Low TSH and FT 4

[Susieg1]

I have been on 90 mg Armour thyroid. TSH - .03 Range .40 - 4.50

FT4 - .78 Range. 80 - 1.8

FT3 - 3.71 Range 2.30 - 4.2

When I was on 75mg, my TSH was high and my FT3 was low and I had more symptoms.

On 90 mg, I feel pretty good for the most part. I still get exhausted if I do too much, and I don't have a great deal of energy as it is. I was diagnosed by my functional medicine doctor with dysfunctioning mitochondria causing a lack of ATP for energy. We have been working on that and things are improving slowly.

My doctor always asks if I have hyperthyroid symptoms, jittery, headaches etc., to which I answer, "no", so she lets me stay on 90 mg, but she wants to bring me back down to 75 mg to bring my TSH up.

Do I need to do something to bring my T4 up? If so, what?

I started taking 10 drops each 2% Lugol’s iodine and selenium.

Any wisdom would be appreciated, thanks.

[SeasideSusie Remembering]

Susieg1

When taking T3 or NDT which contains T3 then it's often the case that TSH will be very low or suppressed, it's just what T3 does, so your results are no surprise and to be expected.

One would expect to see your FT4 within range as there is much more T4 in NDT than T3.

Sometimes NDT has the wrong ratio of T4:T3 for some of us and the flexibility of being able to find your own ratio that synthetic T4 and T3 gives is better for some of us.

Do I need to do something to bring my T4 up? If so, what?

Some people add Levo to their NDT to raise FT4 so that might be an option.

I started taking 10 drops each 2% Lugol’s iodine and selenium.

Did you do a non-loading urine iodine test to know that you need to supplement with iodine? It's generally not recommended for hypo patients, particularly when Hashi's is present. If you look under Pinned Posts (to the right of the screen on a PC, you might have to scroll down on another device) you will see a post about iodine, it might be worth reading it.

[Susieg1 in reply to SeasideSusie]

Thank you! Is it recommended to raise my T4, or is feeling okay enough to go on?

RE: Iodine. No, I have not been tested, however, I have spent the last 30 odd years avoiding all things iodine, so I figured I would be deficient. I took selenium first to make sure I had enough of that before taking the Lugol's.

[SeasideSusie Remembering in reply to Susieg1]

Is it recommended to raise my T4, or is feeling okay enough to go on?

That's entirely up to you. I don't take NDT so can't comment from experience but the aim of thyroid hormone replacement is to feel well so do whatever it right to achieve that but I would keep FT3 within range.

[pennyannie]

Hello Susie :

I think you need to decide who you need to listen to -

your doctor or your functional doctor - as their views will likely differ.

Once on any form of thyroid hormone replacement you must be dosed and monitored on your Free T3 and Free T4 readings - not a TSH :

I think your doctor is confusing hyperthyroidism and a low TSH -

with hypothyroidism and being optimally medicated

and has a limited understanding of thyroid health issues.

You can't become hyperthyroid after being diagnosed hypothyroid - but you could become over medicated -

which you are not as your T3 and T4 are not over these ranges which were actually introduced to be used with Big Pharma's synthetic T3 and T4 treatment options.

There are no recognised blood test ranges for desiccated thyroid - as we treat to the relief of symptoms :

When taking Armour or any NDT we track on the Free T3 and if you feel well - that's job done and whatever the dose that relieves your symptoms is the answer -

T4 is likely to be lower than when taking T4 monotherapy but it doesn't matter if you feel well, have relief of symptoms and ok.

I'm guessing it's your functional doctor suggesting the Lugol's ?

Guessing to bring up your T4 and selenium -

I've never tried this option and can't comment - are you low in selenium ?

[Susieg1 in reply to pennyannie]

Thank you. I didn't know the ranges were for the synthetics. My regular doctor orders my tests and she does go over them with me, so I will stick to her for my test prescriptions. She's nice and she orders everything I ask for and is open to me using natural remedies.

The FMD doesn't deal with my thyroid, only my energy issues.

So, to make sure I'm on the right track, as long as my FT3 is okay, I don't need to worry about my TSH or my FT4 as long as I feel good. Is that correct?

[pennyannie in reply to Susieg1]

Yes, pretty much so - so your doctor prescribes the Armour -

I guessed she didn't as she doesn't seem to know how NDT presents in a blood test !!

No thyroid hormone replacement works well until your core strength vitamins and minerals are up and maintained at optimal - so maybe get your ferritin, folate, B12 and vitamin D checked out and we can give them the once over for you if in any doubt.

[Susieg1 in reply to pennyannie]

Thanks. Last time the ferritin, folate, B12 and vitamin D were checked, all were within range, though my D could definitely go higher.

[pennyannie in reply to Susieg1]

It is not a question of being in the range somewhere as some ranges are too wide to be sensible :

Everywhere I researched when very unwell said that ferritin needed to be over 70 for any thyroid hormone replacement to even work -

I now know I feel better and need to aim for ferritin at around 100 : folate at around 20 ; active B12 75++ ( serum B12 500++ ) and vitamin D around 100 .

[Susieg1 in reply to pennyannie]

How do I get the ferritin up?

[pennyannie in reply to Susieg1]

What is your result or how much are we looking at :

I don't know how easy it is in Puerto Rico but I now maintain my level flash frying chicken livers down into a pate each week and find a dollop pf Mayo helps this medicine go down.

I started taking iron tablets from the doctor which upset my stomach so then purchased an iron glycinate supplement which was softer on my stomach and non constipating.

I also ate liver twice a week and made sure I ate enough meat.

It is quite common when hypothyroid to have low stomach acid so even if you eat the right foods you may have trouble breaking them down and absorbing key nutrients..

There is a ' burp ' test that you can do for yourself -

check it out on youtube - and then follow the advice -

I take a teaspoon of Apple Cider Vinegar with Mother - in a full glass of hot water, around 1/2- 1 hour before I eat my main meal and that seems to work for me and I get an occasional burp or break of wind !!