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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Does Low TSH But High T3 And T4 Indicate Hyperthyroidism?

am 27,full time student in grad school, no insurance, currently teach pre-k, weight: 144 and height: 5’3.5

I was diagnosed with hypothyroidism about three years ago (or so) and have been taking 75MCG for about a year. Before the last dose change EVERY time I went to the doctor they upped my medication to dose til I was at the current 75 MCG and my levels had gotten within the correct range. Six months ago I upped my does to 150 MCG frustrated with feeling tired, being forgetful, no weight loss despite eating healthy and exercising three times a week. In February after only losing about 5 pounds I went to a weight loss center where they took my blood (results below) and prescribed me phentermine. Once taking the phentermine I went back to 75 MCG a day and took a phentermin tablet about three times per week. Since February 2nd I have lost 15 pounds but have still had all my hypo symptoms. I am struggling with severe constipation, lack of energy, dry brittle hair, weird very coarse black (they look like pubic hairs) on my scalp, irregular and very light periods and little weight gain. I say little because I work out for atleast 30 min 5 days a week and eat 6 low carb high protein meals/snacks a day keeping my calories under 1200 a day. I am wondering if I am needing to up my dose, if I am hyoerthyroid (google said I could be since my TSH is low but my t3 and t4 are high), if this means I am infertile or if I have something more severe HELP!

P.S. I forget y thyroid medicine alot Have the whole time I have been diagnosed. Told my doctor that each time I got my dose upped and he still upped the dose.

Results (from February 2011):
T4(Thyroxine): 17.3 ug/dl Reference Range: 4.5-12.0 ug/dl

T3 Uptake 37.5% Reference Range: 23-36%

Free Thyroxine Index 6.5 Ref. Range: 1.1-4.4

TSH: 0.048 uIU/mL Reference Range: 0.350-5.500 uIU/mL


-Alicia
Tue, 27 Jun 2017
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Diabetologist 's  Response
Hello ,I just read your query and from what you have mentioned it appears that you have been on a roller coaster for your thyroid condition.
Well the fact that you doubled your dose on your own from 75 mcg to 150 mcg had caused this drop in TSH and rise in T4.
But then after these test results thankfully you reverted back to 75 mcg so that was a good thing.Congratulation first of all on your weight loss.Having said that the new lower body weight as well has a lower requirement for thyroxine replacement.So i suggest that you get a TSH only done and get back to me so i can titrate your dose .
Last but not the least this dieting and exercise and weight loss no doubt is very good for your body but it does steal your body from all vital vitamins and nutrients and you tend you have a multivitamin deficiencies that gives rise to your brittle hair ,constipation and hair loss.
I suggest that you daily take a multivitamin supplement,a calcium supplement and a vitamin D supplement and just space them for your thyroxine medicine by atleast 4 hours.
Hope you find my advice of some benefit.Goodluck.
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Does Low TSH But High T3 And T4 Indicate Hyperthyroidism?

Hello ,I just read your query and from what you have mentioned it appears that you have been on a roller coaster for your thyroid condition. Well the fact that you doubled your dose on your own from 75 mcg to 150 mcg had caused this drop in TSH and rise in T4. But then after these test results thankfully you reverted back to 75 mcg so that was a good thing.Congratulation first of all on your weight loss.Having said that the new lower body weight as well has a lower requirement for thyroxine replacement.So i suggest that you get a TSH only done and get back to me so i can titrate your dose . Last but not the least this dieting and exercise and weight loss no doubt is very good for your body but it does steal your body from all vital vitamins and nutrients and you tend you have a multivitamin deficiencies that gives rise to your brittle hair ,constipation and hair loss. I suggest that you daily take a multivitamin supplement,a calcium supplement and a vitamin D supplement and just space them for your thyroxine medicine by atleast 4 hours. Hope you find my advice of some benefit.Goodluck.