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Thyroid (Expert Forum)
Extreamly Low TSH and Low free T4
Answered by
Mark Lupo, M.D. - Thyroid Nodules, Thyroid Cancer, hyperthyroidism, hypothyroidism, Thyroid Ultrasound
Thyroid & Endocrine Center of Florida
Sarasota - FL
Questions in the Thyroid forum are answered by Dr. Mark Lupo. Topics covered include goiter, graves disease, Hashimoto's thyroiditis, hyperthyroid, hypothyroid, thyroid cancers, thyroiditis, and thyroid stimulating hormone (TSH).
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Extreamly Low TSH and Low free T4
by @Sunrise, Dec 01, 2006 12:00AM
First and foremost, thank you for having this resource!
I went to my family doc recently to do my yearly physical and we did a CBC. My THS came back radically low so he ordered more labs to check Free T4 & T3 total.
Results:
TSH: <0.02 [0.46-4.68]
FREE T4 0.52 [0.64-1.92]
T3, Total 85 [60-182]
I don't take any meds, OTC's or herbs (well a daily vitamin).
I do have some symptoms of hypo, I have a hard time not falling asleep during the day and once my morning workout is over, I'm beat!
The nurse on the phone said I was hypo, come in to get a scrip and orders to do an ultrasound. I filled the script, took a pill and went home. After looking at the meds subscribed and doing some online research, I think there was an error. Propylthiouracl 500mg/tab. That's an anti-thyroid med. I have not taken another pill since the first day. I confirmed with the doc that he gave me the right med and he said I'm hyper. He's going to talk with an endo and see what the results the u/s (those results will be back later today or Monday). After all my research, and feel like I do have secondary-hypo and have to ask, do I have secondary hypo (a pituitary gland problem which has me very scared) and what other tests should I request? I don't feel the family doc did enough research before starting treatment. I'm in shock and scared without an outlet for more face to face info right now. HELP!?!?
Thank you,
Dawn
I went to my family doc recently to do my yearly physical and we did a CBC. My THS came back radically low so he ordered more labs to check Free T4 & T3 total.
Results:
TSH: <0.02 [0.46-4.68]
FREE T4 0.52 [0.64-1.92]
T3, Total 85 [60-182]
I don't take any meds, OTC's or herbs (well a daily vitamin).
I do have some symptoms of hypo, I have a hard time not falling asleep during the day and once my morning workout is over, I'm beat!
The nurse on the phone said I was hypo, come in to get a scrip and orders to do an ultrasound. I filled the script, took a pill and went home. After looking at the meds subscribed and doing some online research, I think there was an error. Propylthiouracl 500mg/tab. That's an anti-thyroid med. I have not taken another pill since the first day. I confirmed with the doc that he gave me the right med and he said I'm hyper. He's going to talk with an endo and see what the results the u/s (those results will be back later today or Monday). After all my research, and feel like I do have secondary-hypo and have to ask, do I have secondary hypo (a pituitary gland problem which has me very scared) and what other tests should I request? I don't feel the family doc did enough research before starting treatment. I'm in shock and scared without an outlet for more face to face info right now. HELP!?!?
Thank you,
Dawn
Doctor's Answer
by Mark Lupo, M.D., Dec 03, 2006 12:00AM
, Dec 03, 2006 12:00AM
Your research may be right -- would not use PTU at this point based on the T4 and T3 labs you mention -- this is suggestive of secondary hypothyroidism. Repeat thyroid labs -- if still same pattern, need an endocrine evaluation for pituitary disorders. This would include complete pituitary hormone assessment and an MRI of the brain/pituitary.
I'm thinking adrenal gland issues?
Find an endo to give you additional testing before taking any meds.
That doc definitely should have done much more testing, and that medication would have really messed you up with the low thyroid hormone results. When you get the test results back from endo, call that doc and let him know. That guy is going to really hurt someone!
Thank you for the responses. At least someone listens to my concerns and give me logical, sound advice.
Best Wishes,
Dawn
I got full pituitary, thyroid and adrenal tests done, as well as MRI. Luckily, MRI was negative. Found adrenal insufficiency and hypo/Hashis. Being properly treated for both now, and feeling better with time.
When you get all the tests done, let us know the results. Also, go to StoptheThyroidMadness.com, it changed my life.
A second opinion is definitely in order.
When you (dixie1) were in the diagnosis process, did they do a thyroid ultrasound on you? If so, what was your outcome?
Thank you!
Dawn