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What Causes Low TSH Levels?
Question: I have had a low TSH level but normal TS3 and TS4 I have had the uptake tests and everything in between. I was on a drug for it Metho ..... When my TS3 and TS4 became normal, my Endo said that it is oka to stop medicine even though my TSH is very low.
I'm now having panic attacks everyday and by blood pressure fluctuates. I felt much better on the medicine
Is it okay to have a very low TSH if the other levels are normal?
I looked over my reports on my chart
In July TSH: 0.191
In October TSH: 0.422
In July Free T4: 1.04
In October Free T4: 1.03
In July: Free T3: 3.0
In October Free T3: 2.4
Are these normal, I am having severe panic attacks and fluctuating BP
?
Could this just be anxiety?
Celexa I tried for two days and felt worse.
I have to take a xanax every day which I do not want to do
My only other health problem is a large fibroid tumor on my uterous which I am considering getting removed.
Please help
I'm now having panic attacks everyday and by blood pressure fluctuates. I felt much better on the medicine
Is it okay to have a very low TSH if the other levels are normal?
I looked over my reports on my chart
In July TSH: 0.191
In October TSH: 0.422
In July Free T4: 1.04
In October Free T4: 1.03
In July: Free T3: 3.0
In October Free T3: 2.4
Are these normal, I am having severe panic attacks and fluctuating BP
?
Could this just be anxiety?
Celexa I tried for two days and felt worse.
I have to take a xanax every day which I do not want to do
My only other health problem is a large fibroid tumor on my uterous which I am considering getting removed.
Please help
Brief Answer:
Endocrine
Detailed Answer:
Sorry to note your anxiety, panic attacks and fluctuating BP.
Actually these are classic signs of a rare condition called Pheochromocytoma.
There is a simple blood test to screen for this and it is called 'Plasma Free Metanephrines'. It does not require fasting and can be done at any time of the day, especially when you have had symptoms around that time.
An over active thyroid can also cause similar symptoms but often the degree if severity of the thyroid condition is greater than the mild abnormality you have.
Is it so that in July you were started on Methimazole and that is why the October labs show a normal thyroid result?
So was it in this month that your endocrinologist saw the TSH and Free T4 and stopped the Methimazole?
When I see a patient like you in my practice I typically also order
CBC
CMP
in addition to a through physical examination.
Would you know the results of the thyroid uptake and scan test? It is an important test in the evaluation of an individual with your type of thyroid problem.
Endocrine
Detailed Answer:
Sorry to note your anxiety, panic attacks and fluctuating BP.
Actually these are classic signs of a rare condition called Pheochromocytoma.
There is a simple blood test to screen for this and it is called 'Plasma Free Metanephrines'. It does not require fasting and can be done at any time of the day, especially when you have had symptoms around that time.
An over active thyroid can also cause similar symptoms but often the degree if severity of the thyroid condition is greater than the mild abnormality you have.
Is it so that in July you were started on Methimazole and that is why the October labs show a normal thyroid result?
So was it in this month that your endocrinologist saw the TSH and Free T4 and stopped the Methimazole?
When I see a patient like you in my practice I typically also order
CBC
CMP
in addition to a through physical examination.
Would you know the results of the thyroid uptake and scan test? It is an important test in the evaluation of an individual with your type of thyroid problem.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I actaully beleive these symptoms are all from a very large fibroid tumor I have leaning on my bowels etc. I would love a OBGYN to also comment if possibe.
Where would I send you my uptake tests ? Yes in October everything with my thyroid seemed normal so they told me to stop the tyroid medicine.
Uptake and scans were done in Dec 2013
TSI in December 2013 was 114. One nodule was detected on right tyroid Lobe Noduele 1 medial hypoechoic Ant-Post .036 cm Volume 0.032 ml Transv: 0.40 cm SAG: 0.43 cm
Also from July :
Comments from the Doctor's Office
TSH is low but free T4 and free T3 normal. Ok to hold off on methimazole for now. Recommend repeat thyroid labs in 1 month though as the levels can go up again and we may need to restart methimazole. Thanks
Component Results
Component
Standard Range
Your Value
Sodium
135 - 145 mEq/L
138
Potassium
3.5 - 5.3 mEq/L
3.8
Chloride
96 - 112 mEq/L
104
CO2
19 - 32 mEq/L
30
Glucose
70 - 99 mg/dL
103
BUN
6 - 23 mg/dL
14
Creatinine
0.50 - 1.10 mg/dL
0.86
Total Bilirubin
0.3 - 1.2 mg/dL
0.3
Alkaline Phosphatase
39 - 117 U/L
56
AST (SGOT)
0 - 37 U/L
17
ALT
0 - 35 U/L
10
Total Protein
6.0 - 8.3 g/dL
7.0
Albumin
3.5 - 5.2 g/dL
4.2
Calcium
8.4 - 10.5 mg/dL
9.6
eGFR, XXXXXXX XXXXXXX
>89
eGFR Non-African XXXXXXX
81
The estimated GFR is a calculation valid for adults (>=18 years old)
that uses the CKD-EPI algorithm to adjust for age and sex. It is
not to be used for children, pregnant women, hospitalized patients,
patients on dialysis, or with rapidly changing kidney function.
According to the NKDEP, eGFR >89 is normal, 60-89 shows mild
impairment, 30-59 shows moderate impairment, 15-29 shows severe
impairment and <15 is ESRD.
General Information
Collected:07/30/2014 3:37 PMResulted:07/31/2014 5:37 AMOrdered By:Mercy B Moore, MDResult Status:Final result
What are your thoughts ?
Where would I send you my uptake tests ? Yes in October everything with my thyroid seemed normal so they told me to stop the tyroid medicine.
Uptake and scans were done in Dec 2013
TSI in December 2013 was 114. One nodule was detected on right tyroid Lobe Noduele 1 medial hypoechoic Ant-Post .036 cm Volume 0.032 ml Transv: 0.40 cm SAG: 0.43 cm
Also from July :
Comments from the Doctor's Office
TSH is low but free T4 and free T3 normal. Ok to hold off on methimazole for now. Recommend repeat thyroid labs in 1 month though as the levels can go up again and we may need to restart methimazole. Thanks
Component Results
Component
Standard Range
Your Value
Sodium
135 - 145 mEq/L
138
Potassium
3.5 - 5.3 mEq/L
3.8
Chloride
96 - 112 mEq/L
104
CO2
19 - 32 mEq/L
30
Glucose
70 - 99 mg/dL
103
BUN
6 - 23 mg/dL
14
Creatinine
0.50 - 1.10 mg/dL
0.86
Total Bilirubin
0.3 - 1.2 mg/dL
0.3
Alkaline Phosphatase
39 - 117 U/L
56
AST (SGOT)
0 - 37 U/L
17
ALT
0 - 35 U/L
10
Total Protein
6.0 - 8.3 g/dL
7.0
Albumin
3.5 - 5.2 g/dL
4.2
Calcium
8.4 - 10.5 mg/dL
9.6
eGFR, XXXXXXX XXXXXXX
>89
eGFR Non-African XXXXXXX
81
The estimated GFR is a calculation valid for adults (>=18 years old)
that uses the CKD-EPI algorithm to adjust for age and sex. It is
not to be used for children, pregnant women, hospitalized patients,
patients on dialysis, or with rapidly changing kidney function.
According to the NKDEP, eGFR >89 is normal, 60-89 shows mild
impairment, 30-59 shows moderate impairment, 15-29 shows severe
impairment and <15 is ESRD.
General Information
Collected:07/30/2014 3:37 PMResulted:07/31/2014 5:37 AMOrdered By:Mercy B Moore, MDResult Status:Final result
What are your thoughts ?
Brief Answer:
Follow up
Detailed Answer:
I have reviewed your lab results.
Were these done fasting? If so, the glucose of 103 is in the pre diabetic range.
I concur with your doctors recommendation: It would seem prudent to hold off on methimazole at the moment, and recheck labs in a month or two.
But I would also suggest ruling out the pheochromocytoma.
Follow up
Detailed Answer:
I have reviewed your lab results.
Were these done fasting? If so, the glucose of 103 is in the pre diabetic range.
I concur with your doctors recommendation: It would seem prudent to hold off on methimazole at the moment, and recheck labs in a month or two.
But I would also suggest ruling out the pheochromocytoma.
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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