpredictable.

You really need to get your iron levels higher than they are.

Nutrients essential to producing and making use of thyroid hormones :

Ferritin (iron stores) and iron

Vitamin B12

Folate

Vitamin D

Later you could also test :

Zinc

Copper

Selenium

Iodine

[Allthethyme in reply to humanbean]

Thank you so much for all this useful information I will research and try to get them better right now! I am taking iron with vitamin c two 35 mg iron tablets every other day. I have had anemia since childhood. Also I have been taking b12 from moon juice it has the form that gets absorbed better.

[humanbean in reply to Allthethyme]

I'd never heard of moon juice so I looked up its ingredients.

moonjuice.com/pages/ingredi...

Some of the ingredients are adaptogens and one has to be careful with them.

botanicalinstitute.org/list...

Some of them have an effect on cortisol levels - and some can raise cortisol, some reduce it. You could read this thread about members' experiences of them :

healthunlocked.com/thyroidu...