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Forum Name: Endocrinology Topics

Question: Low TSH and Thyroxine Free


 lynda206 - Fri Jan 18, 2008 5:48 pm

I first had trouble with my thyroid at age 19 ( I am now 42) when I found a cyst, and after a lot of testing was put on medication until my bloodwork came back "normal" I didn't think about it much until I had trouble in 2000 and retested again. One Dr said if things didn't straighten out, he wanted to radiate my thyroid and kill it, but my levels became "normal" again until last April with these labs:
TSH . 12 (0.34 – 5.60)
Thyroxine free . 7 (.6 – 1.6)

They waited a month retested me and my labs were:

TSH .10 (0.34 – 5.60)
Thyroxine Free .8 (.6 – 1.6) T 3 was “normal”

After this I had an MRI of my pituitary ((normal), an ultrasound (multi nodular goiter, with cysts), FNA (negative), and a RAI Uptake (both cold and hot spots).
I also had these labs done:
Atch < 5 (6 – 48 PG/mg)
HumanGrowth Hormone 0.1 (6.0 -28.0 UG/DL)
Cortisol am serum 7.7 (6.0 – 28.0 UG/DL)
I was told these were normal

At this point mid August they finally started me on levox 50 mcg I was retested 8 weeks later and my labs were:
TSH .03 (0.34 – 5.60)
Thyroxine Free 1.0 (0.6 – 1.1)
They cut my dose to .25 mcg.

I was just retested last week and my labs were:

TSH .09 (0.34 – 5.60)
FT4 0.95 (0.7 – 2.0)
Now they have cut my dose to 12.5 mcg

I know I just threw a lot of numbers and information at you and I appreciate you taking the time to look at this for me. I had no treatment until August, and the labs just don’t make sense. I noticed that no matter what dose I am on, that my numbers don't change much.
I also was pointed to an article about Central hypothyroidism, and that one thing that can cause it is lithium. When I was 13 or 14, I was being treated with lithium and being young and stupid, and influenced an older crowd, I actually snorted it. I don't know how long I was on Lithium, and my parents are deceased now. But I do know that after it was discovered that I was taken off all medication, and went on to be a fine young person.
Thank-you for your time
 lynda206 - Tue Feb 05, 2008 6:58 pm

I need to make a correction on the human growth Hormone it should read
0.1 Range ( 0.0 - 6.0) sorry about that.

I also didn't include any sypmtoms simply becuase I was worried that it was so long to begin with. I can tell you briefly that my main symptoms are severe calf cramps (Dr's won't give me pain medication, even though advil/tylenol don't touch it) Headaches, Gerd, Diareha, low blood pressure (104/60 to 116/70) fatigue, restlessness, irritable, dehytrated, and sometimes I find it hard to concentrate.
When I was on the higher dose of thyroid medication my blood pressure was actually running much higher 146/96 and I bought a wrist cuff to keep track. Not sure if the medication has anything to do with it.
Thank you again for your time.
 Dr. Chan Lowe - Thu Feb 07, 2008 9:46 pm

User avatar Hello Lynda206,

Unfortunately, most of your lab values did not come through on the post so I am really not able to give you much information on your condition. If you are able, please repost the values and I'll take a look at them.

Regarding the lithium, lithium can have significant effects on the thyroid. It's effect would have been worn off by now. It basically blocks thyroid hormone production while its concentration in the body is elevated. The effect wears off when concentrations drop and decrease.

Best wishes.
 lynda206 - Fri Feb 08, 2008 5:53 pm

Dr. Lowe,
I am so sorry, I don't know what happened. I will repost the lab values without the other info, in order:
TSH 0.12 (0.34 – 5.60)
Thyroxine free 0.7 (.6 – 1.6)

TSH point 10 (0.34 – 5.60)
Thyroxine Free 0.8 (.6 – 1.6) T 3 was “normal”

Atch < 5 (6 – 48 PG/mg)
HumanGrowth Hormone 0.1 (0.0 -6.0 UG/DL)
Cortisol am serum 7.7 (6.0 – 28.0 UG/DL)
I was told these were normal

After 8 weeks of 50 mcg generic synthroid
TSH 0.03 (0.34 – 5.60)
Thyroxine Free 1.0 (0.6 – 1.1)
They cut my dose to 0.25 mcg.

most recent testing:
TSH 0.09 (0.34 – 5.60)
FT4 0.95 (0.7 – 2.0)
Now they have cut my dose to 12.5 mcg

When I mentioned my symptoms, I forgot my one of my worst ones, cold intolerance, and cold hand and feet, and worsening forgetfulness *smile.
I am glad to hear that the lithium is not a concern at this point!
Again, thank-you very much for you time and attention!
 lynda206 - Fri Apr 18, 2008 11:23 am

I have kind of given up getting an answer here, but thought I would post my lab results that I had taken April 8th. I also had a biopsy done yesterday.

Thyroglobulin Antibody <1.8 IU/ml range (<4.0)

Thyroglobulin, Tumor Marker 27 ng/ml reference value <=33

TSH 0.13 range (0.27 – 4.20)

Thyroxine Free 1.19NG/DL range (0.93 – 1.70)

Free Triiodotothyronine 3.14PG/ML range (2.57 – 4.43)

Prolactin 4.3NG/ML range (4.8 – 23.3)

ACTH 8 pg/ml range (6 – 58)

Cortisol Plasma 12.2 mcg/dl range (4.3 – 22.4)

Chloride 110 MEQ/L range (95 – 107)

CO2 21 MEQ range (24 – 32)

Glucose 93 range (65 – 99)

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