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TSH levels

 
Dr Eisenbud's Avatar
  • Answered by:Dr Eisenbud
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Customer Question

Can my TSH levels be .0597 but my Free T4 and T3 levels still be wacky?


I guess what I am saying is the Synthyroid got my TSH levels way down, but I am still very tired and gaining weight very easily.

 

Optional Information:
Person's Gender: Female
Person's Age: 40

Already Tried:
Synthyroid

Submitted: 320 days and 10 hours ago.
Category: Endocrinology
Value: $25
Status: CLOSED
Expert:  Dr Eisenbud replied 320 days and 10 hours ago.

If your pituitary is healthy then the low TSH would indicate that you are taking too much Synthyroid. If the T3 and T4 levels are low-normal I would be very worried about your pituitary(an endocrinology consult would be needed here). If the T3 and/or T4 are normal or high then you are simply taking too much Synthyroid. It takes at least 4 weeks after a change in thyroid dose for the new levels to equilibrate and for the thyroid tests to mean anything.

Customer replied 319 days and 20 hours ago.

So since I have been on this same dose of synthetic for four months and my TSH shows low/normal but I am still having no improvement in symptoms should I be requesting T3 T4 tests or should I just assume its something else? I guess I am sick of being so tired (I can easily sleep 10 hours a day) and gain weight very easily. I don't feel depressed but am on a low dose of Prozac.

Expert:  Dr Eisenbud replied 319 days and 17 hours ago.

I would recommend testing the free T4 and total T3 with a repeat TSH. If the TSH is still low and the free T4 and total T3 normal or high then would cut back of your Synthroid a bit(an easy way to do this is to take only 1/2 tablet one day a week, full tab the other 6 days...then recheck TSH in 4 weeks(it should rise into the normal range...if still low further deecrease the thyroid to 6 tabs/week etc) We sometimes see patients with hyperthyroidism who sleep a lot and have just the opposite symptoms that you would expect. Since you have identified an abnormal endocrine test best bet is to slowly reduce the thyroid until the TSH is normal. If some symptoms persist then it is not from the thyroid and would have to look elseware.

 
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