Normal TSH, low FT4, normal (low end) FT3 - what's goin on?

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Hey everyone,

For the past 3 months I've noticed a bunch of symptoms: extreme intolerance to cold, lethargy, swelling of the eyes and face, swollen and painful breasts, severe pms (with nausea and vomitting) are the major ones. After a breast ultrassound showing no abnormalities, my GP claimed there was no indication for a thyroid checkup and dismissed my complaints. So I got some bloodwork done. Here's what I got:

TSH: 1.54 mUI/L   RANGE: 0.55 - 4.78

FT4: 10.4 pmoI/L  RANGE  11.5 - 22.7

FT3: 3.8 pmI/L      RANGE  3.5 - 6.5

Am I experiencing hypothyroidism? Should I get a thyroid ultrasound before I confront my GP with these results? Anyone out there with similar results and good advice?

Many, many thanks!

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  • Posted

    In my opinion, everything looks fine, though I'm sure others are going to say different.  Let me explain why.  Your results in my opinion are normal because your TSH is at 1.54, which is normal, but you really don't want it much higher than that. Being your body naturally knows this, as your TSH levels rise, your Ft4 and Ft3 will lower in response to your TSH rising, to stop your body from making more TSH ( Thyroid stimulating Hormones).  Also, the same the other way around, if your TSH is lower on the scale, your Ft4 and Ft3 will rise to make your body put out more of TSH.  Your results can also be affected from what time your had your blood work done.  I was told by my endo that you should always have your blood work done first thing in the mornin and before eating.  As you go throught your day, your body naturally will have a higher TSH. Eating will raise your TSH also. Like I mentioned before, when your TSH rises, your Ft4 and Ft3 should be lower.  That's your bodys response to stop releasing more TSH's.   I would say that your next step would be, is to get the antibody testing being you are symptomatic.  You would need the Tgab and Tpo antibody test.  If either one of these is positive, then you most likely have Hashimoto's, which is when your body mistakenly destroys your thyroid thinking it's an invader.  As your body destroys the thyroid gland, you develop hypothyroidism.  Hashimoto's is the leading cause of hypothyroidism in developed countries.  

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    • Posted

      Dear sweetmelissa you are tottaly right about TSH being variable throughout the day but actually TSH will be LOWER in noon and will be higher in the early morning (before 11 am) and TSH will also be LOWER after eating and will be higher when fasting.
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    • Posted

      I am not sure if we can post webpages here for references but a quick google search about TSH fluctuation will show you how fasting/time of the day and season (TSH also raise in winter during cold weather) affect TSH.
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    • Posted

      Oh .. I understand.  Thank you for the correction, as I did not know.  I was just going by what my endo told me, and we all know that they are not always right.  Also, my endo is 87 years old!  I'm sure he most likely goes by what he was taught in school 60+ years ago and not all the newly updated scientific research.  He is very old fashioned..lol. Thank you for that clarity!

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    • Posted

      Yes.. unfortunatly my endo is the only five star doctor I found in my area.  The only other one around me has a 1 star rating and horrible reviews.  One thing I appreciate about him, is that he spends no less then an hour with me, but the one thing I don't like about him, is he is very old fashioned.  He actually makes me get undressed and in a gown every visit and he ckecks every inch of my body with all kind of old fashion medical tools that look like they are from the early 50's.  He even shines a flashlight in my eyes.  Not sure what he's looking for though?  He also uses his very old medical equipment to check for feeling in my legs, hands, fingers and toes.  He even checks my finger nails!  So, I love that he's very thorough, but he's so out dated that he doesn't even use a mondern technology or modern medical equipment.  He actually writes ever word I say, down in his notebook...lol.  It takes forever because he is soooo old and is very slow.  I truly believe his mindset is old fashioned too.  I'm not so sure he keeps up with the latest medical research.  I mean most things have changed from 50, 60+ years ago, sometimes I feel he really doesn't know what he's talking about, and I don't know why I even listen.  It's so hard to know what to believe...lol.

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  • Posted

    Hello IV, 

    Your results seem to be borderline, but concerning because many people with thyroid disease don't show super off kilter blood work. The fact that your TSH is below 2 is a good sign, but 2 can indicate a problem. So with your other levels, I'd be concerned. If you're able to get a thyroid ultrasound, it might offer some useful information and would show if cysts are present (indicating Hashimotos). But I wouldn't pay for this test out of pocket.

    Thyroid disease is autoimmune, and can be triggered by many environmental factors. Heavy metals can trigger a high reverse T3, so some detoxing could alleviate the problem. Also, low iodine can result in thyroid disease. Some of the other symptoms you have  could indicate endometriosis or PCOS. All of these are related to your endocrine system, so if one thing goes down, it affects everything else.

    As a first line of defense, I'd clean up your diet and do some cleansing, herbs and supplements (thyroid support, multivitamin, minerals, chlorophyll, and many others are helpful) to see if you can improve your situation. I know this sounds condescending, but the treatment for thyroid disease isn't great and you'll spend a lifetime monitoring your blood levels, being frustrated with not being able to get the meds you want, the side effects of the meds are horrible.

    Ive been around and around with thyroid disease for decades. I was able to get the disease into remission for a decade, but couldn't figure out how. Then after a move, the thyroid disease came back with a vengeance. I went through half a dozen different meds, none of which were great, many that wee horrible. I finally bagged the meds and chose a healthy lifestyle with supplements, cleansing and acupuncture. It was the most freeing thing in the world to stop the meds and not have to take them, not have to keep getting blood work done that seemed useless. Instead, I'm dealing with the root problem that causes the autoimmune disease.

    Just  letting you know what you're dealing with. There are a ton of books and information available for thyroid disease.

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  • Posted

    Thank you, everyone, I do appreciate your help. I want to offer a few clarifications and what got me particularly intrigued. 

    As an IBS-diagnosed woman of 35, I already have a very clean diet. I've experimented with raw foods, autoimmune paleo, fodmaps... My diet is a mixture of those three trends, I guess, mostly low carb and low on cooked fats. I'm extremely sensitive to conflict and stress, those factors alone can trigger severe bloating, cramps and diarrhea. I'm usually fast and impatient in everything I do and for the past 2 years exercise was a major ally in sleep management. That said, right now I'm the complete opposite. It's hard to get out of bed, I never feel rested, I move slowly and avoid people who will boss me around or speed me up. I still cycle and go to the gym six days a week (mostly for dance classes and Pilates), but I do so with effort. And I've put on 2,5Kgs. As you can see. something has definitely changed and I would like to find a balance between the then, which wasn't ideal either, and now. Preferrably, I won't take meds, I'd rather further work on diet, lifestyle and supplements...

    These tests were taken early in the morning after a 12 hour fast. My blood pressure at that point was 9/6 and I felt beaten. When I got my results, what really hit me was FT4 count, to which the lab added an acknowledgement saying they had it doublechecked... And I've read a couple of articles enphasizing the relevance of FT4 count as opposed TSH when screening for hypo, so I'm kind of lost here...

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    • Posted

      IV, sounds like you're doing a. Great job!  In addition to the other supplements I've tried, I've been on high doses of essential amino acids to treat the thyroid stuff. The interesting thing is that the amino acids helped a bunch of the other problems, particularly the gut sensitivities.  I've also done a ton of detoxing and kidney support. These seem to all help the thyroid. Accupuncture as well.

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  • Posted

    Hi, I see you have several good responses already and I've not read through them all so I may be repeating something and if so, my apologies. I just wanted to share that in cases where a person has secondary hypothyroidism, the TSH isn't as important whereas the T3 and T4 are what is monitored. I guess what I'm saying is even though your TSH is in the normal range, the fact that your TS4 is low and TS3 is borderline, along with your symptoms, is indication enough to follow up with your physician. I hope you get some answers and feel better!

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