Low T3 Syndrome I: It's Not about the Thyroid! | Chris Kresser
ADAPT Health Coach Training Program Enrollment is now open. Learn more

Low T3 Syndrome I: It’s Not about the Thyroid!

by Chris Kresser

Last updated on

Fatigue—like this man is experiencing—could indicate low T3 disorder.
If you’re experiencing symptoms of a thyroid disorder—such as fatigue—it could be low T3 syndrome. iStock.com/OcusFocus

This article is part of a special report on Thyroid Disorders. To see the other articles in this series, click here.

Hypothyroidism involves high levels of thyroid stimulating hormone (TSH) and low levels of the thyroid hormones T4 and T3.

However, in my clinical practice I frequently see people with low levels of T3 with normal T4 and either low or normal TSH. This condition has been reported on in the medical literature for years but it is rarely acknowledged or discussed in conventional medical settings. (1) Most doctors (even endocrinologists) do not seem to know what causes it, or what to do about it. (I know this because I always ask my patients with this syndrome what their doctors said about it, and my patients’ response is almost always some variation of “not much”).

This particular pattern goes by three different names in the medical literature: Euthyroid Sick Syndrome (ESS), Non-thyroidal Illness Syndrome (NTIS), and Low T3 Syndrome.

NTIS has become the term of choice in the literature. However, I’m going to use Low T3 Syndrome in these articles because it’s more descriptive and accessible to the layperson.

What’s most important to understand about this condition is that, although it does involve low levels of T3 (the most active form of thyroid hormone), it is not caused by a problem with the thyroid gland. This is a crucial distinction and it’s what distinguishes Low T3 Syndrome from “garden-variety” hypothyroidism.

In this series we’re going to discuss:

  1. What causes Low T3 Syndrome
  2. Its clinical significance
  3. If it should be treated, and if so, how

But first we need to lay the foundation with a little basic thyroid physiology.

Want to learn more about thyroid disorders?

Download This Free eBook

Find out how a thyroid imbalance could be causing your biggest health problems.

I hate spam too. Your email is safe with me. By signing up, you agree to our privacy policy.

Basic Thyroid Physiology

In order to understand Low T3 Syndrome, you’ll need a basic understanding of thyroid physiology. Regulation of thyroid metabolism can be broken down into the following five steps:

  1. The hypothalamus (a pea-sized gland in the brain) monitors the levels of thyroid hormone in the body and produces thyrotropin releasing hormone (TRH).
  2. TRH acts on the anterior pituitary (directly below the hypothalamus, but outside of the blood-brain barrier) to produce thyrotropin, a.k.a. thyroid stimulating hormone (TSH).
  3. TSH acts on the thyroid gland, which produces thyroxine (T4) and triiodothyronine (T3), the primary circulating thyroid hormones. The thyroid produces T4 in significantly greater quantities (in a ratio of 17:1) than T3, which is approximately 5x more biologically active than T4. (2)
  4. T4 is converted into the more active T3 by the deiodinase system (D1, D2, D3) in multiple tissues and organs, but especially in the liver, gut, skeletal muscle, brain and the thyroid gland itself. D3 converts T3 into an inactive form of thyroid hormone in the liver.
  5. Transport proteins produced by the liverthyroid binding globulin (TBG), transthretin and albumincarry T4 and T3 to the tissues, where they are cleaved from their protein-carriers to become free T4 and free T3 and bind to thyroid hormone receptors (THRs) and exert their metabolic effect.

Mechanisms of Low T3 Syndrome

As you can see, the production, distribution and activation of thyroid hormone is complex and involves several other organs and tissues other than the thyroid gland itself.

Hypothyroidism is a defect in step #3, because it typically involves a dysfunction of the thyroid gland itselfmost often caused by autoimmune disease (Hashimoto’s, Ord’s, Graves’) and/or iodine deficiency.

However, in Low T3 Syndrome, the problem generally occurs in steps #1, #2, #4 and #5. None of those steps are directly related to the function of the thyroid gland itself.

More specifically, Low T3 Syndrome can include the following mechanisms: (3)

  • Modifications to the hypothalamic-pituitary axis
  • Altered binding of thyroid hormone to carrier proteins
  • Modified entry of thyroid hormone into tissue
  • Changes in thyroid hormone metabolism due to modified expression of the deiodinases
  • Changes in thyroid hormone receptor (THR) expression or function

Low T3 Syndrome in Acute and Chronic Illness

Most of the studies on Low T3 Syndrome have been done on people suffering from acute, life-threatening illness. In the intensive care unit, the prevalence of abnormal thyroid function tests is remarkably high. More than 70 percent of patients show low T3 and around 50 percent have low T4. (4)

Many of these studies have indicated a direct relationship between Low T3 Syndrome the severity and both short- and long-term outcome of disease. (5) The lower the T3 level in critically ill patients, the worse the outcome tends to be.

However, studies examining thyroid hormone replacement in these situations have shown mixed results. In most cases—with the exception of cardiovascular disease—taking thyroid hormone did not improve outcomes. (6) We’ll discuss this in more detail later.

Recently, more attention has been given to Low T3 Syndrome in non-critical, chronic illness. Specifically, the question on everyone’s mind (including mine) is whether thyroid hormone replacement is useful in this situation, or if—as some have suggested—it could even be harmful.

In emotional, psychological or physiological stress, the body will convert excess T4 to reverse T3 (rT3) as a means of conserving energy for healing and repair. It is at least possible, therefore, that replacing thyroid hormone in these cases may not be beneficial.

On the other hand, in those suffering from long-term chronic illness, Low T3 Syndrome may be more reflective of pathology than adaptation, and this group may benefit from T4 or T3 supplementation.

We’ll explore all of these questions in more detail in the articles to follow, and I’ll also share some of my observations from my clinical practice. Stay tuned!

Articles in this series:


Join the conversation

  1. Sooo, If i had a growth on my pituitary…it could be a factor in a low T3 after thyroid removal and synthroid not being effective ?

  2. My T3 and T4 are normal. My T3 uptake is low (21%). My TSH is high (4.550). I had half my thyroid removed 3 years ago due to a benign nodule. Before surgery my TSH was 2.3. One year post op my TSH was 2.950. I have been steady gaining weight and have no energy in the last year but my doctor says I am not hypothyroid. Help!

  3. When I was 7 months old , in ’53 , they zapped my thymus gland with radiation that was unwarranted , considering thymus glands heal /adjust without intervention . Then I grew up 9 miles down wind of a uranium /plutonium plant ( Fernald ) in Cincinnati . When I was 15 they removed entire Thyroid because it quit at 14 from all the undue radiation it got . My doctors over the years only give me T4 meds . Nobody even mentions T3 , I have had mild depression , low energy , quick temper , etc. , for about half a century now , at 64 , question , would taking T3 help me and what is the med / where do I get it ? thank you.

    • I have no thyroid due to cancer, a good healthy thyroid gland would produce 5 hormones T4 80% (inactive and converted to T3 on a cellular level) T3 20% active and 3 more that doctors know very little about, my thought is if the gland produces them they must be needed. But if they take your thyroid gland away, then really you should be treated with at leas 80% Levothyroxine and 20% Liothyronine. But if you can find a doctor that will do this for you it is practically a miracle.

    • My mother is 80 and she got her T3 at 79. She is also an Afib patient and she is just fine. She doesn’t take time release. She takes cytomel. If you have rhythm issues or heart trouble, make sure you have a good doctor supervise when giving it to you. It changed her life for the best. No more feeling cold all the time, having brain fog, or fatigue. She is so sharp.

  4. I’m praying someone can help me or direct me to someone who can. My thyroid was removed in 1991 due to Grave’s Disease. I was on Synthroid successfully until last year. My TSH went up to 68 I was in ICU with myxedema for a week. Now my TSH is over 100 (lab only measures to 100. Normal is 0.4 to 4.50. My T3 and T4 were not detectable. I also have severe gastroparesis (stomach essentially paralyzed, no solid food in 6 years, etc) and as a result malabsorption. I’m scared and going back to the dr today b/c I don’t feel right.

    • I am having the exact problem you described. I also have hypothyroid and had y thyroid removed, my last tsh score was 109 and both t3 and t4 don’t register. I too have gastricparesis and was wondering if this is whyvmyvm daughter aren’t absorbing. Have you found any relief or answers to this?

  5. My advice to anyone suffering from thyroid symptoms and getting no where is to google functional and integrative medicine in your area. I’ve felt horrible for over 4 years, with worsening weight gain, cholesterol, suddenly lower BP, iron, Mg, D deficiency, fatigue, muscle aches, brain fog, depression, panic attacks, and numbness/tingling in my hands and feet. More symptoms… but too many to list. ALL symptoms of hypothyroidism. I went to multiple doctors but none put my symptoms together and were willing to dig deeper. They’d test TSH, antibodies, and vitamin deficiency and send me home with vitamin D and a normal thyroid diagnosis. I didn’t give up and my journey continues. But I finally found an integrative medicine MD and NP in my city. They did a full thyroid and hormone panel. And iron panel. BOOM! Although TSH is only 2.2, RT3 is over 20, iron is low, free T3 is borderline low. We started T3 supplementation and iron (in a non constipating form) a week ago. Two days later my energy improved substantially. I feel like I’m on cloud 9! I feel like me again. Able to control my emotions, energetic, positive, not feeling like I continently need caffeine or carbs because my brain is no longer fuzzy and I actually feel energetic enough to exercise, with energy to share. Don’t give up! Find a board certified integrative medicine practitioner in your area!

    • This is so great to hear I’m so happy for you !! I have all the above symptoms as well but the worse I deal with are the panic attacks it does get better ? My doctor wants to start me on a low dose T3 supplement what did you take ?

      • I know your post is almost a year old but personally I take New Iodine ( one or two per day now as maintenance and about 1,000 mg of magnesium. I take magnesium L-Threonate, Glycinate or Glyconate and also citrate citrate And oxide have a mild laxative effect. Your THYROID GLAND REQUIRES MAFNESIUM TO CONVERT T4 to T3! I also eat 2 or 3 Brazil nuts per day for selenium which a healthy thyroid gland needs. So, it’s not only about the Iodine!!! Magnesium is just as important. I took T3 for a few years. I went from a size 2 to 18 in five months and none the the four MD’s I saw knew what to do. Weight gain. Fatigue. Brain fog. Fibro. Panic attack’s. Migraines. LOw blood pressure went to very high HTN. I even started having mini seizures and ENT made me have a brain MRI, which was fine. I had to figure this out Myself! I even had an enlarged thyroid gland yet no doctor would treat me because my thyroid numbers were WNL. The sleep apnea scared me tremendously. I got an old friend of mine… a preventive medicine MD who became an eye surgeon 45 years ago ( couldn’t make a living telling people to keep their minerals balanced and eat healthy) to Rx T3. I eliminated caffeine and all things possibly interfering with conversion. I’ve stopped the T3 1.5 years ago and now just go by How I Feel with the New Iodine, Magnesium’s, Vit D and good quality multi vitamin. I avoid Bromine, Fluoride, Chlorine as they are Halides and will displace my Iodine. PS, the Bromine and chloride chemicals in a hot tub have shut down my thyroid after just a 30 minute dip and caused my Fibromyalgia to reek havoc for a good 3 weeks until I upped my Iodine etc to detox and regulate.

    • Wow, my readings sound really similar to yours. I went over my doctor’s head to order my own blood tests because I was getting the run around from my OBGYN and primary MD. My T3 reading is Low at 2.2. I’m just curious have you had any luck with weight loss, you said you now have energy to exercise which has got to be a win in itself!

    • Dear Elise, I can’t believe I am going through exactly same process with you. I have all hypo symptoms as you did, and doctors only send me with vit D and iron supplements. My rt3 is 18, t3 is slightly lower than the bottom edge, and ft3,ft4,t4 are all at the bottom edge. They say its okay as my tsh is normal. But I am feeling awful because of these symptoms, I believe you can understand me well. I ave visited many doctors, but I believe doctors in my country are not really knowledgable. Could you give me names of your doctors? And also where do you live? I can even travel for this or maybe ask for a skype consultation? I am so hopeless…

    • This all sound similar to my problems I have sufferd for years and told it’s all in my head!!!! They have had me on 8 different kinds of antidepressants they did nothing. I am now expecting and symtoms seem a bit worse so I decided to go private to medicheck and get the full thiyroid check and has come back confirming I have hashimotos I already have in underactive thyroid, a swollen gland, dizzy, irregular heart all day, night sweats, don’t feel human , terrible pain in arms and chest etc. I also have my results if I can post them? I’m going to see an endo for first time on Tuesday and know I need t3 as my results show I’m not converting the t4 right. Any information to help would be great kind regards holly

  6. I’m turning 46 tomorrow.. and all I want for my birthday is to feel better.
    This article is like a life boat in a sea of disinterest and discrimination I’ve been barley staying afloat in for so many years. The past 6 years have been the worse after the birth to my second child. Weight gain of about 1-1.5kg per year going hand in hand with worsening edema. The list of symptoms is long, worsening fatigue, brain fog, muscle weakness, aches resulting in injuries. Hair loss, excess hair in other places etc etc etc list goes on. I can barley cope with my body which is now 100-110kg with edema making it worse during the summer months!. Learnt about Hypothyroidsim and started investigating that with my GP but all bloods come back normal with only marginally low T3 so my GP has written it off. I have been seeing a kidney specialist to see if its my kidneys. So far kidneys look fine but she has trialed me on Spiractin as my aldosterone levels were high… but I’ve also read that aldosterone levels can be high due to insulin resistance hence the cause of PCOS. I’m now trying Metformin and I know it will take a few months to show any results… but still my instincts are telling me there is something wrong metabolically and that is why your article was so interesting. To add to the complexity of my health problems, since my late teens/early twenties, I’ve had a liver disorder. My gastro specialist has boxed me under “biliary obstruction” even though I could say some of the hypothyroid like symptoms I’ve been experiencing could also be symptoms of advance “Primary biliary obstruction” though my specialist doesn’t think that is what I’m going through… end of story. But he did put me on Ursodeoxycholic Acid (one tablet a day) which I’ve been taking for 10 years now. Taking this medication stops my liver having flare ups and blockages. But I have been suspicious for a few years now that my liver is not doing to job its supposed to be i.e. produce essential proteins and enzymes crucial for metabolic conversion and transportation… resulting in an insulin resistance type scenario and/or even thyroid hormone transportation or absorption problems. Even when I’m feeling well my GGT liver function tests are always high to very high and the ALP occasionally dips above normal range as well. But GP not concerned about this? Unfortunately when I try to initiate this conversation with my GP’s and specialists, their eyes glaze over if not completely dismiss me altogether. What are your thoughts and should I stay firm and keep investigating? I’m considering switching my eating habits to a low carb, high fat while I’m on the metformin. One of the symptoms I was having over the last few years is occasional hypoglycemic episodes that would last for a several minutes. Again an indication that somethings not right. Oh and my glucose fasting blood tests come back in the normal range as well. Arrgghhh! So hoping the Metformin and diet change will be beneficial. What are your thoughts and advice? What specialist do you think I should work with to further investigation? Thank you, Gina.

    • Gina – it is so hard to get a true answer, but have you been tested for Lyme? if so how many bands show, even if they don’t call it positive. Also it’s pricey but consider at least 1 initial 3 hour consult with fran sussman to get your answers and then maybe you can get dr’s to help after??? she does skype, phone or in person – located in NY

    • I’m going through the same thing nobody knows what they doing. Remember that I told you this doctors are liars they want you sick they need your insurance money.try to go the holistic?

  7. I came upon this post while doing some research for a client. I’ve worked with many women with this situation. I love, and agree with, what Chris has to say. I’ve had a lot of success addressing the foundation of the issue – the mineral levels and balance in the tissues. Without specific nutrients your body won’t recognize the thyroid hormones that you do have nor will your cells produce enough energy to allow your endocrine system to work as it should. I figure this out using a hair tissue mineral test as a first step in all my programs. It could help you. I’d be happy to answer any questions.

    • Susan, I’d LOVE to speak to you more about mineral levels and more. Thank you for speaking up.
      I’ve been drinking sole (salt) water which has helped gaining minerals. My lips were always dry. This us due to sibo, leaky gut, candida & many food intolerances. I’m not sure what vitamins & minerals are being absorbed & utilized by the body with the above mentioned conditions.

      What do you suggest to detox the body of those yeasts, viral ills, metals, bad bacteria & heal the small intestines? What do you suggest for proper vitamin & mineral absorption?

      • Don’t mean to but in, but, was reading your article with much interest. I also started have what I thought was thyroid issues. Started seeing a holistic doctor here in Florida, she started me on Fulvic Acid and Humic Acid. I have been taking this for about a month and have noticed BIG improvement in my skin. She also has me taking Thytrophin pmg and Prolamine iodine these are not prescription medications. Must say I am feeling a lot better. She also talked to me about leaky gut and has me taking Enzymes after each meal.

        • Hi Sharon,

          I also live in Florida. Could you please tell me the name of the holistic doctor who helped


          Jo Shays

  8. I had my thyroid removed in 2003 because of multiple modules (too many to be biopsies – these did 9 before stoppping). I believe the surgeon nicked my parathyroid because no one bothered to check my blood work before discharging me from the hospital. I went through months of problems and finally doing my own research asked my GP if that could be the case. Upon checking the TSH – my levels were low and I subsequently went to hospital and got a copy of the original lab work day of discharge and it was already low and this was not mentioned. Anyway I have a great GP and we got that resolved. Things would be fine for 3-4 years and I would need a slight adjustment in Synthroid. Then I went through a depressed state when my Mother died followed by my Father less than 6 months later. Everything got off balance – B12, potassium, Vit D. Got that resolved and fast forward to 13 months ago. I had gone on a diet and working out and lost 45 lbs – 10lbs from goal weight when suddenly the weight started coming back on – at a continuous rate. Lab tests revealed TSH OFF. Do an adjustment was made and after 1 month it went from 19 to .30. More adjustments- it swung back the other way. All the while I’m getting more and more fatigued. We did this back and forth until 4 months ago when the doctor said he thought part of the problem was the generic Synthroid I was taking. He switched me to brand and the numbers seemed to stabilize. But then he fatigue hot so bad I could hardly function, joint pains – just generally felt horrible plus weight kept going up more slowly now to where I am back less than 10 lbs from where I started post diet & workout. Went to doc for blood work. He did whole thyroid panel. T4 normal, TSH at .56, but free T3 low. So he did some research and added Cytomel to my Synthroid. I’ve had 2 doses now, but woke up this morning seeming not feeling as tired. I hope this works. I’m at my wits end. I downloaded all the Ebooks and can’t wait to read them.

    • Hi Mary,
      Wonder how you are feeling now that you’ve been using the combination of Synthroid and Cytomel? Reading you entry sounds very similar to my situation and my doctor is now recommending this drug combination. Hoping it works.

    • The parathyroids don’t control thyroid levels, they regulate calcium levels. We have 4 parathyroid glands. If the parathyroids are stunned, damaged or accidentally removed during a thyroidectomy then your calcium level will drop, usually to dangerously low levels and needs to be supplemented. They should always monitor your calcium level right after surgery and before going home. I had one parathyroid that was accidentally removed and my surgeon was able to save it and re-transplanted it in the muscle in the side of my neck. I just had to supplement calcium for a couple months and it regained function.

  9. I’ve been diagnosed with Hashimoto’s 3 minutes nags after giving birth.
    Won’t talk the numbers and tell you one thing that has improved the quality of my life,- I’ve had to go on a dairy gluten free diet!
    GP and endocrinologist hadn’t had a clue (apart from giving me wrong medicine) so I went to an alternative medicine specialist.
    Have been given B12, B6, fish oil, folic acid,multi vitamins, ToxiPrevent (to clean the gut), Zink and a super bitter drink (3 times per day) to clean the liver.
    7 years I’ve suffered from migraines which magically has stopped, eczema disappeared, hair stopped falling out, lost some weight and only one symptom is left,- light tiredness so had to stop Thyroxine (cause it has got gluten fillers) and started to drink capsules that are made from pure pug thyroid.
    I am not 100% my self YET but the correct diet and supplements has healt many things already!

  10. My problems all began 3 years ago right after I had my daughter. I literally gained 25 lbs during my pregnancy and lost 2 after I had her. Right away I knew something was wrong I went to the doctor a month after 1 had her and complained I was little losing weight like I normally do and how tired I was. She ran blood work and my Cholesterol had gone from being normal my whole life 189 while I was pregnant to 235, it still remains high. My t3 and t4 were also very low but my Tsh level went from being 1.2 to 1.75 and fluctuates from 1.75 to 3.30 now. I weight more now regardless of how much I diet and exercise. I am tired all the time and force myself to workout. The only way I can lose weight is by not eating at all. I finally went to a specialist in July and he said my thyroid was enlarged and said my tsh was normal at 1.75 and I needed a b12 shot. I looked and my free t4 is at .69 and he couldn’t tell me why my t3 and t4 are low. I went to my GP and complained today about them not even trying to figure out what’s wrong with me and she said basically it’s because I need to sleep more work out more and diet more and low t3 and t4 levels do not matter it only counts if they are high only tsh levels count… I am about to just give up trying, but I am so damn tired.

  11. Hi there. I have had something strange happen with my 25 year course of Hashimoto’s. The first thing was I started needing less Naturethroid after popping out some salivary gland stones. That was two years ago. Six months ago, I cut back meat in my diet (from daily to about three times a week) and added potassium iodine (250 mcg a day) and a high quality spirulina (various dose, but I’d say an avg. of 1 TBSP a day, sometimes up to 4). I started having hyperthyroid symptoms. My blood tests showed a total t4/reverse t-3 ratio of 20. My total t3 was very high, free t-3 marginally high, total and free t4 normal, and tsh normal (not suppressed). What happened here? Is this a common detox response? I decreased my naturethroid dose again, from 1.25 g to 1 grain, and started feeling hypo within two weeks. Now my tests are marginally hypo, esp. the T4. I still feel like crap and have lost half of my hair. My doctor is now adding 25 mcg of Syntrhoid, which i will try, because i”m desperate to feel better. I am 45, and my periods are occasionally shorter and crazier, but otherwise no sign of menopause. Should I stop the iodine? Resume daily meat? Any insights more than welcome. Sabine

  12. Hi there. I have had something strange happen with my 25 year course of Hashimoto’s. The first thing was I started needing less Armour Thyroid after popping out some salivary gland stones. That was two years ago. Six months ago, I cut back meat in my diet (from daily to about three times a week) and added potassium iodine (250 mcg a day) and a high quality spirulina (various dose, but I’d say an avg. of 1 TBSP a day, sometimes up to 4). I started having hyperthyroid symptoms. My blood tests showed a total t4/reverse t-3 ratio of 20. My total t3 was very high, free t-3 marginally high, total and free t4 normal, and tsh normal (not suppressed). What happened here? Is this a common detox response? I decreased my Armour dose again, from 1.25 g to 1 grain, and started feeling hypo within two weeks. Now my tests are marginally hypo, esp. the T4. I still feel like crap and have lost half of my hair. My doctor is now adding 25 mcg of Syntrhoid, which i will try, because i”m desperate to feel better. I am 45, and my periods are occasionally shorter and crazier, but otherwise no sign of menopause. Should I stop the iodine? Resume daily meat? Any insights more than welcome. Sabine

    • You may want to get a ultrasound on your thyroid gland. You may have a hot node. If so the iodine ….even though your taking a small amount it can cause hyperthyroid… A hot node can make your levels unstable .

    • How dumb Armour gives both t4/t3 both my Dr is not in favor of Armour he said only synthetics when all he had to do is lower my Armour my numbers are messed up as well

  13. My tsh was 5.59 but t3 uptake is 30
    free thyroxine 4.4
    the weird thing is T4 is 14.5 and too high
    how can i have high tsh and t4?
    im on synthroid..75mcg which just ot changed to 88
    any suggestions for me?
    suffering from horrible leg pain and sore muscles

    • Ask your dr to test your t3, actually full thyroid panel should be done but I had all the same symptoms and my naturopath prescribed cytomel. Huge change for the better.

  14. I have low t3 and normal t4. Large weight loss 12 years ago (130 lbs.). Have been on specific food plan this entire time. (No sugar or flour, weighed and measured meals) 6 months in lost menstral and it never returned. Since then, low pulse average 40, always cold, low white blood count 2200, I am 48, not pre or post menopausal. Have been experiencing weight gain. Can low t3 and low white blood count be related as well?

  15. I’ve been having so many symptoms of a thyroid problem, I decided to get some test done. Would greatly appreciate any input. Feeling confused about TSH range and T3 uptake.
    TSH 3.28. (.45-4.5)
    Thyroxine T4. 9.0 (4.5-12.0)
    T3 uptake 22. (24-39)
    Free thyroxine index 1.04. (.82-1.77)
    T4, free 15.5 (9.2-24.1)
    Triiodothyronine free 2.7 2.0-4.4
    Once again any help would be greatly appreciated

    • With similar numbers, my endocrinologist told me i’m fine. The fact that I have no energy, am lethargic all the time, would just like to spend all day in bed, appears to mean nothing so long as the numbers are in range or close. Let me know if you find anything that helps you as I have not had a good day in three years.

      • I have just discovered I have a 6mm cystic node on my thyroid and over the last two years gained weight, felt completely exhausted and kept falling asleep at every moment; my feet and leg bones were excruciatingly painful, I passed out three or four times, felt hellishly depressed, brain all foggy and thought I would probably die very soon from something. I even cancelled a dream holiday because even the thought of the car ride to the airport was more than I could cope with, let alone the packing, flight and holiday. Just before the cyst was diagnosed, I started taking a kelp supplement – low and behold, after a few days I felt significantly better and stopped falling asleep. My blood tests show everything is normal, apart from cholesterol raised from its previous figure of 3.9 to 6.2 – a symptom of hypothyroidism, even though all my other results are normal, although often at the low end of normal. There is a history of adrenal tumours and thyroid tumours in my family and I have also had a pleomorphic adenoma (salivary gland tumour). Am off for a biopsy on cyst, but kelp seems to have helped enormously and you would have to wrench the jar from my hand to stop me taking it at present, because before I decided to give it a go, I simply wasn’t functioning on any level and just wanted to crawl into bed and not wake up again at times, despite a diet full of pears, broccoli and other helpful ingredients. Sometimes you just have to find what works for you, but it is wonderful to feel more like my old self and it was such a simple solution. If they want to remove the cyst, they can have it willingly, but I am keeping the kelp until afterwards.

      • If you can get a doctor that is a DO rather than an MD, you may have more luck as they are a little more out of the box. Seriously, I’d demand a trial of Armour Thyroid or get a 2nd opinion.. best of luck!!

  16. I have never weighed a lot, even when I ate horribly, and always eat a lot. It was discovered in 2009 that I have a t4-t3 conversion issue. I never felt any different on t3 (my guess is I was never given enough as Dr’s are afraid because of my irregular heartbeat). So fast fwd, I asked about weaning off, and was basically just on natural supplements, then we find the reason behind all my issues is Chronic Lyme – the thyroid gland barely exists upon physical exam (who knows if that’s always been) – U/S didn’t show anything – and now my Endo (who put me back on t#, and even added more t4 due to labs, me freezing all the time, dry skin, hair falling out etc has now decided I do not have a true Thyroid hormone issue, rather a low weight issue, so my body isn’t producing enough t3. I can’t gain – AND my gut is so destroyed as that is where Lyme 1st presented, that I am very limited in foods too – so he has me off t3, symptoms are worse, levels have fallen as my body tries to adjust to being off, but even my nat ppl are saying I need it. I get what he is saying, and if gaining weight were possible, and could replace meds, great!!! but I am not going to, and now am balding quickly, and freezing, tired etc etc – Syndrome??? Should I take t3, even if low t3 being caused by low weight??? Thank You

    • You might not feel any “better” on T3 compared to T4 if either way you are getting enough T3 to satisfy cells in every organ. However, just make sure your thyroid blood tests show that you have enough Free T3 and not too much Reverse T3. If you are chronically Low T3 even when T4 is sufficient and TSH is normal (as was my case), then neither tweaking your diet & supplements nor relying on T4 drugs alone will do anything to you get out of that dangerous state, especially if you have a damaged, atrophied (or just extremely tiny) thyroid gland that can’t produce direct T3 in times of need. If that’s your situation, you should take at least some T3.

      • Thx Tania! Yes always low t3, TSH around 2.3 – I know Nat ppl like it 1.5 to 2 tops, used to get Rt3 checked, but recent guy doesn’t check rt3, but asking a new dr tues to do all again, and see what’s up now that’s it’s been 2 months of just t4 50 mcg, plus nat stuff. And yes, TINY, almost non existent Thyroid gland, (not sure if Lyme destroyed it, or it was always small – never had u/s till last year). Thanks again.

  17. Hello, I stumbled across this while looking for some answers 🙂

    I have hypothyroidism but I have been suffering servere fatigue,40kg weight gain in a very short amount of time I can’t lose, total loss of libido amongst other things these past few years and have only recently been referred to an Endocrinologist. Seems my TSH and free T3 are normal, but my free T4 is low.
    TSH: 2.54 (0.50-4.00)
    Free T4: 8.5 (10.0-19.0)
    Free T3: 5.0 (3.5-6.5)

    My ferritin levels are also low, as is my cortisol and liver function was a tad on the low side. All immune disorders were negative.
    Ferritin: 10 (15-165)
    Transferrin Sat: 14 (13-47)

    9am Cortisol: 132 (145-619)

    I am having the synacthen stim test in a couple weeks and they are also talking MRI to check my pituitary.

    I would love to hear your insight.

    • I’d actually guess you might have cushings. I had cushings and my AM cortisol was low too. 24 hour urine? High. Midnight serum? High. Midnight saliva? High too. My thyroid was whacky then too. Had pit surgery 4 years ago.

  18. I’ve been unwell for long time, though lab tests were normal diagnosed Hashimoto’s year ago as ultrasound test were showing damage in thyroid gland. Symptoms got worse gradually, tests were normal every 6 months until 5 days ago

    tsh 7.48 mU/ml normal should be 0.35 – 4.94
    freeT3 2.68 ng/dL normal should be 1.71 – 3.71
    freeT4 0.86 ng/dL normal should be 0.70 – 1.48

    Given 50 mcg levothyroxine day one felt ok, day to ok but felt a slight strange headache for 10 minutes. Day 3 some palpitations at night (on betablockers since 3 years I suffer from tachycardia reason unknown, heart seems to be ok). Day 4 severe headache and severe palpitations had to take betablocker at 4a.m.

    Stopped the levothyroxine for 2 days repeat the test

    baffling result,

    Tsh increased to 9.1 and free T4 is 1.4

    Thyroxine hormone replacement actually increased Tsh, what should I do?

    • After removal of my thyroid, I’ve been working for a year and a half to get my free T3, Free T4 and TSH in range. Initially, my TSH was very low and T4 borderline. From before surgery and throughout the ensuing period of time, my T3 has consistently been right in the middle of the normal range. My Endo has gradually reduced my Synthroid in six stepdowns from 150 mcg to 88 mcg at present. My readings are now all in range, my Endo is happy, and claims success. But other than the change in the readings, nothing else has changed. I still feel weak, exhausted, lethargic, brain fog, and fall asleep easily if I stop moving. I took a stress ECG and only lasted six minutes. Nothing showed up on the test except that my recovery rate was slow. I’ve given up on finding anything that will help from my Endo and have just had my first meeting with an alternative medicine doctor. His early testing has shown a few things out of balance so we will see how this works out over time. Unfortunately, all of these new tests and meds are not covered by insurance and that hurts.

      • I too had a total thyroidectomy 3 years ago and, can honestly say I wish I hadn’t bothered!
        My TSH level was over 40! I was under 8 stone and ate like I hadn’t eaten for a month, my heart pounded went through my chest and I was sweating like a pig. The joys of going grey and losing clumps of hair in my thirties was just another daily battle.
        Since my op, I’m shattered beyond a level I didn’t think existed, I’ve blossomed to 11 stone, my chest is like B Windsor and my body aches, let’s not discuss my stomach pains, which are crippling. I try really hard to keep my mood up and not cry but I feel this silent illness destroys lives…. i am 41 and am to tired to do anything so, it would be foolish to have children. I recently lost my job. My hopes and dreams of a full life has long left me.
        I’m told my hormone range is normal – seriously! If this is normal the country wouldn’t get out of bed.
        For all those out there, please find a cure. I truly believe I would have preferred a shorter fuller life than the one I have asleep!!!

  19. my t3 level is low 1.73pg/ml and i had a irregular heartbeat and iam taking medicine to low my herat beat or make it normal medicine are xcept 20 mg and concor 2.5 mg and cordarone 200 mg and iam a dibetic patient.is t3 can be effected by medicine is there is any relationship with heartbeat???? age is 63

  20. For 2 years now, my T3 has been .8 rather than between .9-1.8 My T4 and TSH are within range though on the low side.
    I have only 1/2 of my thyroid.
    Is there a food/vegetable/fruit I can eat to raise my T3 level? … or one that I should avoid???

    • When i see comments like this – i actually wonder whether you have read the article at all. No one food, vegetable, fruit or supplement will improve T3 and Chris would agree you need to look at why T3 is likely to be low and address that cause.

      • Dr. Lewis, Dr. Chris mentioned psychological factors that could possibly affecting my thyroid. I feel I’ve been dealing with PTSD, post-traumatic stress disorder, for most of my life, primarily depression. I’ve come to see that things that occurred between my father and myself, from the time I was in diapers till I was a teenager, is sexual abuse. I was forced to take part in things not of my own choosing, and my mother knew of this from the time I was five years old and did nothing but slide into one mental illness after another. I’ve been on synthyroid/levothyroxine since 2010. I’m still fatigued, still gaining weight, and still considered depressed since I’m taking bupropion 300mg/day and abilify 2g/day. Are the tests t3, t4, and TSH enough to properly test my thyroid for health? Isn’t it possible that all that may be “wrong” with me is iodine deficiency and “all” I’ll need do is include an iodine/iodide supplement from a heath food store, under supervision, of course? I don’t like table salt, it’s too salty. I prefer sea salt. Thank you for whatever you can tell me, I appreciate it.
        Sincerely, Mary Monju

        • some anti depressants stop the uptake of iodine to the thyroid gland which in turn gives you all the symptoms of depression, also does not show up on blood tests for your thyroid. This happened to me for 23 years . It was the fatigue that got me down , then i started taking lodoral salts , OMG 2days later I felt as if I was a teenager again so please give them a go. read all the reviews on amazon about Iodoral. they are amazing ..I too have a similar story to yourself .good luck …things in your life will change for the better..

          • Depression and anxiety are both part of low thyroid stop that depression one your labs are normal u make be not depressed once those numbers are correct

    • Did you ever try taking Amour. Thyroid or Naturethroid? I have had several issues with hypothyroidism. Using NDT’s have given me back my life.

  21. My 22 year old son has had TSH 3.16 – T4 9 and T3 2.6
    His Testosterone levels are 0.9 rock bottom his doctor doesn’t think the TSH is too high and doesn’t really care much about the low T3.

    Is there anyone who has dealt with this issue, I need some direction on this. He has had MRI to rule out pituitary tumour and has had extensive testing otherwise….suggestion is testosterone injections.

    • The most simple reason for this pattern on the Thyroid bloods and most common is energy restriction – as in caloric deficit – not matching energy output with demands.
      The body goes into shut down – conservation mode. This is hypothalamic pituitary axis dysregulation.
      Improving diet, in both macro and micronutrient quality – addressing any psychological issues related to such and reducing adrenal stress improves the picture. Giving hormones to a 22 year old with a normal MRI is not an advisable path as the body will become dependent and this is ignoring the root cause.

  22. Hi, My daughter was diagnosed with Hashimoto’s thyroiditis at the age of 5 and her anti TPO’s have always been > 1000. She take Levothyroxine and her dosage is changed when needed. She just turned 18 years old and said that she has felt her worst this year. I thought for sure that her levels were off. We just received labs back and her TSH is in the normal range, and T4 is normal. Anti TPO’s are 641 ( for the 1st time). She has been having headaches daily, bouts of nausea, night sweats, diarhea, hair loss and extremely exhausted. Any suggestions… what to ask at our next appointment. I am going to ask that he check her T3?

    • This sounds like what I’ve been through. My Hashimoto’s left me with only a sliver of thyroid. Over the years my dosage needed to be constantly adjusted. Why?

      I kept digging for the root cause.

      Due to other health issues, I started eating gluten and casein free. Migraines cleared up, night sweats went away, as well as a long list of other issues.

      4.5 yrs later, headaches returned and my sinuses were constantly clogged. After testing negative for air borne allergens, and negative to food challenges for oral food allergy, and cleared by an ENT that I didn’t have a sinus deformity or polyp, my allergist/immunologist said I have either chemical sensitivity or a metabolic issue.

      In researching chemical sensitivity, this is related to the bodies ability to detox, which can be affected by a vitamin deficiency or a genetic mutation (like MTHFR) which means somewhere the body may not be able to convert ingested nutrients into the active level cells need. Like converting T4 into the active level cells need. This is why T3 supplementation helps some, but doesn’t nessecarily clear up all symptoms. Because there’s still an underlying metabolic issue that needs to be addressed for other deficiencies.

      I’d recommend testing for the active level of nutrients in her body or possibly genetic testing for metabolic issues.

      • Don’t forget, Hashimoto’s is an auto-immune disorder and simply taking Levothyroxine, etc., may not be of help. The body is attacking its own thyroid so taking hormone replacement can sometimes be just that……replacing the hormone. However, since it is technically not a thyroid problem, per se, the hormones can only be of help for a short time and you still haven’t addressed the real underlying issue of the disease itself. I have Hashimoto’s and Levothyroxine was minimally helpful and after some time I actually started feeling worse on it than off. Rapid heart rate, shaking/tremors, shortness of breath, not sleeping, etc. Just a thought 🙂

    • She has a lot of the symptoms of hyperparathyroidism. What are her calcium and vitamin D levels? If calcium is high and vitamin D is low, have her PTH checked.

    • Read blogs and books by Elle Russ and how she cured her thyroid imblances with diet.

      Immediately change your daughter’s diet:

      No grains (what, corn, rice, etc.)
      No sugar or sugar substitutes, except xylitol and stevia
      No process foods (boxed, pre-made)
      No canola, corn or vegetable oils
      Nothing with soy or soybean oil!!

      Very important:
      Cook with extra virgin coconut oil, and use avocado oil and California olive oil for other uses
      Eat organic vegetables, whenever possible eat pasture fed meats and eggs

      Please read blogs like Mark’s Daily Apple, Wheat Belly, etc., Elle Russ and others write and do podcasts on how this diet helped to stop the cycle of inflammatory disease caused by thyroid imbalances

  23. My wife has been in and out of hospitals and doctors for months. This last one said her th3 was low but the other was normal. Symptoms include nausea, weight loss, shaking, etc. Can anyone shed any light on the situation please.

    • I had some of symptoms your wife has I had weight loss, nausea, fatigue , tiredness , heart palpitations and I was shaking at times.. tremors and dizzy . Later, I was told when the central nervous system is amped up from all the symptoms you will shake it is so scary! I had. It took two years and over 30 doctors. I got lucky and saw a doctor that was an MD/ND /LA.C he suspected it was mycotoxins poisoning which is black mold poisoning the doctor had attended a conference on black mold poisoning studied with Shoemaker We had newer house we began tearing open the walls and behind it was black mold in the bathrooms we remediated and sold the house my doctor told me I could never go back because I would react. Took 18 months for me to feel like myself again .

  24. It seems everyone who responds to these messages is low in something. After having my thyroid removed my TSH dropped to .015 on a normal range of 0.4 to 5.5 and I had no energy. After a year and Synthroid adjustments, my TSH is now 2.9. My free T3 has remained through the year at about 2.7 on a normal range of 0.8 to 5.5 and my free T4 has remained steady at about 1.5 on a normal range of 0.7 to 1.8. My Endocrinologist is very pleased but I still fall asleep if I sit down and have no energy to do anything else. All my regular tests are also normal including metabolic screens, CBC, adrenal gland function, etc. I’m in process of undergoing several cardiac tests and they are not showing anything. Something is missing but I do not know where to turn for help. I’d appreciate any suggestions.

    • Have you had any viral illnesses before your extreme fatigue? I had a CMV virus with symptoms like mono. I took a 500 mg tablet of l-lysine twice a day and avoided high arginine foods (Per Dr. Tent, Michigan) to get out of this. Susan

      • Thanks for the advice. After 2 1/2 years my free t3, t4and Tsh are now in about the middle of normal range but that is all that has changed. I still want to sleep all day and fall asleep during the day. I recently had a stress test and ultrasound that showed everything to be OK. I’ve tried several nutritional supplement programs but no change. Your suggestion regarding arginine sounds like something I might try, though I’m not sure I’m lacking in any of them. I’m a bit confused as to the l-lysine. It appears to be used primarily for cold sores. I have never had a cold sore or anything similar so I don’t see what that would help. In any case, I appreciate your advice.

        • I can’t say it enough on here, but pls try to get a good Lyme dr to see – it is the root of a lot of the things u mentioned. Even if u shoul dneg , u may find treating it helps? but I do recommend Fran Sussman, via skype, phone, or in person in NY – at least for 1 3 hour consult to see what is at the heart of the matter- pricey, but worth it

  25. Hi, I am confused; my blood work shows
    TSH = within range/normal, T3 = below and T4 = below.
    I can not find this combo anywhere and my doc thinks it’s just fine to leave untreated.
    Where do I go from here?

  26. my T3-6.8, T4 -5.27 and TSH -24.0 yesterday!!! and i am MDR TB Victim 19 month medication is going on. Now last month is remaining to complete the MDR Tuberculosis! May i know the level of my TFT any one knows ??

  27. Hi I have suffered from hypothyroidism hashimotos for 11 years since birth of first child ! Iam on nature thyroid 113 my free t3 is 2.3 I feel horrible so exhausted tired, barely make it through workout, feet so cold going numb all the time , knee pain, heavy periods so bad can’t leave house,heart pain, and weight gain!!!! I’m at my wits end

    • you dont take armour or nature thyroid with Hashimotos. THese are natural and have the same or similar anitigen that our own thyroid has so you will make blocking anitibodies to these as well. Change a synthetic pharmaceutical. Decrease stress with activity and yoga, add iodine drops topically to your body.

      • This not so Karen and it has been proven. I read the article on it several days ago. Also my bother and myself both have Hashimotos. He is on synthetic and suffering terribly. I am on WP thyroid and doing much better now. My Dr is in the dosage adjustment phase now. My TSH is 2.63, working on bringing it down to somewhere between 1 and 2. My T3 is low @97..working on getting it up to mid range. Also a low iron level affects the T3 conversion process. Desiccated thyroid meds have all the thyroid hormones our bodies naturally make. Synthetic has only T4.

  28. Good Evening,
    I am a 34 year old female. Four months ago, I stopped taking my birth control pill ( I had been on for 17 years). I immediately started to gain weight. I have gained approximately 20lbs. My diet has not changed…I am actually eating healthier and exercising more than I ever have. However, I have not lost a pound. I continue to gain weight on a weekly basis.
    I went to a doctor and had him do thyroid tests ( which I had to ask for). I picked my results up over the week end and my T3 is below normal. My TSH and T4 are in the normal range. I am calling the doctor tomorrow to set up a follow up appointment. I have to stay on the office because they do not.
    I would like to know what medications I should expect and should I see results or changed in my weight.
    I have become very stressed and depressed over this situation. I am relieved to know I do have a problem, but now I need to know how to fix it.
    Thank you for any advice.

    • Hi Tammy,
      I was going through the comments on this page and found yours, and realized we have similar situations. I, too, gained weight after stopping birth control and my thyroid exams came back with a low t3 and normal t4 and TSH. I was wondering what your doctor told you about your condition? Any advice would be great! I can’t seem to find anything to fix my weight gain situation despite healthy eating and a lot of exercise.

      • I’m in the same situation. Normal TSH, and T3, reverse T3, T4 are on the high side of normal. T3 uptake is low at 21, with normal starting at 24. High thyroglobulin antibody at 1.0. Test also showed c-reactive protein 4.56, way over the high of 3.00. I have lots of strange feelings in my heart. I’ve felt awful for nearly ten years and no definitive diagnosis. Weight gain, inability to breathe normally (feel as though my lungs shrank overnight ten years ago and never recovered) and zero energy. Hopeful the kinesiologist can untangle these test results. Anyone else with similar symptoms? Help, please. Nothing I’ve tried has worked.

  29. Hi, Ashley from SC here. I was diagnosed with Hypothyroidism back in 2007. I will admit I haven’t always been the best at taking my medication until recently. I was once hospitalized due to chest pain. Every test possible on my heart came back normal, except for the fact that it did seem a little bit enlarged. At the time of my hospitalization my TSH levels were WELL above 100! I was in the hospital for 3 nights while on Potassium and a high dose of thyroid medication my chest pain slowly went away. Before I had went to the hospital it had been about 6 months or so without taking any thyroid medication. I’ve been on Synthroid 200mcg since August 2015 and my doctor finally just rechecked my levels after complaining for a few months that I still didn’t feel right. My TSH was 18.350 (Above High Normal), my T4 was 6.4 (Normal), my T3 Uptake was 23 (Below Low Normal) and my Free Thyroxine Index was 1.5. Needless to say my doctor increased my dose of Synthroid to 225mcg and wants to repeat lab work in 6 weeks.

    • I have had Hypothyroidism Since 1979. And have been treat by over a dozen doctors for this. my new insurance requires for the go the re-evaluation. Because I start this condition due to hashimotos disease which is hereadity. You really need to google this because back 1993 I almost died with my nowhere near what your are at time Tsh was 13.57, T4 was 6.2 and T3 21. my husband brought all four our children to work to have lunch with me, he took one look at me and called ambulance. I spent 16 days in there 12 of which I was in ICU of those 12 days, 9 of them my family. include my four children I was most like was not go to live to come home. I had heart attach because my levels not right and was on diet that was high soy product, kelp, lettuces, and foods that blocked intake of my medication getting in to my blood. That’s when I began read every medical fact I can find about this problem. I found there a lot food, over count medication, vitamins, sinus medication a you cannot eat. The some foods and juices the mess with you test result in you before blood draws, etc, etc!!! It is real important the have month until feel right. And for I will always for the of my life have my blood work month. You have let your doctor know the want your way .

  30. I recently had blood work done again to test my thyroid levels and I noticed that my TSH was low (.36), my T4 was low (50), and my T3 (.364) was also low. This is becoming a pattern. My Dr. switched thyroid meds and put me on a pretty high dose (180mg of Armour). What does it mean when all of these levels are low? My Dr. said the levels were discoordinate and should not be this way but did not offer an explanation other than I wasn’t absorbing the thyroid meds I was on previously. I am most definitely NOT hyperthyroid and I have Hashimoto’s.

    • Hi Mindy!!!

      My name is Michael Scott. I specialize in Thyroid disorders with particular focus on its relevance toward weight gain. What you have appears to be a pituitary pattern. What does that mean? As T4 levels drop our bodies compensate by releasing more TSH from our pituitary gland. TSH tells the thyroid to make more T4 ((when T4 is low)). T4 is then converted to T3 ((by several mechanisms)) in the body. Because all 3 of your markers are low we should look at the process. Doing so reveals a possible issue with the pituitary not making adequate TSH to stimulate the thyroid to make T4. Perhaps you should ask your Dr. to perform diagnostic tests to rule out a pituitary issue.

      • Okay. I got a question. My TSH was 1.9. Over the years the TSH climbed, until it reached 3.9; which I know is normal. However, my WT went from 115 to 160 (2010 to 2016). Along with severe depression, lack of libido, blurred vision, dry skin, lack of appetite, increased appetite, cloudy memory, achy joints, unable to sleep, to sleeping all the time, swelling joints, bloating, and heavy irregular mensus, lethargic. Finally, found a natural path (needed a doctor who could look at the entire picture). So, she had my T3 and T4 tested. My T4 was on the high normal. My T3 was at .8. So, what does that mean? I’m currently taking 60 Armour thyroid. The labs were taking prior to starting my Armour thyroid. Side note my TSH level since starting Armour thyroid is now at 2.2.

    • Again if you have Hashimotos you make blocking antibodies to the thyroid and so when taking a natural thyroid you may make blocking antibodies to this animal thyroid that has similar antigens. Take the synthetic thyroid, lower your stress, do yoga, clean up your diet. Suppliment with iodine drops on your body…read up on this.

  31. My lab results were TSH 3.1, free t4 .95 and free t3 2.0

    My Endo increased my T4- Tirosint from 112 to 125. I feel a bit better but not great. She did not make changes to my T3 medicine-cytomel which I take 5 mcg in the morning and 2.5 mcg in afternoon. Should I increase my T3 dosage?

    • I don’t have very much experience in this area having just been diagnosed with low t3 and high ft3 (5.5) but my dr put me on 5mcg 3 times a day. When I wake up, 30 min before lunch and 30 min before dinner. Always take in an empty stomach he said. I’m not sure why he started me on 3 a day but I hope to be feeling better soon.

  32. Let me start out by saying … I’m so sorry many of you are not getting answers to your questions about your health. I have found that when I feel as though my doctor starts passing me around like a hot potatoe it sends a flag up that he doesn’t know the answer on what is wrong nor does he know how to fix it. That only causing more stress. for me only causing me more stress. Stress can worsen things greatly. Which brings me to my question. I’m a 38 year old female and my blood work has been all over the place. My recent visit with the nuclear doctor his diagnoses is Graves’ disease hyperthyroid. I am seeing a enducrolgist today. My symptoms are… Throat pain, tremors, anxiety, headaches, weight gain rather than weight loss, heat and cold sensitive, stomach pain, headaches, heart paputations, sweating and I noticed a small lump in the right side of neck and now another on my left. Head and neck doctor said it’s probably a lymph node but it has NEVER been there before. I am having hair loss but again they state it’s from alopeci.

    My blood work is showing T4 Free 1.7, TSH 0.01 (L) T3 Total 216 (H) D Dimmer test is 800. They tested my D Dimmer because with me being so heat and cold sensitive I get these red and white blotches all over my legs and arms. The bloches don’t hurt but they come and go which seems weird to me. Anyone have any ideas on what is going on because I’m not being given any direction on what to do and how to get back feeling normal again? I feel it’s important to try and fix a problem before you can’t fix it at all. I appreciate any advice. Thank you, Tiffany

    • your description is classic hyperthyroidism, agrees with Grave’s disease diagnosis. the lumps could be lymph nodes, or could be thyroid nodules, depend on the location and what shows up on the thyroid US/CT scan. treatment is relatively simple and straightforward, PTU and propranolol, maybe radioactive iodine. please consult your endocrionologist.

      • What are thyroid nodules? What is PTU and propranolol?? I’ve been having my own battles with being hypo but I’ve never heard of those terms before.

  33. I had a total thyroidectomy in 2012. Since this I have had a horrible time regulating my thyroid. My general practitioner referred me out of their practice as they were unable to maintain my thyroid. The only time the results were stable was when I was pregnant with twins. In January I was on 90 mg of Armor, I switched practices and my levels were TSH 0.027, T3 Free 7.2 and Free T4 1.26. As of yesterday, on 120 mg of Armor, they are TSH 0.005, T3 Free 9.4 and Free T4 1.32. The only level in a normal range is free T4. What is wrong with me? What do you recommend? Is this hyper or hypo? I have had drs lower armor meds, up armor meds, change to a compound. When I had the compound medicine I showed up as zero thyroid hormone in my body. I am very discouraged and would like some advice.

    • Hi Allison, I am sorry to hear the fact you had to go thru….I am an acupuncturist in MA specialized in women’s hormonal imbalances. Your TSH is 0.027 and 0.005 which indicates that you have HYPER-thyroidism. What kinds of symptoms you are having? Restless sleep, palpitations, anxiety, racing thoughts?

    • I had my thyroid removed last May and have had issues ever since. I’m no endocrinologist but simply based on my experience with ultra low TSH, as my Synthroid was reduced step by step from 137 mcg to 100 mcg my TSH came back into normal range.

    • I had a total Thyroidectomy due to Thyroid cancer. My doctors keep my TSH low, .335, to suppress the likelihood of the cancer coming back. My father had the same problem and his doctor keeps his TSH at .01.

    • Please switch off of Armour and take Synthroid in addition to separate T3 (Liothyronine). Armour is not consistant and you need consistant levels. Hope this helps.

      • I would agree with cam. Armour has a set amount of T3 in it. When our endocrinologist took her off Armour and regulated the amount of Cydomel T3 along with Synthroid, it was like a veil had been lifted after 8 years in a fog.

  34. I usually work with nontraditional doctors but I needed a PCP for insurance. I’m now with a traditional doctor that’s saying I’m hyperthyroid though I have no symptoms of this. In fact, my symptoms are more hypo — cold, brittle hair, dry skin, constipation, fatigue. My test results are TSH .10, T4 .77 and T3 2.7. I guess this means that my TSH is very low, my T4 is low and my T3 though not high, is in the normal range. Generally, I think a high T4 with a low TSH show hyperthyorid. I have NEVER been diagnosed at hyperthyroid and in the past when doctors have lowered my Armour dosage, I’ve gotten worse. Anyone know of a good doctor in the Albany area to help me with this? Thanks!

  35. Hi,
    I just had a total thyroidectomy. After 2 weeks I did a blood test. My results are: T4: 4.24, T3: 5,08, anti-TPO: 1,4.
    Any advise please? How this should be interpreted. I hate to make medications….:(
    thank you for your time and effort!

    • Kate,

      Unfortunately, you will have to take medication for the rest of your life in order to live. Not taking thyroid replacement hormones will cause you to slip into a coma and die. It is called a Myxedema Coma.

  36. Can someone help explain my latest test results? I have not seen the doctor yet but received the results through quest. This has been a challenge and struggle for years and it’s debilitating.
    T3 reverse 7L
    TSH 4.11
    T4, free 0.8
    T3, free 2.5

  37. These are my test results I’ve struggled for years with muscle cramps, spasms, fatigue, difficulty sleeping, then sleeping way to much in July my TSH was .006 I was taking 150 mg of synthyroid my doctor accused me of doubling up on my medication I asked if the lab test could be wrong he cut my medication to 75 mg synthyroid retested 8 weeks later TSH .216 by now I was starting to feel tired all the time he cut my meds again to 50 mg I again asked if the test could be wrong because I was starting to feel really bad leg muscles cramping and spasming more and so painful that it’s making it impossible to fall a sleep. I just had my labs drawn again and ask if he could do more extensive testing these are the current results done on 2/4/2016 He just wanted to raise up my synthyroid but I questioned him about the normal T4 level and low T3 he got mad and said he’ll refer me to specialist and I’m still waiting for a call still on the 50 mg of synthyroid and sleeping 16 hours when I can finally fall asleep because of my leg cramps and spasms, My nails and a hair are now brittle and breaking and falling out. Do you think these lab results are just hypothyroidism or something else???
    TSH 50.640 uIU/mL Normal Range 0.450 – 4.500 uIU/
    T3 56 ng/dL Normal Range 71 – 180 ng/dL
    FREE T4 0.81 ng/dL Normal Range 0.82 – 1.77 ng/dL

    • It sounds like secondary (also called central) hypothyroidism. Caused by a problem with the hypothalamus or pituitary. I have this caused by my pituitary…its treated the same as primary hypothyroidism but its a good idea to have other pituitary and hypothalamus hormones checked too.

    • Theres a natural way to cure hypothyroidism. Do not take synthetic pills gambling with if u are getting the right dose. I had half my thyroid removed. I have had chronic constipation with terrible abdominal pain. Not anymore…natural way to see if u are hypo..put a dollar coin size amount of topical iodine (not povidone it has plastic in it) buy a 2-4 percent solution brown in color. Put a dollar size amount on your abdomen. If it absorbs within 12 hours ur body needs it. You can supplement in this way. I put more on for supplementation. I do not have constiparion anymore. This is safer than natural pill ingestion because ur body will only absorb what it needs. Also read about benefits of organic brazil nuts on thyroid.

  38. my results for thyroid are; TSH = 0.5
    T3 = 3.3
    T4 = 10.7
    I’m told they’re all normal but 12 yrs ago had hyperthyroid and got quite bad. i don’t want to go thru that again but are these results really normal can you tell me as somedays don’t feel right.

  39. hi new to the site.as with many of you the last few years has been long journey with a overloaded suitcase of signs symtoms ,periods of relieve and long stretches of hell.with varying degree of diagnosis from GP’S.ENDOCRINOLOGISTS ,INTERNISTS AND GASTROENTOLOGISTS,ONCOLOGISTS AND HEMOTOLOGISTS
    heres the lab results
    TSH 0.05 [0.30-6.20]
    FREE T3 3.4 [3.8-6.2]
    FREE T4 8.8 [10.0-28.0]
    tests are consistant and many over the last year at various labs throughout the province
    wbc 3.6 ref 4.0-i0.0
    rbc 4.45 4.7-5.80
    hgb 135 140-175
    hct 0.397 0.42-0.52
    currently on .88 levothyroxine Ihave classic symptoms hypothyroid with occasional rouge hyper indicators im currently having a stretch of ibs and soft and hard stools constipation ,neausea with gas,bloating poor digestion and inadequate medication absorbtion to name a few.ive had many gastroscopes ,mri’s ct scans throat,thyroid, petuatary,stomach duodenium,colon. doctors cannot agree or make sense of the endocrine or blood count levels

    • my blood test hormone TSH T3 and T4


      TSH :0.35-4.9
      T3: 0.6-2.6
      T4: 5.0-13.0


      TSH (0.37)
      T3 (1.5)
      T4 (6.6)
      please someone help me on this result what is my problem

    • I would suggest trying NDT (natural desiccated thyroid) or T3. Also have your magnesium, potassium, B and D levels checked.

    • I’ve had sever Graves had RI131 – high cancer dose – took 2 times to kill it. So I’m experienced with hyper & hypo. Been miserable with on going off & on issues – found another new doctor. For the first time ever in all these years was tested for allergies – duh – graves is autoimmune disease – why the others don’t consider this is beyond me – I have full blown allergies to milk protein – egg white protein & wheat!!!! Look up all the different reactions your body does do to allergens!! Amazed!! Also very low on vitD – & B12 – NOTE blood work for allergines only show full blown allergy – intolerances (which can have as sever reactions) & sensitivity doesn’t show on blood – but eliminate the known allergines & you can pretty much figure by body responses what your body reacts to…. Also Know that you’ll feel like crap as body goes through withdrawal once you eliminate allergines – not unlike alcohol or tobacco. Lasts about 2 weeks…. Now that your body is not fighting allergens maybe thyroid hormone doses can work & respond better…

  40. I would love some feedback on my labs. I have all of the symptoms of hypothyroidism, including puffy face/eyes, headaches, intolerance to cold, weight gain, hair loss, etc, but the last time I had labs run, in September, my TSH and other labs were normal…although several were not optimal. Below are my results:
    TSH: 1.04
    Free T4: 1.0 (0.8 to 1.8 reference range)
    Total T3: 84 (76 to 181 reference range)
    Free T3: 2.5 (2.3 to 4.2 reference range)
    T4: 5.3 (4.5 to 12.0 reference range)
    Vitamin B12: 322 (200-1100 reference range)
    Any help would be much appreciated. Thanks!

  41. I have struggled with hormonal issues for years. I was diagnosed with a pilitary tumor and nodules on my thyroid years ago. My endocrologlist says my thyroid is functioning ok. I have a problem believing that being that I am completely exhausted most all the time and my hairs falls out my nails are brittle I struggle with depression. My scalp/hair hurts!!!! I haven’t been to my regular endocrologlist in over a year but last week my regular doctor did a blood test. My Free T4 is low but she didn’t say anything. I am just beyond frustrated. I am extremely tired and no engery. Help someone!

    • Try going to a natural path Doctor!!! The ine I went to took all my levels very seriously and is testing my low T3 level! Good luck!!

    • Id b changing Drs .she needs to test tsh ft3 ft4 antibodies vit b 1.25 vitamin b12 iron magnesium ferritin zinc normal tsh is 0.5 to 2.0
      ft3 needs to b optimal as well as ft4 needs to b optimal

    • I have had a complete thyroidectomy about a year now.

      I am on the meds 125mg thyroxine. I have not had a blood test in a while. I found that my leg psins have come back and my inability to lose weight. I was in the pharmacy and one of the ladies was a naturopath. After a conversation she told me to do the Caruso detox, cut out gluten, dairy meat and any thing processed.

      I lost 5 kg (10 pounds) and my energy levels even my sleep patterns have improved. I have to go back and see her for part 2 of her plan

      Only my leg pain has returned I think it may be time for another blood test.

      I thought i would share my experience of detoxing with hypothyroidism,

  42. hi i had to get a second opinion on my thyroid today the endocrinologist said i was taking way to much medication as my tsh level is0.04 and my t3 is 189 he said my meds to high and can cause a-fib or stroke symptoms ? I’m taking natures throid 97.2mg and natures throid 16.2 2 of those tablets also what do you think?

  43. Hello, can someone please help me. My lab results are as follows. T3 reverse 25 normal 10-24 Free 3 is 2.6 normal 2.2-4.2 Free T4 .8 normal .7-1.7 I feel horrible. thank you

    • Seems like they are normal ! Please test your zinc and iron and blood test ! If these were normal than it is anxiety !

  44. Hi! Hoping you may have some insight for me. A year ago my Dr prescribed me 30mg of arm our thyroid for a sluggish thyroid. Normal t3 abd t4 (although both on low end of normal) and tsh on high end of normal. But I was having horrible fatigue and constipation and infertility problems so we started on a baby dose of armour. It brought my tsh down. Symptoms improved almost immediately especially the fatigue. Stayed on same dose all year and everything was normal when retested mid year. Now- one year later I just had labs done and while tsh is normal at 2.1 my free t3 and free t4 are low at 1.95 and .69. ? Doctor also says I have hashimotos because I tested postive for antibodies but tpo was still in range at 6.8? Just wanted to get an outsider opinion – I hate the idea of taking hormones the rest of my life but they help the fatigue so much I am reluctant to stop. Thanks!

  45. I had my thyroid removed last May because of large nodules. On a normal scale of 1.8 to 4.6 on free T3, I was 2.8 before surgery and 2.9 now. On a normal scale of 0.7 to 1.8 on free T4, I was 1.2 before surgery and 1.8 now. So far, so good, but then there is the TSH that on a normal scale of 0.4 to 5.5, I was 0.5 before surgery and 0.015 now. I was started on 137 mcg of Synthroid after surgery and been slowly reducing it to slightly under 100 mcg now but have no energy and am beginning to experience muscle pain in my legs. Trying to find the right meds is a long process. If anyone has any ideas as to what would cause this extremely low TSH and borderline T4, I’d appreciate hearing from you.

    • Ron, I take Nature-Throid. It was suggested to have my nodules removed but I wanted to try the medication first. A year later and my nodules/goiters have shrunk and I can swallow without pain. I also take iodine and Selenium. A low vitamin D can cause muscle pain. I take a high dose of vitamin D 3, cofactors vitamin K2m7, magnesium glycinate to boost and become optimal. You can read more at Stop The Thyroid Madness, Vitamin D Welness, Root Cause of Hashimotto.

      • Thanks for the info. I’ve looked at the Stop the Thyroid Madness web site you suggested but did not find anything to connect with my situation of the extremely low TSH while all else looks fine. I take 4,000 units of D3 daily and a lot of other vitamins and minerals and my tests show I’m good there. My adrenal tests also looked good. I never had any pain but after removal of the thyroid I have had an occasional difficulty swallowing large pills. My Dr. says I’m hyper, not hypo and continues to decrease the Synthroid after each test. I’m now taking less than 100 a day and am feeling better but not great.

      • Is it normal to swallow and have a lot of pain? I have three small lumps in my neck. Started with one lump on the right and now I have two on the left. Head and neck doctor said its a lymph node but I NEVER had them before. My blood work now showing T4 free is 1.7, TSH 0.01 (L) and my T3 total is 216 (H). My D dimmer test is 900. I am now having trouble sleeping, and it’s very hard to swallow. To top things off I have three small lumps in my neck, headaches, Very tired, weight gain which is weird because being hyperthyroid I assume you loss weight? Of coarse doctors want me to have surgery to remove my thyroid but I was trying to lower my results without medication or killing my thyroid.
        Any of this seem normal?

  46. I had my thyroid removed about 15 years ago, I take 200mcg of Synthroid and have been told my T3 is low. When you do not have a thyroid what is the connection with the T3 hormone?

    • Under a normal situation, your pituitary gland sends TSH to your thyroid where it causes your T4 to convert into T3. T3 is many times more active than T4 and is needed for normal health. With no thyroid, you lose most of your T4 and therefore most of your T3. Synthroid is a synthetic T4 so the TSH now has something to convert into the needed T3. This is not adequate in same cases so some folks also take Cytomel also which is T3. Of course, there are other variations using similar products. I’m convinced that endocrinology is not a science, but an art to see what works for each person.

      • Ron, You’re in the ballpark, but TSH isnt ‘sent’ to the thyroid to make T4, into T3. TSH i sreleased into the bloodstream, and picked up by the Thyroid to produce T4. It’s is in the liver, gut, skeletal muscles and other organs that t$ is then converted to the usable hormone T3.

    • Hi Lynn

      From what I understand, the Thyroid gland produces mostly T4 (95%) and a little bit of T3 (5%). T4 is then converted to T3 as a result of the normal metabolic function of a range of organs in the body. This is why in the vast majority of people on thyroid replacement therapy simply take Thyroxin (T4).

      In a normal thyroid function test T4 makes up 75-80% of the total thyroid hormones in the body and T3 the remaining 20-25%.

      Because T3 is hormonally 5 times more active than T4, it seems that the ratio of T4 and T3 is important, in addition to the total concentration of both; although there is likely to be some debate around this issue.

      The key is the Thyroid gland is not the driver for T3 production. This is discussed in the article above, highlighting the complex nature of T3 regulation.

      If you do have low T3, then it is may be caused by one of the factors outlined in the article above.

  47. Hi,
    would really appreciate it if someone could help me interpret my test results.
    My free T3 is 4.1 pmol/L (lab range is 3.5-6.5).
    My Free T4 is 13.6 pmol/L (lab range is 9.0 – 25.0)
    My TSH is 4.28 mIU/L (Lab range is 0.40 – 4.70)
    Am i Hypo?
    Really really appreciate any help at all

    • Hi Nidhi

      Just on the basis of the numbers alone – you appear to have normal thyroid function. Your TSH is near to the upper range, which may just be where it was on the day you were tested or it may suggest that your thyroid is working reasonably hard to keep your T4 and T3 in range.

      So, no you are not technically hypo, but if I was you I would have a test in 3 – 6 months to see if there is a change.

      Also are you 40ish and/or do you have a family history of thyroid dysfunction – if so these are considered risk factors.

      Good luck

    • If you have symptoms I would say yes you are. I don’t usually rely on blood tests because they can be very unreliable. However the new TSH standard range that came out in 2012 is 0.30-3.0 so yes your TSH IS high.

    • Tests are normal ! If yours blood test are normal than please check your tsh3 , t3 t4 and antibody test after 3 months in morning ! Also Check ur iron and zinc and cholesterol level !

  48. Maybe somebody here can help me because my Endocronoligist sure can’t! One year ago I started to get symptoms of what I thought was low Testosterone. I got my testosterone checked, and it deffinetly wasn’t that. I knew something was wrong though because I had a list of about 20 symptoms that started very suddenly. One weird syptom I got was 2 big patches of Hyperpimentation on my face, and because of this I went to the Dr. right away. My Dr. suggested I have hyperthyroidism. I went and got a blood test and my results were TSH .075 (.550 – 4.78) T3 33.4 (22.5 – 37) T4 8.5 (4.5 – 10.9) T3total 112.6 (60 – 181) Free T3 3.3 (2.3 – 4.2) Free T4 1.15 (.89 – 1.76) My Dr. saw my low TSH and handed me off to a Endocronoligist. My Endo Dr. wanted me to retake my blood test because it had now been about 4 weeks since I had gotten them. My 2nd round of tests were:
    TSH .567 (.550 – 4.78) Free T3 2.9 (2.3 – 4.2) Free T4 1.24 (.89 – 1.76) I also had an Ultrasound done on my thyroid and the result was that my thyroid is slightly enlarged. Because my 2nd round of blood tests were in the somewhat normal range, he said there was nothing he could do for me and to come back in 6 months with another blood test. If I didn’t have about 20 symptoms like nervous energy, I lost 25 lbs and can’t gain weight, sweating under my arms constantly, shakiness, and of course the hyperpimentation on my face. Then I would be incline to agree with him. I’m only 34 and this definetly is not just aging. I know this article was for hypothyroidism, but everyone seemed very knowledgeable on thyroid issues so I thought I should ask. Please if anyone can help, I feel like I’m going crazy and no one is listening!

    • Hyperpigmentation and hypopigmentation can be signs of Addison’s disease. I may be way off base, but thought I’d throw it out there.

    • Hi Nate

      I have had Graves decease (autoimmune hyperthyroidism) for almost 10 years.

      I’m not a qualified Dr but your thyroid function results appear consistent with normal thyroid function – in that your T4 and T3 levels are in normal range and appear to show limited fluctuation during the test period. I would have another test within 6 weeks to get a longer data sequence.

      You are likely to experience variations in TSH from one test to another – because this is the bodies regulating hormone. Variations in T3 and T4 are much less abrupt. Having TSH outside of range doesn’t necessarily point to thyroid dysfunction. But your significant variations in TSH between tests appears unusual. This might be a consequence of some other condition – ie. the body is working hard to stay in normal metabolic function.

      It is unlikely that your symptoms are associated with thyroid dysfunction because your T4 and T3 are within normal range – albeit nearer to the higher end. From experience, your T4 and T3 levels need to be significantly outside normal range to experience severe symptoms. Mine were 2 – 3 time outside of range and I could still function, although I lost weight, had the shakes, resting heart rate of 90 bpm, and experienced moderate levels of anxiety.

      Note that Addinson’s is a metabolic disorder and often goes undiagnosed.

      Good luck

    • Secondary (central) hypothyroidism! I have this. caused by pituitary or hypothalamus. Took me 20yrs to figure it out and no one would listen! finally found a dr that would and i feel so much better!

    • Hormones test changes very often tsh3 increase and decrease often ! Your tests are normal ! But I suggest you to do your blood test Cbc complete wbc complete , zinc , iron , calcium , pt , cretinanine c protein active , vitamin D , ! Let me know about these tests!

  49. Hello all!

    You all are courageous! Hope you all got better!

    I recently received a tetanus shot on 11.10.2015 and now it is the 22nd of November.

    Right before the tetanus shot, the doctor told me I may have hypothyroidism and it was around 6.7 and then he took my blood again and I got the tetanus shot.

    The following day, my body reacted odd. I figured that was the shot. After a few days, the symptoms calmed down but then came back. They left again and came back.

    Now I feel like the symptoms I have are like hypothyroidism.

    After the second batch of blood work, before the tetanus shot, my levels were at 4.7 making me supposedly borderline hypothyroidism.

    I am a 24 year old female and my mother thinks I should go to get an X-ray because I have a swollen right leg and now I woke up with numb feelings in toes and now fingers. Please pray for me and help me.

    I’m thinking I’m going to buy B12 today. The doctors didn’t give me much of an explanation and said all the symptoms sounds like hypothyroidism when I have never had these symptoms until I GOT the tetanus shot.

    I think they will subside on their own but I am at a loss for words and also desperate. I also had trouble breathing last night. So I’ve been up since 6 AM and now it’s 8 AM.

    • Hi Farrah,

      It seems like the tetanus shot was not injected perpendicularly but injected into shallow muscle layer (subcutatenous layer) so that you are experiencing strange symptoms like swollen muscles which very likely moves around. I am an acupuncturist and have seen the case like yours before. I just wanted send you my thought.

      • Hi Tamie,

        Thank you for the comment!

        Okay, so update. . . I still have muscle aches. Went to an acupuncturist and the ER. The acupuncturist I am seeing again on Friday at 9:30 AM.

        I am terribly cold but today I am going to get an infrared sauna treatment to detox my body from the shot.

        I used the bathroom finally, which I sometimes struggle to use.

        Also, at the ER they said I did not have hypothyroidism.

        This is all very confusing and at least I slept for like 10 hours yesterday after the acupuncture.

        So grateful for alternative medicine! Keep me in your prayers!

        How long does acupuncture take to work?

        Best and good luck all,


    • If all this has happened snce you had the vaccine, then it is highly likely the vaccine is the culprit. People are not told how toxic vaccines can be, or about any adverse effects. No one questions the Doctor. No one questions the ingredients.

      Adverse reactions to vaccinations are way too common for comfort. If you are given a drug, you can at least, in most cases, read the accompanying information leaflet before deciding whether to take it or not. With vaccines, you are not given that choice. Straight in the arm – wham, bam, thank you ma’am…….

      It may be worth Googling information like ‘tetanus shot adverse reactions’ to see if others have experienced similar issues (and believe me, it looks like they have). At least then you would be able to return to your Doctor with knowledge….

      • I did and they think it’s odd.

        They said I have toxic pee and I am going to an infrared sauna treatment today, eating lots of veggies but need more money to get better since I can’t work full hours like this.

        Hoping I get better and get rid of the toxins soon!

        If you have any suggestions. =) You can email me too [email protected]



    • I too received a tetanus shot back in June 2014 and have had problems ever since. My problem however is they placed the shot in the wrong area causing frozen shoulder, a bone cyst, and now tendinitis and thoracic outlet syndrome. I am also being told by my regular doctor I have low thyroid levels and after researching thyroid on the internet, the T3 area is where a lot of the swelling and pain takes place when my shoulder is acting up. Wondering if that’s related.

      • Hi Alicia,

        It might related. I had one patient who had frozen shoulder and got tetanus shot. The unusual swelling and sensation (cold and hot) moved around and developed the frozen shoulder on the other side. She later complained about hypothyroidism like symptoms but TSH is normal but High end rT3 and Low end T3. I really think these factors are all related. I am figuring out my problem with High end rT3 and Low end T3 I have responded to you a couple of days ago. I am just like you – trying to figuring out high fasting glucose level.

    • Dear ,
      Please give your complete medical history ! Tsh3 increase and decrease often ! Please test your Cbc , wbc , iron , vitamins B and D as well as please do your t3 t4 tsh 3 and anti body test after 3 months ! Do you have anxiety and depression? Pregnancy?

  50. I am getting very frustrated that I can’t find a doctor that knows what to do. I just got my test results back. My TSH was 0.16, my free T4 was 1.35 and my free T3 was 2.80. She wants me to reduce my Levothyroxine and start taking Cytomel T3. I just don’t have faith in her. The last time we were experimenting, I got so depressed and tired. I don’t know what to do. HELP

    • Unfortunately, trying new doses is part of figuring out what works for your body. More than anything I’ve experienced, what works for one patient work differently in the next. When you post your labs, you need to post the ranges- not because you need to be in the range but just for reference. I feel best when my t3 and t4 are both out of “range.”

    • Please follow your doctor and even if I get anxiety and depressed the hormones level change ! So please be happy !

  51. Hello!
    This is an interesting article. Thank you for posting it. I recently had some bloodwork done to try to figure out why my hair is thinning prematurely and I keep shedding an excess and my T3 (total) came back low at 59L (it should be between 76-181 ng/dL). My doctor says it’s okay, because something to do with my other numbers, that it adds up okay, or something and that this would not be why my hair is thinning. But, I still do wonder: IS this level for my T3 (total) really ok? If not, what should I do? My other results were in range at 6.2 for T4, 1.1 for T4 (free) and 2.4 for T3 (free). Thank you!

  52. Hi there, I have found Kresser’s discussion of “low T3 syndrome” to be very interesting, as for quite some time now I have suspected myself to be a sufferer of the opposite condition, ” high T3 syndrome”. Does anyone out there have any idea of where to look in order to find treatment and diagnosis of this genetic, peripheral conversion disease? It is very severe for me, so any suggestions would be much appreciated.

  53. I’m wondering if this may be something I may have. I have recently had lab work done showing my already low TSH levels dropping from 0.11 to 0.07, my FT4 levels were in the normal range at 1.5.

    My Obstetrician caught this but thinks I may have hyperthyroidism which I cannot even fathom. I am 13 weeks pregnant and already have gained 15 lbs. The only thyroid symptoms I have are complete intolerance for cold and fatigue. I also have awful acid reflux but it could be from the pregnancy.

    I’m terrified they’re going to give me medication presuming I am hyperthyroid under the wrong impression. To make matters worse they won’t check my T3 levels or give me a referral to an endocrinologist!

    I had preeclampsia with my last pregnancy and gained 75 lbs!! I lost almost all of it until I got pregnant again this time and I’m scared they’re going to exacerbate weight gain by wrongly treating my thyroid issues!

    • Evelyn, honey, if they are refusing to even check your Free T3 and T3 Reverse levels then guess what, they have no f-n clue about how thyroid even works and they could be endangering your pregnancy, your baby’s neurological development (cretinism) and your health in the process.

      I’m going to give you some unsolicited advice, because I’ve been there:
      1. You can go to a lab that just does blood tests and pay for whatever blood tests you wish to order, and the heck with what the doctor says. Get every thyroid test they offer, or, if $ is an issue, just get your Free T3 and Reverse T3 run and it will tell you everything. You should compare this with what “optimal” levels of these should be at your stage in pregnancy (because it’s higher than what a non pregnant person should have and the needs for more T3 increases through pregnancy). Your doctor will hate you for this but F their egos. A hyper thyroid patient doesn’t gain 75 lbs in pregnancy. Sorry. They clearly have no idea how to read thyroid results and don’t even know which tests to order.

      Don’t feel bad, my OB and I had an argument about it while I was pregnant. He insisted that T4 was what your body uses and T3 was what gets converted so there’s “no way” synthroid could have caused me weight gain and taking Cytomel was “pointless.” Friggin idiot! He had it exactly backwards and I knew it. I switched to another dr in the practice who wasn’t so ego driven. Just so you know, it works like this:
      Deiodinase-2 stimulates
      TSH which stimulates
      T4 which is then converted to
      T3 active (the gas pedal) and T3 Reverse (the brakes).

      The “free” T3 and T4 levels indicate what hasn’t been chemically “bound” by the body and really, the free T4 is not very telling since it’s not the final product your metabolism uses.

      Dessicated thyroid is probably going to be the best solution for you.

      As for your preeclampsia and acid reflux: start taking milk of magnesia every night before bed, this will help both of those issues tremendously and won’t harm the baby. Also if you can order some magnesium chloride powder to mix in water (“Calm” is a brand that works well but try to get it unflavored since the flavored ones include citric acid) and/or get topical magnesium chloride (body oil or bath salts) and that will really improve your blood pressure. Try to avoid chewing tums and excess calcium if at all possible, as excess calcium will jack your BP up (BP meds are, after all, “calcium channel blockers”). Try to avoid acidic foods like tomatoes, vinegar, orange juice, look for the additive “citric acid” on labels and avoid it like the plague. Don’t eat after 8:00 pm, period. Cut sugar out of your diet (amazing how much this actually makes a difference), don’t eat fried anything, time & structure your meals, and maybe try going on the diet for gestational diabetes even if you don’t have it. It’s a healthy diet and won’t hurt you or baby to follow it. Get some extra pillows and sleep on an incline, gravity makes a huge difference with acid reflux. Also try getting Thayer’s Slippery Elm lozenges to help calm your irritated digestive system, it helps a LOT.
      Cut your coffee & caffeine consumption back as far as you can too. Tell everyone (besides your older kids) who is stressing you out to go F off because you are making a baby and nothing they are concerned with supersedes that for you right now.

      I’m praying for you and sending you good calming healthy vibes ok!!!

      • Evelyn,
        Thank you! I have Hashimotos my numbers all came in back in the normal range but my T3 was slightly low. I have been on same Synthroid meds for over 20 years. I had RAI about 30 years ago. My brother suffers with diabetes and had triple bypass and is only 58. Most of my siblings have thyroid issues he doesn’t yet he is showing more of the thyroid symptoms and diseases that come from thyroid. Any help would be appreciated. Thank you. Blessings. Cassie

    • All pregnant women have thyroid issues ranging from minor to major, that’s why its redundant to have a thyroid test done while pregnant cuz our hormones are already whacked out due to pregnancy. Gaining weight while pregnant, some women just actually gain a lot of weight no matter how much they watched what they are and exercised. Remain to an exercise program that is suitable for you while pregnant, take up swimming that will help. Wait approx 3-6months to re test thyroid. Usually after pregnancy and if you breastfeed your hormones( including thyroid) will fluctuate for about a year. After your completey done breastfeeding re test to see where your at.

  54. Hi, read this article series with interest. I have lifelong T4 conversion issues. After gallbladder removal at age 16, I started experiencing fatigue and was placed on synthroid. I gained 50 lbs in 6 months of taking it! I leveled off after quitting it but have never lost the weight in 20 years of trying. I used a bioidentical compounded T3/T4 to good success in 2010 but was unable to afford it & was told it wasn’t available later on. I tried synthroid again in 2011 and gained 20 lbs in 3 months. I started cytomel in 2012 and almost immediately got pregnant (a wanted miracle, I also have PCOS as a result of my grandma taking DES when she was pregnant with my mom in the 1950s). I increased to 50 mcg while pregnant and actually gave birth 3 lbs lighter than I started. However, blood pressure issues caused me to have difficulty maintaining dosage levels and I discontinued it for Armour briefly in December 2013. I gained 25 lbs between December 2013-March 2014 on Armour (90 mg). I went back to Cytomel and hovered at a very low dose of about 10 mcg until recently. I sought out a thyroid specialist who put me on 1.5 grains WP Throid along with grain free low carb, 12.5 mcg iodine, iron supplements, and 4 weeks of HCG shots. I lost 15 lbs in the first 2 weeks but it came to a screeching halt after that no matter how much more I tightened up on the diet end. The dr’s diet coach kept insisting it was my diet although my free T3 levels started crashing immediately. The initial appointment Free T3 level (48 hours after discontinuing Cytomel) was 380 (3.8?) and exactly two weeks later after faithfully taking the WP Throid 1.5 grain, it was at 300 (3.0?). A 4 week level wasn’t taken since their phlebotomist had just quit. I’m supposed to be starting an increased 2 grain dosage next. I’m feeling better in a lot of ways, and proud of being grain & sugar free for almost 5 weeks now (well, I did cheat yesterday by eating very delicious fresh mountain apples we got at a roadside stand, but that is the only splurge). But my problems set in at 2-3 weeks of any therapy with T4 and I’m just terrified of gaining weight yet again now that the HCG shots aren’t artificially causing calorie burn. Should I add Cytomel back in? The dr had mentioned it as a possibility. I really think that would help a lot. Also, my mom has fibromyalgia and I’ve developed a lot of acute muscle sensitivity in recent years. I think getting this 150 lbs off would help everything, but do the math, at least 75-100lbs is directly the result of thyroid medicine backfiring on me over the years. FYI, I also take 500 mg metformin for PCOS, atenelol for my BP, and Prilosec for acid reflux caused by having no gallbladder. Super frustrated, please help. It’s like I can do everything “right” and still get nowhere.

    • Hi,
      Sorry to hear about your long and tiring journey. Have you thought to take herbals for your thyroid? My mother has Graves’ disease and she’s been on her meds(dr rx) for over 7yrs never once have these worked for her or my grandmother. All those meds your on and my
      Mother too, have severe warning labels, if they have no helped by now then they will never help. Your body becomes “ammuned” to them, they stop working of what little they were doing. Too many RX is polluting your system, and for what? It is not helping. If I were you, I would go a natural route. Try T-Balance for your thyroid, heard /read/researched great things about this . A lot of people have felt a difference 3daya-a week of taking the supplements; everyone is different so it could take longer to feel a difference. You could also try a birth contr for pcos issues too it works way better than those so called meds for pcos. I gotta give it to the doctors you are one great customer for these tx companies. Talk to your doctor about going a natural way, If your doctor refuses to help you seek alternative sYs of dealing with your thyroid; then my guess is he gets paid to push that med you take. Pharmaceutical companies do not create cures they create customers! I actually started my mom on the T-Balance and slowly weening her off the RX she takes for her thyroid. If you decide to try a herbal for your thyroid after consulting your physican , always ween yourself off little by little while taking supplements. Do not ever stop taking your meds, always ween off first. But consult your physician before taking anything and always get more than 2 opinions from different docs. Hope this helps I hope you find peace quickly with this issue.

  55. Blah I think this is what I have. I need help! I’m looking for doctors in Los Angeles who can please help me- seriously willing to pay whatever at this point. I want to try nascent iodine but scared. I’ve been on selenium for months and have no more Hashi antibodies…
    My free T3 is low like below the range low. My TSH is normal and T4 is normal. I’m starting to feel anxiety and weight loss has been extra difficult whereas before it was easier. On top of it I have a nodule that doctors are pushing me to remove surgically (its 4cm). Biopsy was suspicious.
    I’m a recently single mom with two kids and I’m scared what will happen if I get sicker…

    • I had this same problem with T4/T3 conversion, and what fixed it for me was B vitamins (and for me it took a B complex with the methyl forms of B12 and folate).

    • All this is linked to Metabolic Syndrome. You couldn’t do better than get off the carbs and go very low carb to help your body heal. Many out there are even eating Zero Carb and Fasting and healing their bodies.

    • Don’t drink tea, green or black. It contains a lot of fluoride which can take the place of iodine and cause iodine deficiency symptoms even when you’re not iodine deficient.

      In addition to iodine and selenium, you also need iron for proper thyroid function. Iron is needed to make thyroid peroxidase, which does the job of adding iodine to thyroxine inside the thyroid. Many women who have had hypothyroid for a while have more frequent and heavier periods and can be low on iron.

      I had hypothyroidism from drinking tea, which I only discovered after stopping tea suddenly for a completely different reason. It’s been a long summer of trying to figure out what was going on, but once I added iodine and supporting supplements I’m doing much much better. My TSH was normal while drinking tea, and none of my doctors caught the problem.

  56. can I take Alpha Lipoic Acid if I am slightly Hypothyroid and taking pig thryroid prescription?? My MD told me to take ALA, he knows I take the pig thyroid for low thyroid even though that is prescribed by another Dr.

    • ALA, even in small amounts, made me very tired and low energy. I am on Armour, and it seems that the ALA interfered with the Armour.

      What I found helpful was a B-complex that includes methyl forms of B12 and folate. Regular B vitamins with the cyano B12 and folic acid has no effect on me.

      In addition, I am taking pretty much all of the supplements recommended for thyroid support: Iodine, Selenium, Magnesium, Zinc, D3, vitamin C.

      What really helped the most though were the methyl B-vitamins. I actually feel really good now, although my Armour dose had to be reduced a bit.

    • Amy- are you familiar with Andy Cutlers work on mercury/ amalgam illness and chelation? I ask because in my experience using ALA (a chelator) infrequently can redistribute mercury (which may already be playing havoc with thyroid gland) and cause symptoms such as Jon describes. I would avoid it you think mercury is an issue and most certainly if you have any amalgams in place. J

    • Hi,
      As long as you let your doc know all what you were talk g as far as RX ( armour pig hormone) ms she/he said you should take ala then I would say it would be safe to take. But when in doubt as a pharmacist too.

  57. Hello,

    I’ve been on thyroid meds (nature-throid) for years and feel good. I was on synthroid when first diagnosed but that med made me feel worse. I also went gluten-free after discovering I had hashimotos (years ago) and my antibodies dropped to almost nothing!

    Well, this year, I’ve had 3 miscarriages. I’ve also developed anti-phospholipid antibodies (treated with blood thinners and baby aspirin while pregnant) after the first miscarriage.

    After the most recent miscarriage, a different doc (than my normal doc) ran thyroid labs. My normal doc usually looks at total t3 and reverse t3 = ratio. This other (new) doc thinks my T4 is too low and wants me on synthroid/cytomel or tirosint/cyotemel as she doesn’t believe in desiccated thyroid hormones. I don’t want to switch meds as I feel good and have felt good on NT for years. I felt horrible on synthroid.

    Recent labs:

    TSH 1.0 / Total T3 1.26 / Free T4 0.6 L / TPO 296

    What are your thoughts? I see no reason to switch meds as even with all the hormone changes with these miscarriages, I still feel good on NT. Is there a way to increase my T4 without switching meds?

    I’m also concerned about my TPO. My TPO antibodies jumped from 28 to 296 in two months time. TPO was at 28 while pregnant the third time, but after the miscarriage/d&c my antibodies jumped to 296. No idea why. I haven’t had antibodies that high in maybe 7 YEARS. I’m still eating gluten-free. Why would the TPO jump so high all of a sudden (in two months time)? This new doc thinks antibodies are no big deal and is more concerned about the low T4.

    Considering we are trying to conceive I want to be at optimal levels but I also want to stay feeling good and worry following this new doc’s advice will turn me into a sick woman.

    By the way, the miscarriages, we’ve discovered, are not due to my thyroid but due to a genetic chromosomal issue, in case you were wondering. Thanks

    • Hello,
      Sorry for your loss. Personally, I would t worry about antibodies as much as a low T4 level. In my opinion, I don’t like putting toxic junk in my body(RX) I prefer the natural route to go( not all herbal supplements/brands are created equal). I would try getting your thyroid under control before trying to conceive ( having a low/high fun ting thyroid can and will lead into a lot of issues. I have given birth to 7 children girls all 2 yrs apart. Two out of 7 pregnancies, my body tried to naturally abort the fetus due to my thyroid being messed up while I was pregnant. I ran into ALOt of issues that I probably normally wouldn’t of had if my hormones were in check before getting pregnant.) anyways, if you wanted to stay i a natural route especially since your trying to conceive , speak with your doc( if your doc doesn’t want to seek alternative avenues with Thai thyroid meds, my guess is they r getting paid by pharmaceutical companies to push your meds) I would seek a doctor out until you find one willing to seek alternative methods on help creating a healthy functioning thyroid. I know certain foods will hurt a low fun ting thyroid ( spinach,kale, broccoli) try to refrain from those and see if that helps. Wish you the best of luck

    • I take both natural thyroid (Armour) but needed to add in generic Synthroid a year ago because my t4 was a little low. There is no harm being on both when it makes you feel good.

  58. I have been battling with hypo for more than 20 yrs. In Dec 2014 my TSH was 4.28, June 2015 my TSH was 1.75. Today my TSH is .38 and my T3 is 3.34 and T4 is 1.39. Currently, I take 112 mcg 1xday. I feel so bad and don’t know what to do. Should I be concerned?

  59. my t3 0.62,t4 is 4.90 and TSH 2.4 ug/dl…I have the symptoms of the hypothyroidism please let me know what type of treatments available for my condition. I am Male 29 years old.

    • Hi,
      I’m assuming your doctor told you what you should or should not take. If your not fully 100% happy with what they said seek another doctor until you find one that will listen . For me personally, I like to go a natural way not a pharmaceutical route. Start researching different natural ways and brands( not all brands are created equal). Hope you find your answers.

  60. Hello, I have almost nonextent TSH and rT3 with normal range of T3 and T4. I feel completely exhausted, like I could collapse just from standing up. I feel like it has effected my heart as well, I feel SOB at times and irregular tachycardia.

    Also, my sodium levels are slightly high too.

    Pls advise, I get no help from my current MD. I am taking 10 grains of Armour Thyroid and just starting taking 30 mcg of T3.

    • Hi,
      I would get a different doctor asap! You shouldn’t be SOB! Seek a different doctor until you find one that will listen. Also check for low iron, that will make people SOB with low iron levels.

    • Little confused here since Armour is mostly t3 as well.
      I’ve been on meds for years now and the “range” needs to be taken with a grain of salt. My labs were in the range- my doc listened to me and increased my meds- I felt good for a good long time. I go through this cycle about every 9-12 months with increases here and there.

  61. The problem is too much RT3

    And taking T4 will make it worse

    You cannot see the high RT3 in the blood tests of TSH T4 T3

    Hashi will increase RT3 due to inflammation in the tissues, intestine or thyroid

    Sometimes you cannot see Hashi as its Antibodies to the Sodium Iodine Pump (35% of Hashi people have it) which is not tested.

    It is not “Emotional” stress, this is total BS. Its inflammation in the body due to an autoimmune disease. You can see it in the CD4:CD8 ratio and other markers like C3, C4.

    It probably needs NDT or T3 alone to clear the RT3 from the body.

  62. I’ve seen a lot of postings of people who have symptoms of Hypothyroidism, have a normal thyroid tests, and don’t know what else to do. I was here a few months ago with the same exact symptom sets. Weight gain (for no reason), inability to lose weight, cold hands and feet, brain fog, memory loss, fatigue, mood swings, headaches, just to name a few! If you are a WOMAN you need to look into your hormone levels. Start looking into “Estrogen Dominance” and Natural Bio-identical Progesterone creams. Starting as early as 35 (or sooner) these a fore mentioned symptoms can start along with shorter/lighter or longer/heavier cycles, bloating, PMDD, migraines and a whole page of other symptoms. And yes you can have a low estrogen level and have estrogen dominance. Progesterone regulates your estrogen levels and if you aren’t producing enough you will get the above symptoms. Your estrogen will go out of control and this all will also mess with your thyroid and adrenal glands. All the glands are interconnected. When one of your hormone producing glands (Adrenals, Thyroid, or sex (Uterus) glands) aren’t working it will mess up the other glands. Read Dr. Lee’s book “What Your Doctor May Not Tell You About Premenopause.” If you are close to menopause age then read Dr. Lee’s book “What Your Doctor May Not Tell You About Menopause.” Do not let any doctor put you on Premarin (A progestin-synthetic). You will get worse! Maybe not at first, but it will happen. It causes breast and ovarian cancer! Bio-identical creams do not cause cancer. Just Google what Progesterone does, Dr. Lee’s website, and see for yourself.

  63. My tsh was 5.9 and my b12 was 238. Started taking b12 shots and my b12 is good now but my tsh is 7.6 now and my t3 is 2.3. T4 was normal. My symptoms that sent me to the doctor were memory and concentration problems. Also my fingers started pruning up during the day without having been wet. Now my vertigo is bad. I haven’t experienced any other “new” symptoms. I am generally lethargic and cold because i tend to be anemic since childhood. I go to the doctor tuesday to go over lab results. Anyone else have the pruned fingers? I have read it is thyroid and diabetic related. I also am prediabetic. My a1c varies between 6- 6.8. Currently it is 6.6.

    • Yes, when my hypothyroidism wasn’t being treated consistently I had Pruney fingers, blood sugar creeping up, A1c high but not ore diabetic. Since I’ve been back on levothyroxine for the past 5 weeks my fingers are no longer Pruney. My Doc is going to test blood sugar, bun creative, etc as he’ s very hopefully that these numbers will slowly move down as we get my TSH, free T4 and T3 in optimum range – which for him means TSH under 2, t4 mid, and t3 upper high but he says he’ll stop any where on these ranges where I feel good. Is doc treating you for hypothyroidism? My d was low and we got that to 43 in less than 45 days through sunshine and supplements and my b12 was 428 and I’ve been supplementing also. Hope my feedback gives you encouragement.

    • You may find your blood sugar irregularity is linked to the thyroid issues. Dr. Kraft found that far more people actually have metabolic syndrome than has been estimated, due to being hyperinsulinemic.

      Have you tried going on a very low carb, high fat gluten/grain free diet? Many are reversing their blood sugar issues by doing that and helping their thyroid into the bargain. I am so insulin resistant I have to eat virtually carb free, but it’s working. I am now off insulin and my sugar levels are coming down.

  64. Posted previously re; lack of improvement in symptoms despite ?? TSH and T4 NORMAL…. My leg pain became so severe I decided to again see my physician……the only thing she suggested was to decrease my Tirosint from 50 to 25mcg. Slight improvement in pain BUT other symptoms unchanged. One week ago I QUIT taking any thyroid med and today feel immensely better…. HOWEVER…..I am seeing an integrative medicine practitioner this Friday. I HAVE LITTLE TO NO FAITH IN TRADITIONAL WESTERN MEDICINE.

  65. have bottom scale low levels of tsh, t3 and t4 currently on .75 lithothyroxine and have classic signs and symtoms of hypothyroid. any one care to weigh in ?

  66. Can low t3 syndrome cause anxiety and can other thyroid imbalances cause it also? If your tsh is low does that always mean that your t4 is going to be high?

    • YES!!!! Both hypo and Hyper thyroid can cause anxiety for different reasons. For Hyper too much T3 causes Hugh metabolism and heart palpitations. For hypo, low metabolism can cause adrenals yo attempt to compensate and they produce too much adrenenalin.

  67. I have had thyroid issues for 32 years and it seems the last 10 years I always have to change my synthroid dosage because my test are either high or low. I am tried, on an off I have a sensitivity to cold, I eat well but cant lose the extra weight, I get headaches and I feel like I’m in a cloud. My last test results are:
    TSH 1.86, Thyroxine free 1.25 ng/dl, and my Triiodothyronine 57 ng/dl. My doctor said my TSH is normal so I should have nothing to be concerned about even if my T3 is low. Can there be other issues here?

    Thank you,

    • My T4 levels were good; but, my T3 levels were low. No obvious health issues except tiredness and sleeplessness. I have stomach issues and decided to pursue that issue to see if it would help my thyroid levels. Raw, unfiltered apple cider vinegar, probiotics, extra iodine, pineapple and several herbs known to help stomach problems – my last test was within normal ranges. Don’t know if I have licked it; but, I am getting results.

    • TSH within range. T4 within range. T3 low or low within range. Not good to me. If taking thyroid replacement hormone-TSH should be very low almost nonexistent ( we no longer have a need for the pituitary gland to give a TSH signal to make T4/T3), t4 at the upper end of the labs and t3 at about mid range, Dr’s currently have their gold standard to go by which is getting the TSH within range. If they allow the TsH to be out of range low it could mean potential law suits, so they are discouraged from prescribing higher levels of T4 or prescribing T3 for goodness sake. I started on T4 only (2007)and noticed my t4 was at the high end of the labs and T3 at the low end within range. Told my doc that I still didn’t Feel right and told him I thought my T3 should be better than low within range and he prescribed cytomel once a day. It is fast acting and short lived and should be divided into a minimum of 3doses/day….for me and most, you feel the effects…fast heart rate and extreme fatigue from it. I tried to stop taking t3 and was off of it for 2,5 years. I just started taking it again. While off of it my vitD levels became deficient, have ichthyosis vulgaris skin, brown patches appearing, tennis elbow that I have had since August 2014, my toe nails are dry, peeling, felt cold in air conditioning/72 degrees, bumps forming on the finger joints closest to my nails ….again(did this when I was undiagnosed for 3.5 years) also again… I was hearing crashing noises upon waking. Didn’t get the severe tinnitus back. Just started T3 again about 3weeks ago. Tennis elbow is not nearly as bad as it was, still waiting for my neck to stop crunching when I stretch, will get retested for vitD in a couple of months, don’t hear crashing sounds when waking, time heals. I would rather grow old gracefully on T3.
      Compounding pharmacies can tell you which dr’s are ordering time released t3 for their patients. It is the best way to find one that is willing to make you feel better instead of using the TSH as the gold standard. Does low t3 mean there is a not yet discovered disease in a patient in every case? I think it means that you are not getting enoug t3from the t4 you’re taking which is most common. It could mean we are not a good metabolizer of T4. Some are not good metabolizers of pain medicine…but there are tests for that to adjust meds. No test for genes that show low metabolizers of thyroid meds yet. Until the medical industry learns that the TSH is not a gold standard for those taking thyroid replacement, we will have other ailments, take more medications than needed and so one. Those who are informed have a chance to do something about it. I tried to find a dr close to where I liive and Fired 2 TSH gold standard physicians before going back to my dr that is across town.

    • Vaccines can cause all sorts of issues in the body, even death in some cases. Far better to focus on improving the immune system and health of the body. Diet – too much sugar, grains, carbohydrates can weaken the immune system.

  68. Hi .
    I am 22 years old male. I have mild tremor, irritability, tingling of extremities, episodic palpitations, hot hands and feet, bounding pulsations (especially at finger tips). Last week i saw my doctor for these symptoms and he told me that this is just anxiety. I was advised to get my tsh, ft3 and ft4 checked to rule out hypERthyroidsm.. ECG was Normal. but Thyroid profile report shocked me because it showed high tsh level and low free T3, though T4 was normal.
    My TSH is 10.5 (high)
    FT3 is 2.0 (low)
    FT4 is normal.

    I was shocked because hypothroidsm was totally out of picture and i got my thyroid test done just to rule out hypERthyroidsm!! I have NO SIGN OR SYMPTOM OF HYPOTHYROIDISM!!!

    My doctor says it is subclinical hypothyroidsm. Im afraid because he is not able to find out the CAUSE of my hypothyroidism..

    What should I do next?? Shall I start taking Thyroxine daily or i shall wait and recheck my tsh after few months????

    Also, i had a tetanus booster 8 days back. Can this be, in any wat, the possible cause of my thyroid underfunctioning?????? (I somewhere on internet read that tetanus toxoid can induce autoimmune reactions in the body). Please help. Thank you

    • I’d get thyroid antibodies checked. Dont let anyone (including doctors) push or scare you unto treatments that you are uncomfortable ith, especially any surgery. You may consider supporting your thyroid nutritionally. 200 mcg of selenium per day could be beneficial. Talk to a naturopath if you can.

    • I’d try find the secondary problem. You may have some other health issues; my research indicates the whole body is involved in converting T4 to T3 in the body. I believe I have narrowed my problem down to my gut. I had H pylori that resulted in an ulcer. I take Nexium with magnesium supplements. I’ve been treating my stomach and have had my T3 levels back in normal ranges. This is just my personal treatment, my doctor doesn’t know why I had low T3. Regardless, taking care of my gut is a good thing.

      • Hi Alice, I am very much like you. I had stomach ulcer then H.Pylori treated by triple antibiotics which knocked out the stomach lining resulted in leaky gut then Low T3 and High rT3 but normal T4 and TSH syndrome. Are you taking any supplement to keep your T3 level nice and higher than before / and lowering reverse T3 if you ever get tested. Mine is Low end T3 and High end rT3 which is not good. I also have blood sugar problem (I am 5′ 110 lb, not obese). Fasting Glucose is 103. A1c is 5.7. I do not eat gluten, sugary food… not sure why.

        • Hi Alice and Tammy, I am on the same boat as you are. I got stomach ulcer then H.Pylori, and now having hypothyroid-like-symptoms (brain fog, thinning hair, Fasting Glucose 102, A1c 5.8, spare belt around the belly) but my TSH is normal and I do not have Hashimoto’s. I am like you, Alice. 5′ and 112 lb. Not obese at all. Free T3 is Low End and rT3 is High End. I started taking 1 gram of barbarine for lowering blood sugar and Biotic Research’s Meda Stim to lower rT3 and a couple of other supplements. I am working with functional medicine clinician distally. If you would like to get connected, please feel free to email me – [email protected].

    • Your tsh is more than 3 times the norm?! I’ve hashimoto’s it’s an autoimmune disease they say levels should be between 0.4-4… Some Drs vary up to 5 but 10 is way too high
      My advice is always the same try going to see an endocrinologist they specialise in this area…

  69. I am taking 4 grains of armour a day. Tsh is great. Under 1 but T4, free T4 and free T3 are all low. What does this mean. I am not feeling so great either.

    • You could try a liver detox to improve liver function. That might improve hormone conversion. Also, you can have low tsh production and hypothyroidism. Eat lots of kelp harvested from cold water around scandinavia to support thyroid nutrition.

  70. Hi ,
    I have had problems for years and just keep getting the disregard from my doctor and told my thyroid is normal.
    Had my numbers checked in 2013
    TSH was- 1.39
    My Free T3- 1.8 (Range1.4-3.8)
    My Free T4- .09 (Range.08-1.8)
    My doctor told me everything was normal, we’d check them again in a year, but I sure didn’t feel normal so took it upon myself to go see an endocronologist for some help was told I need to exercise more and watch what I was eating and drink more water, lol great advice doc, she totally made me feel like an idiot. Would love to workout if I wasn’t so darn tired everyday hard enough to pull myself out of bed, along with the aches and pains.

    Had my numbers checked again last year by my doctor 2014.
    My TSH was 1.87.
    My Free T3 was at 2.7 (range2.3-4.2)
    My Free T4 was at .09 (range.8-1.8)
    Still to be told Im in the normal range and shouldn’t worry about anything. Easy for him to say, bet he doesn’t feel like I do everyday, so I went to a holistic doctor, he told me that my adrenals were off to make me feel like this, so took his meds for a couple months and they helped, but its right back to the same old thing.

    I’m so tired of feeling crappy all the time, so hard to function, have all the typical symptoms and have had them for years. Its coming up on the time to check my numbers again, and I’m thinking of going a different route, just not sure which route that is. Don’t wanna be told its all in head when I know its not.

    Should I try finding another doctor or endo doctor.
    Im wondering if all of this may stem from my pituitary gland as Ive been reading online if my thyroid is normal.
    Wondering if I may need my hormones checked. I’m frustrated with all of this and dealing with people who cant understand what it feels like to go through life like this everyday. The worst part is not having anyone to turn to to get the help that’s needed.
    Anyone have any insight they could add I’d appreciate it.
    Thanks for letting me rant a bit!!!!

    • Hi Maria,

      I’m sorry to hear about your frustration. Consider reading/watching YouTube.com videos on adrenal health. When the adrenals are stressed, they will make us feel tired, fatigued and they will affect thyroid health. This book is supposed to be good: “Adrenal fatigue, the 21 Century Stress Syndrome”, by James Wilson. You may check your adrenals with a 4 point saliva cortisol. Maybe could be ordered at directlabs.com. Pituitary could also be a problem, they are all connected (hypothalamus, pituitary, thyroid, adrenal and gonads).

      • Thanks Alex, was thinking of purchasing some self testing kits online, and also thinking it be time to find a new doctor as well. I appreciate the response, not gonna give up till I get to the bottom of this. Im only 45 and have felt this way for years but was able to handle things better at a younger age, but cant imagine living the rest of my life feeling this way! The biggest challenge is actually finding a doctor who can help!

        • Hi Maria,
          You are welcome, if you are in South Florida, Dr. Blyweiss, David is awesome. As Jenniferlyn K. wrote, try finding a FM doc or at least a doc that is open to learn more about biochemistry and thyroid function. It is obvious yours is lost. To improve thyroid and adrenals, life style, nutrition, toxicity, yeast and gut must be considered, among others. The book by Isabella Wentz, a PhD in Pharmacy might help, it is an easy read and very comprehensive. Functional Medicine Docs are generally more expensive, but they will try to go to the root causes instead of focusing on symptoms and conventional lab ranges. The institute for Functional Medicine is a resource to locate practitioners like MD, Nutritionists, Health Coaches, Nurses and so on trained in this field. https://www.functionalmedicine.org/
          Last but not least, never give up, never, never…

          • Hi Alex,
            Thank you for the link on FM doctors. I am going to look into it. I live in Chicago and sometimes without a referral some of these doctors claiming to help turn out to be a big waste of time. I went to a holistic doctor who also practiced Chinese Medicine and accupuncture not too long ago his website claimed he could help with thyroid, hormones etc. and after a few visits it turned out to be a dead end. Its quite frustrating but I refuse to give up until I get to the bottom of all of this.
            Thank you again, my quest continues! 🙂

    • Hello Maria,

      There is a difference between clinical ranges and functional ranges. Honestly – your Doctor seems to be just following what the clinical ranges say without much thought into your overall symptoms to see if something other than just thyrioid is involved. Unfortunately in allopathic care, we see this a lot. I would suggest finding a functional medicine doctor in your area who can help you determine if there are any other issues going on within the HPA(TG) axis, such as adrenals as Alex mentioned above.

      Good luck!

      Jenniferlyn, CHHC

      • Thank you Jenniferlyn, I appreciate the feedback! I’m going to look into finding an FM doctor as you and Alex suggested to help me get to the bottom of all this, as much as my doctor is telling me I’m ok my body is telling me otherwise. Thank you again!!!!

      • I am a 61 yr old male who was reasonably healthy and physically active through to my 40’s with allergies through my whole life… within the past year and a half I had a mini stroke, (temporarily effecting speech) I have had 3 24hr urine test with higher protein results each time, at Christmas time through the first of the year I had major flu like symptoms chills, no fever… I have been having joint pain, more fatigue, depression, hand and face swelling and now I get low T4 results back from a simple blood test..
        I am concerned that taking more tests, or drug trial and error, (Dr’s with no real time to look into) that I have and underlying condition that resulted in the Low T4… Any suggestions?

    • Hi

      Just to say reading your comments it was like reading about me!! I had a total THYROIDECTOMY 11 years ago..since then on T4…never really feeling great but managing..last year I had an awful time of palpitations, I had to go private to get a result as the doctors just didn’t review my bloods..one of my readings was off the scale..I was told to reduce my meds to 75mcg..this helped the palpitations.

      On such a low dose however after time I really struggled particularly at work, as a carer doing a very physical job I was exhausted and most shifts felt crap..excuse that word but it best describes how we feel doesn’t it!

      I e mailed my oncologist who raised my dose to 100mcg…this appeared to help but in the last two weeks or so I have starts to feel awful…I was struggling at work on Sunday and had to leave early. I was very emotional as I couldn’t see how I could finish my shift.

      My oncologist has suggested adding T3 which I am awaiting..as she is away at present..it’s all a complete nightmare..I am dreading returning to work and feeling so ill.

      I am hear to chat and perhaps we can somehow support each other??

      In the UK T3 isn’t routinely prescribed and the oncologist suggesting it was quite a breakthrough…I hesitate to go to my GP as they appear to no next to nothing about what we are coping with.

      Best wishes to you


      • Hi I had my thyroid removed was on 200 mg levothyroxine lost 100 lbs was still on 200 when I weighed 169 I was having tremors ocd insomnia panic attacks no energy etc I had my labs done my endo said everything was normal and I said I’m not normal I’m finally reduced to 137 mg of synthroid but still have no energy ocd panic attacks and I got.my blood.work done and my t3 was .08 my t4 was 1.8 I have depression cry all the time this thyroid issue is all crappy I have a dctr apt and I still have panic attacks I have no energy I feel like I weight 1000 lbs. Hopefully today at apt they put me on armour or t3 medicine cause this is crazy. I have severe anxiety low progesterone and low vitamin d

        • You need to get on armour, get your vit D levels up and progesterone leveled out. A great website that has helped me is hypothyroidmom.com there is a ton of helpful info. I had graves, then RAI and now hypo. I thought I can’t live like this for another month and this website has helped a lot I demand to have tests done by my docs and demanded armour. Fight and don’t give up. Good luck!

    • Maria you sound exactly like me. My levels are the same as yours and I feel like crap everyday. Low energy, muscle aches, stomach problems and the list goes on. Don’t listen to the Dr regarding the weight loss thing… I’m 5’9 and only 130 pounds and I still have the same symptoms as yours. One thing I did find is that my Cortisol is low, so I’m starting to take Cortisol and progesterone supplement from wholefoods with the B vitamins and feeling a little better. I take it first thing in the morning. My whole family has thyroid issues, hypo and hashimotos and my Dr still says I’m fine. I’m also 42. So frustrated!!!!

    • I feel just as you do. My tsh is low, my t-3 and t-4 are also low, but just within what is considered the”normal” range. I have overwhelming fatigue, aches and pains, hair loss….you name it. I obviously do not convert T4 to T3. I have started to read about “low t3 syndrom”, which basically ignores your tsh and just supplements with t3 (the active thyroid hormone) until you feel better. I liked the comment the gal made about finding a compounding pharmacy, which I have as I have my sex hormones compounded into a cream, and finding out who prescribes a time release T3 and then go to that doctor. I’ve been chasing this mess for years and want a life back. Good luck.

    • Hi,
      Sorry for your issues.
      Try checking g estrogen dominance, adrenal fatigue ,going on natural supplements will help( not all brands are created equal) find a brand that works best for you( I know nature valley is a bad brand) take a vitamin B complex supplement( it will say vitamin B complex has all of them in there that you need). Hope this helps

  71. My levels are all low Tsh .007
    T4 Free 0.16
    T3 Free 2.09 been taking Cytomel for hypo thyroid for years but just had an episode with my heart rate soaring ended up in ER. Not sure what’s going on

    • Hi,
      That’s scary!
      I would consult with doc on changing your RX or gojng a natural way might help. That is a horrible side effect heart going through the roof! I hope you get this fixed!

  72. The hypothalamus-pituitary-thyroid (HPT) axis will naturally respond to stresses in the body such as starvation, illness, etc. by slowing down metabolism to compensate for reduced food, or energy demands high enough to cause “wasting away”. As I understand (and several studies have suggested), the body will naturally start converting more T4 to Reverse T3 instead of active T3. I believe this process is seen in anorexics. As the active T3 plummets, the appetite can also plummet (so anorexics can end up “stuck” in low appetite mode and low metabolic syndrome). I believe the hypothalamus is somewhat responsible for appetite, and when T3 levels go back up to normal, so does the appetite. In fact, in Prader Willi syndrome there is a problem with the hypothalamus. If I understand correctly, some other mechanisms for low T3 or conversion problems of T4-T3 may be autoimmune in nature or perhaps antibodies which attack the particular deiodinases responsible for T4-T3 conversion (there are several diffferent of these, found in different tissues). By considering that antibodies can be found in almost any SPECIFIC step, this would account for why some hypothyroid patients will have more problems in their muscles (fibromyalgia), vs. others having other issues. Also, exogenous T4 supplementation (Synthroid) will naturally place excess demand on the pituitary gland to convert T4 to T3, which then artificially suppresses TSH production. The HPT axis acts a lot like an electrical circuit, or complex (mathematically) control system. By mathematically complex, we’re talking about its function being represented by a series of differential equations (CALCULUS!)– not the simpleton math formulas which most endocrinologists assume. In fact there have been a few studies representing parts of the thyroid or HPT axis as such. And problems can occur almost ANYWHERE.

    There are SO MANY problems with the current thinking in endocrinology it’s hard to detail them all here. Endocrinologists have over-simplified the HPT axis, under-appreciated the many subtleties of thyroid disease, and over-relied on TSH for disease maintenance, which is a disaster for many thyroid patients, including myself. By the time my THYROID levels are adequate (read — NORMAL) and most my symptoms resolved, my TSH will be very low. The knee jerk reaction by most physicians is to lower the dose and make me sick again. This approach is so simplistic, I could actually teach it to middle-school children. I actually have to hunt to find a physician more sophisticated in thyroid disease management. The longer a patient has been on thyroid meds, or more severely hypo (including removal of gland) the more problems they will have by the stupid approach of TSH management levels. Gone are the days when physicians treated the patient according to their symptoms. It’s just plain stupid how most physicians use TSH by itself to treat thyroid disorders.

    • Boy did you peg this, like you by the time t3. And t4. Get to normal tsh very low and Dr took me off armor put me on 75% less equivalent dose of synthroid , severe symptoms within 7 days by 13 days calling office… I will say before these changes made Dr promised if I went south, she would put me back to what I was on…. My question, since happened to me more than once, when will the medical community get this one? And stop diagnosing and testing on tsh level alone… It has been a week and finally my bowels, heart and energy are feeling mire normal

    • Wow, melinda. Can you be my doctor? I don’t even see western doctors cause they still use the 1930’s mentality and want to put you on synthetics so eventually, the thyroid burns out. Still, integrative medicine approaches are hard to find but also vary so much, adding to their bad wrap. Overall, I seek holistic meds (armor, westhroid), in addition to same for hormone issues. Still, I’ve NEVER had anyone tell me my flare ups of muscle pain and joint pain are related to thyroid. You’re the first one. I live with the pain, but am desperate to be treated correctly and find the best medicine. WHERE SHOULD I GO???

    • It is comforting to read these comments and personal experiences. I was diagnosed with Hashi’s over 4 yrs. ago and despite the different Drs.,and meds,etc.— I continue to struggle. If my TSH and T4 are WNL they assume their tx. plan is acceptable. I have come to question this as my S&S are not improved!!!!!!! I have textbook symptoms of low thyroid which are progressively worsening plus I now have severe arm and leg pain. (????related to Tirosint—-my latest med ). I am sick and tired of being sick and tired!!!!!! VERY weary of all this and I am losing hope of my life ever being NORMAL.

      • Hi,
        Personally I would try t-balance plus supplemrts will regulate thyroid and symtpoms will disappear. Look into adrenal fatigue as well.

    • Melinda, can you provide more info/resources on why low TSH shouldn’t be the prime focus? I have this exact problem. The doctors jump to reduce my thyroid meds based on TSH. I was seeing a doc that didn’t test TSH once treatment stated and I was doing well, however, I moved out of state and my new doctor immediately reduced my meds based on my TSH level. It’s a recipe for disaster. I’d like to find some resources that explain this in more detail.

  73. You, and every doctor (holistic or otherwise), are missing a HUGE factor in internal energy, cell, heart, brain, and organ (basically all METABOLIC) functioning… In addition to a huge environmental factor which alters how all medications are metabolized in the body. Electromagnetic radiation and fields, namely from microwave radiation (from cell towers, cell phones, wi FI, blue tooths, SATALLITE transmissions, and basically a thing that operates wirelessly with an antenna) which is emitted in ubiquitious and varying amounts throughout most modern living environments. In some national forests off the power grids and cellular phone network grids you can find some relief and stability withing these fields. The body is ELECTRIC, CONSTANTLY INTERACTING WITH NOT ONLY THE THINGS YOU PUT IN IT BUT THE EXTERNAL ENVIRONMENT. PLEASE RESEARCH THE HEALTH EFFECTS OF ELECTROMAGNETIC RADIATION AND FIELDS, ELECTROMAGNETIC HYPERSENSITIVITY, AND THE BOOK “The Body Electric”

    • I agree with Tasia 100%. I avoid using a cell phone at all cost and only switch on my WiFi a couple of hours a day just to Google, e-mail, and research hypothyroidism – which I am doing now. If I see a mother handing a cell phone to a child (I’ve even seen them give one to a baby!) in the supermarket or on the street I go up to them and politely explain the dangers. I was a physics major so I have no fear of explaining the effects.
      Stay away from radiation guys – I recon that’s how I got thyroid cancer, but that’s impossible to prove.

    • I used to ignore this angle, I was too overwhelmed to add in yet another factor in my treatment of chronic Lyme, but I finally (after 8 years) tried turning off the breaker to my bedroom at night and also turning off wireless in the house at night.

      I’ve been sleeping better, and falling asleep faster, than I have in a very long time. My brain fog has also improved (but not completely gone away). I have an appointment with a specialist who assesses EMFs in people’s homes, so I hope to find out more about what I can do to mitigate EMFs in my home.

      This is a factor that shouldn’t be ignored when dealing with chronic illness, even though it’s a pain in the arse and a confusing topic for many people.

  74. I have been hypothyroid for 6 years. My tsh was high t3 free and t4 free were low..I am now on 120mg armor thyroid, 60 mg in am 60 mg in afternoon. My most recent labs show free t4 to be 0.77 free t3 to be 2.6 and tsh the lowest ever at 0.04. Dr mercola mentions when on armor thyroid it is not unusual to have a low reading on tsh and that if asymptomatic and free t3 and free t4 is within normal it means i am in the right dosage… Is this true?

    • I am not a doctor, but have experience as a hypothyroidism patient. I had to convince my doctor to do several things:

      1. Test for something other than just TSH. We looked into free T3, Free T4, reverse T3. So even though my TSH was in range, my active hormone was in the bottom 1/3 of range. I was very tired even though my TSH was in range.

      2. I asked the doctor if we could treat low FT3 symptomatically as long as we stayed in range.

      3. Asked the doc if we can ignore what might look like very low TSH as long as I felt good.

      This is working well for me.

      Another thing that has helped a lot is adding bioactive B vitamins as supplements. Do some research, and look into methylation protocols (essentially this is adding bioactive forms of B12, folate. The folic acid and cyano form of B12 don’t work for up to 50% of people due to mutations).

  75. Does anyone know the cause of high T4 AND high TSH? I am on Levothyroxine (I had a total thyroidectomy 14 years ago) and I am taking Vitamin D3 due to my low levels of VitaminD, low calcium and high phosphorus. Thanks

  76. Thyroid hormone replacement labs vs newly diagnosed thyroid problem labs
    So, if a patient has been on thyroid hormone replacement for 10 years and they go to a new physician, the physician sees a low TSH or nonexistent TSH. They tend to get a little upset and try to reduce The level of medication you’ve been taking for 10 years. If I were a patient that had never been diagnosed with a thyroid issue, and my TSH was nonexistent, I believe my T4 and T3 would probably be through the roof. If a patient has been on thyroid medication for 10 years and her TSH is nonexistent, is it possible that it is due to stuffing T4 down the throat every day and causing the pituitary gland to not make a request for T4. Therefore causing the TSH to be nonexistent. Do I have this process right? And, if the T4 causes the TSH to be nonexistent, then certainly the the thyroid gland is not producing T3 as it did when the thyroid gland was healthy. So the only T3 we get with replacement therapy is what we get from the conversion of the T4 pill. If we are very careful with how we administer the T4 pill, we can get a little T3 out of it. So, without the help of additional T3, it may be impossible to have optimal levels of T3 since our suppressed TSH is no help in providing the natural production of T3 as it once did. But, it is the oral T4’s fault that all this is the way it is. If I am thinking this through correctly, then why can’t the medical profession understand that it is unnecessary to try to bring the TSH within normal lab ranges. If the dr tries to bring a nonexistent TSH within range, the person would be in a vegetative state by the time that happened…or dead. So, no…low T3 is not about the thyroid. It seems possible that it could be about the T4 replacement causing the pituitary not to send a signal; therefore, no signal for T3 either- which makes us t3 deficient with only the replacement T4 to depend on for a minimal conversion to T3. Is it a mysterious unknown disease that causes the low T3 problem once we take thyroid replacement in the form of T4?
    I am venting and need to find a dr that doesn’t want to try to bring my nonexistent TSH within range. If they take me from 112mcg to 100 mcg-my TSH will still be nonexistent. I don’t want to be their guinea pig.

  77. Hi
    I am a 53 yo female that 2 years ago was diagnosed with cervical dystonia. Its been extremely painful and stressful. I get botox injections every 12 weeks, They have helped me to look better but I still am in extreme pain. I am a very active person, if I don’t exercise every day I cant move. I also am very careful with my diet. No pop, sugar breads etc. but every time I have lab work I am concerned with the numbers. This last week I had some blood work done and feel so discouraged with the results and really don’t know where to turn for help. My HbAiC is 5.70 and has been that high now for about a year.
    other labs that are out of range:
    Potassium 4.60 (4.0-4.50}
    Phosphorus 4.30{3.8-4.0}
    Globulin 2.3 (2.4-2.80}
    LDH 213.00(189.209.00}
    AST/SGOT 27.00(10.00-26.00}
    Serum iron 81.00(85.00-135.00)
    Triglycerides 204.00[75.01-99.99}
    Cholesterol 206.00(100.00-199.00}
    HDL 68.00{0.00-59.00}
    TSH 0.66 (1.80-3.00}
    T3U 25.00 (28.00-38.00}
    VLDL 41.00 (5.00-40.00)
    I suffer from extreme tiredness. I don’t sleep unless I take a sleeping med. I have no energy. I suffer from depression. I crave sugar so badly. I feel like I am in a down ward spiral that I cant escape. Can you please help me or at least give me some advise.

  78. hello sir,

    I am on 175 thyroxine for the past 5 months and tests 2 weeks ago were :-
    TSH 0.04 (0.3-5.6)
    T4 4.7 (4.8-11.7)
    T3 1.7 (0.8-2.0)

    feels sleepy especially mid morning despite having 7 hours of sleep at night.

    what do thinks



  79. Good morning. I am wondering whether it is possible to have these kinds of issues if the thyroid has been completely removed, and if so how I would know or what tests would I ask for? I had my thyroid removed in 2005 for pre-cancerous cells and about 36 nodules, at the time it was alternating high/low/high/low. It’s been stable on medication but now my T3 is low and my weight has not changed. I’m just wondering if that’ a pure medication issue or possibly anything else should be considered? Thanks.

  80. hello sir,
    this is swathi again…a dermatologist saw my reports and said that my blood levels are really very very very low….
    these are my thyroid test results
    T3,Total : 1.02 (Reference range 0.60 – 1.81)
    T4, Total : 12.80 (Ref range 5.01 – 12.45)
    TSH : 1.81 (0.55 – 4.78)
    by looking at this…he said that its..OK…there is not much problem..don’t need to worry…but better take second opinion from thyroid specialist…
    do i have to worry about this???
    i mean even if have problem , can it be cured or not???
    or else i have to take tablets forever??
    pls reply me…
    i am worrying a lot because of this…from past 3 weeks…

  81. hello sir,
    this is swathi again…a dermatologist saw my reports and said that my blood levels are really very very very low….
    these are my thyroid test results
    T3,Total : 1.02 (Reference range 0.60 – 1.81)
    T4, Total : 12.80 (Ref range 5.01 – 12.45)
    TSH : 1.81 (0.55 – 4.78)
    by looking at this…he said that its..OK…there is not much problem..don’t need to worry…but better take second opinion from thyroid specialist…
    do i have to worry about this???
    i mean even if have problem , can it be cured or not???
    or else i have to take tablets forever??

  82. hi,
    yesterday i got my tests done…my haemoglobin levels are lower than ref range….but what i want to know is..
    these are my thyroid test results
    T3,Total : 1.02 (Reference range 0.60 – 1.81)
    T4, Total : 12.80 (Ref range 5.01 – 12.45)
    TSH : 1.81 (0.55 – 4.78)
    I just want to know, do i have thyroid problem ???
    do i have to , have those pills daily for lifelong????

  83. Interesting article. If I read this,
    These are my lab results. My doc says they are ok but my free t3 is pretty low. I’m a celiac patient and I’m following the AIP diet since 6months (to get the gut inflammation down). My thyroid lab results are actually worse (lower free T3) in comparison with one year ago (at that time I was eating only gluten free then). Should I consider natural dessicated thyroid or not?
    Free T4: 1,16 (range 0.94-1.56ng/dL)
    Free T3: 2.41 (range 2.47-4.36 ng/dL)
    TSH: 1.84 (range 0.27-4.20 mU/L)
    Antithyroglobulin : 28 (<115 IU/mL)
    Anti-TPO: 18 (<34 IU/mL)

    • My T3 went down on AIP too. I read somewhere that can happen without enough starches/carbs. It is hard though because I seem to get stomach problems when I go off of AIP?

  84. Hi
    My FT4 is 15.3 pmol/L (10.0 – 22.0)
    My FT3 is 4.6 pmol/L (3.1 – 6.8)
    My TSH is 4.16 mIU/L (0.30 – 4.20)
    I have a nodule in my thyroid and had a biopsy done and was told I have Hashimotos.
    I use to take 100mcg of oroxine and was told by my doctor to reduce it to 50mcg and add 5mcg of Liothyronine (T3) twice a day.
    My question is why such a drop in oroxine as my T4 was good, shouldn’t have I just added the T3 to help bring up the level which he would like to see at 5?
    Since dropping the T4 feeling worse.
    Any professional advice as I am thinking of returning to the 100 mcg of T4 and only adding 5mcg of T3 once a day to see if I feel better.

    • How do you feel? Don’t just look at the numbers but consider if you have any abnormal or troublesome symptoms. Then be sure to recheck in 6-8 weeks so if it is too big of a change another adjustment can be made.

  85. My name is Debbie read a lot of everyone’s complaints, been there been through a lot of the same symstems! I have Hashimotos, gluten intolerant, low T3 I’m on Liothyronine 10-MCG.per day. And Porcine thyroid75-MG. Never being able to lose weight ever to the understanding that if you have a Leptin issue, you more than likely are going to have a low T-3 leptin and t3 are interrelated! Long story, but I’ve had to be so proactive about my own health because most docs don’t get this stuff? ( not fun) but there is hope keep digging into your own health until you get your answers as like I did been through many a docs, but you have to or you will never fill right!

  86. I was diagnosed with hypothyroidism 4 years ago- I take armour thyroid- last month my tsh was 2.58 – it had gone up from 0.44. My dosage was increased to 90 mg.
    I paid cash for a comprehensive panel a month later –
    This is the reading Tsh 0.22 ; t4 10.10; T3 246; Fti 2.50 ; T3u 25.0 ; ft4 -1.44 Ft3 -6.80
    Rt3 – 19.60
    I never took the increased dose because the two days I took it I felt hot and uncomfortable.. I had in fact reduced my dose because I broke the pill in half.. I am confused how can these readings be all over the place.. I am at my wits end – any suggestions?

    • It takes.a few weeks for your levels to stabilize. Some natural thyroid hormones are not consistant doses and would cause fuctuations.

  87. Sir I am a 17 years male and have been experiencing high fatigue and cold intolerence lately..
    My doctor advised Thyroid Profile test which shows low levels of T3 & T4 while TSH lies in the normal range.
    Headache, drowsiness and muscle pain has also become a cause of worry.
    I am also suffering from constipation and experience twitching in my facial nerves at times..
    My test reports are as follows:
    T3,total: 0.43 ref. range:(0.80-2.10)
    T4,total: 2.20 ref. range:(5.01-12.45)
    TSH: 0.93 ref. range: (0.70-6.40)
    Vitamin D3: 58.2 ref. range: (75-250)
    Vitamin B12: 255 ref. range: (211.0-911.0)

    • Hi akshath singhal u need to b on meds get antibodies tested for Hashimoto ‘s. A hair analysis will tell u what minerals your lacking or have too much of have iodine & adrenals tested. U need to b on b12 vitamin d .u might need t3 meds if so magnesium & selenium & iodine but gets these checked as too much iodine will make symptoms worse. U will have to find root cause to fix. Going gluten free dairy & soy free helps. U wiil have to take control of your health as a lot of Dr ‘s don’t understand. Good luck

    • I am freezing all the time too, have you heard of Wilson’s thyroid syndrome? Look it up on his website and then hyporthyroidmom.com this has helped me get back to normal.

  88. I’m sure you’re right Chris – there’s something else going on, forcing our thyroid into slowing…still working, just not at full steam. That said – it took me 15 years to find the answer to my Raynaud’s (cold fingers) was a temperature that never climbing above 96 degrees, it’s just resolved, period, when my temp is above 98. Mainstream and alternative healthcare providers offered me nothing but calcium channel blockers (which I refused) or iron for my accompanying anemia. Neither of which is THE PROBLEM. When I go to see the doctor today, they don’t even take my temperature anymore!!! lol
    I’ve done all the right things, and yet continue to suffer from low temps – one day, at a normal temp, feeling fantastic and energetic, the next day, at a low temp, unable to see an end to the doldrums, unable to look for work, much less actually keep a job! It’s infuriating. The mind/mood connection to that temperature is FASCINATING!
    At this point, I’m unwilling to spend the rest of my life unemployed and unable to cope with life. So I’m self-medicating with T3, two days on/two days off – it keeps my temp up and me functioning as a productive member of our society, rather than living off unemployment benefits and food stamps.
    I agree with you, it’s probably not the RIGHT answer, but it is a better answer than calcium channel blockers, the best answer I’ve found – and frankly, after 15 years of searching for the right answer, I’m willing to accept a word-around. I’ve done all the right things, and I only got worse when I suffered some extreme stress. And when I let carbs back in my life for the heat they create, I gained 25 pounds.
    T3 makes me feel like a human being again, and I’m able to function and lose weight and have actual interest in life again. If there is an underlying health issue that has not presented itself fully that my body is fighting, it’s just going to have to do it while I’m being a productive human being. I’ve had enough of 96 degrees and lying on the couch.

    • ow are you self medicating yourself with T3?? I also have Raynauds and supposedly a thyroid issue, however I dont lose weight on synthroid. I was able to lose weight on Armour bc it has T3. I can’t get a dr to prescribe me T3. im desperate, been to all endocrinologists in my city and no one has been able to help me lose weight again and I feel extremely bloated; almost pregnant-like but I’m not pregnant

  89. Hi There –

    I was wondering if anyone could help me. I am 24yo/F. For a very long time I have felt extreme exhaustion/fatigue (there is not one point I am awake that I do not feel tired – I can also sleep for 15+ hours). I have really bad concentration/brain fog (which has gotten worse recently) and I most always feel dizzy/nauseous. I also have sensitivity to the cold.

    My dad has the same problems, and my mom has hypothyroidism. I have gotten numerous blood tests done which have all come back “normal”

    Here is my most recent test results:
    TSH .57 (.40-4.50 mIU/L)
    T4, FREE 1.0 (.8-1.8 ng/dL)
    T3, TOTAL 75L (76-181 ng/dL) *Out of range

    My doctor told me this was normal but I am certain there is something wrong with me. Having to feel like this everyday has caused me depression and thinking of having to live my life like this everyday is a terrible, terrible feeling.

    Please help me – thank you so much in advance.
    [email protected]

    Thank you-Michele

    • Hi Michele,

      While TSH and T4 are within range, your T3 is out of range (75 Low). It should be around 120 ng/dl or a bit higher to be close to the optimal values. The T4 is also borderline low.

      Please find another doctor who at least can prescribe cytomel (T3) for you. Preferably a functional medicine doctor to understand thyroid labs and functional ranges and the root causes of your condition.

      I also have low T3, cold hands and slow reaction/thinking at times, etc. Used to feel much worse though, I feel much better now. The same will happen to you.

      You must also clean your diet. In a separate message I will send a simple handout of stuff that you might look into it. Diet and stress are fundamental, as well as toxins (mercury, lead, root canals, etc.)

      Wish you luck


  90. I am hypothyroid on porcine compound thyroid meds 105mg a day lately I have very low Tsh, low Free T3, normal Free T4 not sure if I am hypo , hyper or Hasi or graves I have simptoms of shakes, 3hrs of sleep only, sweat a lot, tired ,I get sometime head acke on top of my head I am on gluten free and a very gentle diet. 5years since I had my right thyroid gland removed and have not been able to get the correct dose because of my
    up and down range of mt t4 and t3 ( they used to be high now free t3 is low so my tsh please help thanks

  91. great article!!!!! just happened to stumble upon it while reading up on thyroid stuff. really like how you tie in the connection to the hypothalamic-pituitary axis. have known this for some time but it validates me and what I have had to go through. I took a blow to the head (right in the face, badly broken nose) a little over 5 years ago. it felt like an explosion had gone off in the center of my head and then I felt the shock wave rip through the rest of my brain, resulting in a tbi. i never had thyroid issues before, i instantly started having lots of endocrine issues due to the injury to the hypothalamic-pituitary axis and thyroid malfunction!!! because all the tests were “normal” it was very difficult to get the doctors to believe there was anything wrong. finally when I had gained over 70 # and my hair was falling out by the handful, and I was sleeping almost 12- 16 hours per day they tried me on thyroid meds. voila’, what a difference it started to make. I eventually switched to a doctor that understood the connection btwn tbi and thyroid issues he put me on both T3 and T4 meds. the T3 was the key!!! my hair stopped falling out, I had more energy and it helped stabilize my anxiety/ptsd, mood fluxuations, etc that all went along with the tbi! it was very frustrating that the professionals that I had gone to (one was even a specialist in brain injury and endocrine issues) couldn’t look beyond the numbers on the paper from the tests. they also wouldn’t take into account the blow to my head. duh, the pituitary and hypothalamus is right behind the nose and the bridge of my nose, septum and right eye orbit had been broken or had hairline fractures. I never been told that I have low T3 but what a difference it has made in my life taking it. recently I’ve had to switch to a new endocrinologist who knows nothing about tbi and thyroid issues and he is not a big proponent of prescribing T3, but I am hoping to educate him on how vitally important it is for me ( and other patients) and maybe he’ll give it a second look. 🙂 and maybe he will also not just look at the numbers on the page from the blood tests! thanks for a great article! can’t wait to read your other articles. cheers jennifer

    • Thank you so much for posting this. I have been struggling with my 17 yr old daughter. She has low T3, low vit D and high calcium. A few months ago she fell on her head thought concussion. Symptoms of dizzy, low concentration won’t go away they keep going back to concussion but I think something else. The concentration has been over a year but feel the fall did something else. Her pediatrition keeps saying eat better and drink more water. It’s making me crazy. Glad I just found new doctor to test the t3, maybe we can get some answers. Feeling overwhelmed

  92. I have had hyperthyroid for 16 years and I’m still struggling last test shows low t3 and I feel horrible everyday …

  93. Hi there I had my thyroid removed a total thyroidectomy 12 years now. I take 150 eltroxin daily. I am 50 now and I am beginning to worry about the affects of having no thyroid now that I get older. I get a blood test done once yearly to check all function except T3. Due to having papilliary carcinoma my levels have to stay at a certain state even though the tumor on my neck was cancer none showed up. I suppose now that I have got the all clear I am conscious how important the thyroid is. Is there anything u woulf advise me to do. Thank u

  94. Out of one side of your mouth you said that you are going to use terms the lay person can understand, but then you start using terms without defining them. What are D1, D2, and D3? The only D3 I know of is a vitamin, are you speaking of vitamins and minerals or are you talking about other hormones that we just weren’t introduced to? I am going to try to finish reading the rest of the article now, but it is already confusing.

    • They are not vitamins they are enzymes which exist mainly in the liver. They “deiodinate” the thyroid hormones. Most mammals have three of them hence D1, D2, D3. More than that I do not understand but you can Google “What is D1…….etc” – but it’s a bit complicated!

  95. I was put on WP Throid NDT 3 months ago. I was started on 3 16.25 mg a day. My endo would not up my does in the req 2 weeks so I stayed on the starting does for 3 months. I was doing good till 6 weeks or so ago I started to feel awful.

    I Feb 2014 TSH: 2.34, FT4 1.08, FT3 3.1
    March 2014 (took my NDT before bloodwork by mistake TSH: 4.6, FT4 1.08, Ft3 4.6.
    April: Blood test in the afternoon TSH 1.44, FT4 0.8, FT3 4.6.

    I was getting dry skin again and the red dots on my legs, I had problems sleeping nausia, headaches, anxious and wieght gain. It got worse and I actually stated to feel sick.

    My Endo did not want to raise my starting dose. I called back again to tell him I was still sick and he said raise my NDT from 3 16.25 to 4 everyother day. I did 4 pills on Wed and Thurs on 4/30 and 5/1, 2 days in a row and on the 3rd day 5/2 took 3 and felt worse. I went back on 4 day on 5/3 and have been it ever since. I noticed in a few days my skin on my legs arms was soft and the red dots were gone. I started to get some relief on being so sick.

    On May 3rd I had my GP call in blood work for reverese T3, FT3 and FT4 and TSh. This is the results.

    Reverse T3 7.0, FT4 0.9, FT3 2.9, TSH 3rd generation 3.25.

    I know my RT3 should be in the 20 range. I never have had my T4 under 1 or 1.08 in 3 years and I feel good with my FT3 at 3.1 or 3.3.

    I spoke to my ENDO today and said reverse T3 is never used it has nothing to do with the Thyroid I was shocked. He also said my T3 is normal which for me it is not and my T4 is a little low. He does not like the idea I raised my NDT to 1 grain.

    Now I have to find another ENDO that treats with NDT.

  96. When you say

    “D3 converts T3 into an inactive form of thyroid hormone in the liver.”

    Do you mean Vitamin D3 or something else in the body-I’m confused

  97. I have been diagnosed with low T3 while my T4 levels are normal. I have diverticulosis and have been treated for H Pylori. I take medicine for my stomach ulcers caused by the infection off and on. My doctor prescribed 25 mg synthroid. Is there something I can do to boost the T3 levels? If my stomach issues improve should my levels even out?

  98. I am 64yo…had postpartum hyperthyroidism at 34yo (never told it was Graves), with heart failure and extreme weight loss (92lbs). Treated with Radioactive iodine. In 2013 was diagnosed with parathyroid adenoma and had surgery for that in January 2014. I am a registered nurse for 35 years and have done extensive reading/research to better understand the relationship between the two. My labs today (4/23) are TSH 0.12 – t3 1.4 – t4 8.2 – Ca 9.5 (the best I have had in over a year) – Vit D 30 (also good for me). Have been taking Synthroid since approx. 3 months after the radioactive iodine treatment in 1983. Just wondering if these levels may indicate to you (although I understand without prior recent labs for comparison that may not be easy). Thank you

  99. all my thyroid and part of my parathyroid has been completely removed about ten yrsago, I had my bloods taken yesterday and I had a phone call today saying that my t3 was low and the doctor wanted to see me on Monday, what is t3 exactly and how will this effect my health thank you

  100. I’m currently on compounded liothyronine and feel so miserable I can’t stand it. For a time, the liothyronine seemed to be doing a great job. I also take vit d, b, c, fish oil, calcium, magnesium and compounded progesterone that I’m nearly out of and estrogen. I had a full hysterectomy 1.5 yrs ago and it seems to have made me feels worse than ever and I’ve hit a brick wall. We recently moved to Europe from the U.S. and I don’t have access to my compounded meds once I run out, like I did before and the docs here don’t seem to have the same forward thinking mentality as my doc in the U.S. I don’t think I’ve been this desperate for help in quite awhile. It’s all I can do to get out of bed in the morning. People tell me I need to exercise and I would feel better but no one seems to understand how absolutely exhausted I am because I look great. I’ve gained 25 lbs in the 1.5 yrs since my hysterectomy and was already 70 lbs overweight prior to that. Desperate doesn’t even come close to how I feel right now. I had a lot of stress with the move but for the past few months have a little to no stress so that doesn’t seem to be the problem. I don’t know where to turn. I don’t know what to do. I start work at a physical job the beginning of April 2014 and am scared to death that I won’t be able to hack it. I had my blood work done last October and for the most part things seemed ok….but it’s hard for me to read because of being in Europe. Does anyone know where I can get help? I really, really need it. Should I go back and see the doc and see if he can put me back on Armour again. That is what I used to take up until about 3.5 yrs ago. I just don’t know where to turn for help but I honestly can’t live in such misery. Thanks for any help that anyone can provide.

  101. Hi everyone I’m a 37 year old female & I got my blood work back and here are my levels. Please help me understand it, Quest labs did it:
    tsh 1.95 reference ranges (1.5-2.5)
    t4, total 5.4 (4.5-12.0)
    t4, free .9 (.8-1.8)
    t3, free 2.3 (2.3-4.2)
    thyroglobulin antibodies <20 (<20)
    Rt3 .7 (8-25) (But I know you go by the ratio of Free t3 divided by Rt3 and if it's lower than 20 then there is a Rt3 issue, correct)
    Iron and total iron
    Total: 139 (40-175)
    iron binding capacity: 353 (250-450)
    % saturation: 39 (15-50%)
    Ferritin: 16 (10-154) Doctor says I have low Ferritin, which can cause a problem with the convertion of t4 to t3, correct? He wants me to take iron pills

    progesterone: .7 (follicular phase: < = 2.7 Luteal Phase 3.0-31.4)
    testosterone, total: 15 (2-45)
    Free testosterone: 1.6 (0.1-6.4)
    Waiting on the Estrogen (which usually is on the ower end)

    .. why are my levels soooo low already, I'm only 37?
    And what is the difference between blood levels and urine levels, bc I just did a hormone urine test and it showed my progesteron and estroge were high but on the blood work it shows they are low?

    Anyways my doctor wants me on t4 & t3 and I'm afraid because of the rt3 issue.. but when you look at my numbers is it justified to put me on t4 & t3 since both numbers are low?
    He wants me on t4 33.3 & t3 10.1 Sustained release for 15 days then up it to t4 50.4 & T3 15.2… if I can take t4 and t3 together does that sound about right?

    He wants me to up my 25mg of progesteron pill to 75mg pill and he wants me to take 1mg of testosterone.
    Once we get my esterogen I may have to be on estrogen too.

    My urine levels showed that I had high cortisol later in the day but my Am and PM blood cortisol showed I was in the normal range.

    Oh yeah my DHEA levels weren't ideal either, on the lower side. so he wants me to take 10mg of DHEA each day. What do you think about that?

    Please help me sort all this stuff out and thanks!
    I just want to live anxiety free and feel great everyday! Sometimes I have no anxiety and sometimes I'm not sure where my anxiety comes from, but it is present and I know it is bc of this hormonal imbalance.

    Hugs and thanks for helping!

    • WOW! How did you get so much data? How much did you have to pay for all these tests? My insurance (Cigna) wouldn’t pay for all that testing and my PCP wouldn’t order it. I don’t even see these to check off on the blood work request sheet. Are you paying out of pocket to see a Naturopath? Good luck with your quest to find the truth!

  102. I have Hashimoto’s as well as Epstein Barr. I ran some tests couple weeks back. Results: TSH 1.72 (0.45-4.5); FREE T4 1.43 (.82-1.77); FREE T3 2.2 (2.0-4.4). With the exception of Free T3, My labs are within optimal however my symptoms were terrible. I was taking Synthroid 88 mcg but had to lower it. But my question regards my mysterious Iron lab results from December:My FERRITIN was 25 (15-150) which I believe is considered too Low for Hashimoto’s patients (it’s recommended that we have 60 or higher) while my IRON SERUM was 160 (35-155) which is high. TIBC was 316 (250-450) and Iron Saturation was 51 (15-55). What could cause Low Ferritin with High Iron Serum? Could this be Epstein Barr feasting on Ferritin? I changed my thyroid medication last summer from Naturethroid to Synthroid (my ND actually instructed this change). Could it be the T3 in the Naturethroid (if it was too much) was depleting my ferritin? Would love to hear your thoughts on this. Because I can’t tell if I should be careful with my iron intake or if I need more.
    Thank You.

    • Hi sorry this doesn’t answer your question but i was just wondering if you experienced any weight gain with Free T3 of 2.2 .I got labs done and only my Free t3 was considered low I got 2.2 like yours but I’ve put on 8 lbs just in this month despite working out.I go tired to the gym wake up tired its depressing 🙁

  103. I want to know what happens if at the age of 27 approx a male having both T3 and T4 low but having high TSH about 253.32..
    Is it a thing to worry or can be medicated as early as possible…

  104. Hi Chris, I remain confused…. Maybe you can clarify a few things for me? After the birth of my 7th child I developed all the classic signs of hypothyroidism. THS got up to 29, TPO was over 1000 for a year, body aches, brain fog ect, ect. With homeopathy, acupuncture and lot of diet and stress changes I have gotten my TSH down to 5.6 and my TPO under 500 but I have stopped making progress. How do I keep progressing without taking drugs? Is it possible? I do cheat with diet occasionally eating gulten and dairy…..

  105. i had a bad case of hives to start with doctor did a blood test and found that my thyroid was off ( low thyroid ) so started off on 75 then 100 112 now on 125 my last reading was TSH 5.75 range .034-5.60 free T4 0.79 range 0.50-1.60 and lately been having hive issues again not as bad as the first time i was completely covered in them i saw a nutristist at the health food store and put me on a gluten free diet which helped also with a regimen of vitamins and taking adreal health i feel so so just not sure if i should take iodine i guess i am lost in all this as i do not understand the the ranges and i have noticed that my aniexty levels are out of control i get very nervous when i have to go see the doc at times it feels like my heart is gonna pop put of my chest ….HELP

  106. So for years I have battled my thyroid and I am so confused. I have been on synthroid for years and in the last years an endocrinogist put me on cytomel. My blood work always shows my tsh is low and my t3 and t4 low. It is confusing because my symptoms are weight gain and exaustion! My recent labs show 0.55 t4, free: 0.40 tsh: 2.7 t3, free: and a normal t3 total. I am so tired of going to the doctor and not getting any answers. I feel better on my current dose of meds but wish I had more energy to get rid of this weight I have put on over the past few years. Any imput would be greatly appreciated. Michelle

  107. I am 48 year old and have under active Thyroid last 15 years. I have been taking Synthroid 125mcg over 10 years… I did the test in November and my results were T4 1.20 ; TSH 4.75 and total T3 was 0.67 . After that my doctor decided to increase my dose to 150mcg. The last test we did 30 days after I started the new dose was T4 1.38 ; TSH 0.65 and Total T3 was 0.86. My doctor told me to continue with the same dose and redo the test in 3 months… What is your opinion based on the listed results? One more question would you recommend I take Ashwagandha Root pill in addition to my Synthriod? Thank you for your time I apperceive it very much

  108. I too have low levels of T3, and other hormones. I had a gastric by-pass last year and have not had a period in over a year, do you know if these levels will have an impact on me getting pregnant? I am at the stage where me and my husband would like another child, but its just not happening.

  109. Can you recommend a doctor who is willing to prescribe t3 or consider combination therapy in Zurich Switzerland? Many thanks, Jennifer (Hypo since 1999 and consistently had lower t3 levels, that doctors continually ignore!)

  110. My teen started three years ago with all the symptoms of hypothyroid and chronic migraine following a severe flu-like illness. At that time she had normal TSH and normal free T3 but free T4 =.78 – This continued for a few years as her TSH gradually got higher – peeking at 6.75 with a free T4 of 1.15 and an ‘ok’ T3.

    There was a short respite that occurred when she went on an anti-inflammatory diet. At that time her free T4 went to 1.3 and free T3 to 3.5. She felt really good. Since then however, she’s regressed.

    About 6 months ago, she started taking Armour thyroid – beginning with a slow dose and increasing very slowly. At first she felt better – but since then her T3 and T4 have actually gotten worse. Currently, her TSH is very low. Free T4 = .83 and Free T3 = 2.5. She tests negative for Hashimotos. Reverse T3 is 9.4. So, what could be wrong? She’s on 2 grains of Armour. She takes iron (but not at the same time). She recently started taking iodine drops – at 3 x the Daily Requirement…but no improvement.

    Please help. She is totally missing out on her teen years.

  111. I have all hypo symptoms. No eyelashes on one eye, dry course hair that has all changed in last 6 month. Fatigue, moods. TSH is 2.5 but T3 is on low end.. Dr put me on synthroid.. Does this sound right?

  112. Hello Chris,
    I am trying to understand my blood results and have not had a great response from the doc who ordered them. I have high TSH (5.05), low T3, Free (2.0) and mid range T4, Free (1.0). Would you kindly explain? Any light you can shed would be appreciated. Thank you.

  113. Hi Chris, Love all the info you have on your site. I just got my results back and I am showing slightly low T3 (.49, where normal is .58-1.59) and slightly low T4 (.70, where normal is .71-1.48) and a normal TSH of 3.91. Do you think this is enough to consider T3 syndrome? My doctor said to get more iodine and retest in a few months. I am in Korea and am not sure how much my doc knows about this condition and the language barrier makes it difficult to ask all my questions. Thanks so much!

  114. Hi I am struggling with my TSH levels being extremly low, my T4 and T3 and all other blood work is great, the doctors think I have hyperthyroidism, but I don’t have one syptoms other then my TSH being very low, if anything I feel I have HYPO syptoms. I did have a virus in my hpyothalamus years ago but that is now gone, I have been taking selemium, 2 times a day 400 mcg total daily, L-carnitine, and one lemon balm a day, I keep putting on weight and I eat gluten free organic and exercise a lot, i need suggestions

  115. I’m very confused. I also feel pretty sick. My labs have been showing a TSH of 0.64 Low, Free T4 0.55 low with low vit D and elevated RBC. THEY HAVE BEEN LOOKING LIKE THAT FOR THE LAST YEAR! I’m so frustrated that I am seeing a Endo. Spcialist and he won’t supplement my thyroid hormones. He seems to think I Have some virus attacking my thyroid or my immune system is attacking my thyroid/enfocrine system. The plan… labs every month just to monitor. Until I croak?? I’m fatigued, sick and very depressed.

  116. I had some blood work done, the DR said it was normal but it says out of range on the T3 the range is 76-181 and mine says 67 L I’m confused. I have been having muscle aches, pains, dry skin, tried all them time, sleepy, kids say i’m cranky, and the list goes on.Should I got to another doctor and have him look at this blood work? Help I’m confused!!!!


  117. I have been in 0.25 of tirinosint and levels have been ok. The last blood test my tsh was up to 3,35 so dr increased by 0.13 sob taking a 13 and 25 pill. I seem to have now developed terrible muscle aches achilues tendon problems and keg aches. The last blood test tsh was still 3,35. Free t4 was 1.15 and free t3 was 2.68. That was the thing I noticed most it was usually around 3,36. I asked dr she said t3 is not a test she looks at only for hyper
    Could this be causing my aches? I also have rheumatoid arthritis that is not doing well too

  118. I have low T3. I started taking Armour and experienced improvement in my symptoms for about 2 weeks. I have been taking Armour at a stable dose for 6 weeks now and just had blood testing done. My labs come back with both T4 and T3 on the “normal” range, but TSH is very low (as was expected). I am having quite a few thyroid symptoms, though. My naturopath mentioned that she wondered if I have Wilson’s Temperatue Syndrome. What are your thoughts on Wilson’s Temperature Syndrome? And do you think it is possible to have both low T3 syndrome AND Wilson’s Temperature Syndrome or do you think this is just inadequate treatment for my personal symptoms?

    • Hi,
      I Know it’s been a while but did you have any luck figuring out if you have Wilson’s Temperature Syndrome? I think my daughter might have it. Seeing an endocrinologist tomorrow. Hope you are feeling better. Thanks, Teresa.

  119. I have .014 TSH level. T4 (free) is 1.05. I still suffer from hypo symptoms.. Any suggestions on what I need to do??
    I am 44 years old. I have had my progesterone tested (which was low and have increased my dosage). Cortisol levels are good except a little high at night. I take vitamins. I workout daily..

  120. I’m 80 yrs male.
    Recent labs:

    TSH: 0.86 (0.40-4.50)
    T4 Total: 3.5 (4.5-12.0)
    T3 Total: 36 (76-181)

    Presently taking Armour 45 mg in the AM and 30mg in the afternoon.

    Recently took 2 Dosepaks plus had injection of Methylol Prednisolone for pinched nerver.
    Could this have affected my T4 and T3 readings?
    Prior to Dosepaks and injection TSH, T3 and T4 were all within normal ranges.

    Please advise

  121. Drs. I have normal TSH, T3 uptake%, low within reference range of free T3 and free T4 but a Total T3 of 0.88. What would my next step to take, please advise. I have many symptoms since 2006 but docto would mot treatr at Kaiser because normal valu of FreeT4 and TSH.

    • Hi Lluke,
      I have Kaiser too and my Endo refused to treat my hypO symptoms because my T4 was pushing the high margin and my TSH was <.01. I am desperately trying to find another Endo, one who will look further than TSH and T4. I am now sleeping 11 hours per day and worried that I will eventually become too tired to help myself.

  122. Low TSH, Low t3 Normal free t4 I’m so confused! Please help!


    Hi and thanks for reading. I am hoping for some insight on where to go from here. These are my past 2 labs.

    Oct 19,12

    TSH- (5.800) Range-(0.300-4.700) Total T3-(42) Range-(60-80) Free thyroxine (ft4)- (1.3) Range-(0.8-1.8)

    I was instructed by my family phys to take one more (Levothyroxine 125mcg) on W and Sun. Check in 8 weeks, below.
    I also started low carb high protien under 15 carbs a day on Nov 15th. When I do this diet, I notice my thyroid goes wacky.

    Re-check,different lab.
    Jan 17,13

    TSH-(0.06) Range-(0.35-5.50) Total T3-(58) Range-(60-181) Free T4(1.02) Range-(0.59-1.17)

    Doc now says to take 2 less pills of Levo on Wen / Sun.

    I have not been back for a re-check, as I really don’t know at this point if I trust my docs opinion on treatment.

    Backround info.

    I am a 56 year yr. old female in Post Meno. (I had the blood work done also in Oct. for meno) I started on Synthroid when I was 17. I stopped on my own at 20 (couldn’t afford doctors or meds)
    Checked at 22, no problems.

    Checked yearly. Not Hypo again till 1991, put on 88mcg synthroid and increased the next 10 years till up to 175mcg. In 2000, switched to Armour by alternative doc. Felt the worst ever for an entire year and my t3 was just not improving. Switched doc again. (one I have now) she gives me script for 175mcg synthroid. It’s been a rollercoaster since. Up and down. 2006 labs shows thymoglobin antibodies (83)and thyroid peroxidase is (238) Hashimotos, I was told. Never been retested for it.

    So present day I again am so confused. The past two weeks, I am sweating off and on, hot than cold, heart pounding, shaky, anxious and my hair is falling out. Thought maybe, female hormones but my labs show I am post menopausal.
    Also, I noticed going through my labs the past 12 years that every single one, I have a low rbc and was never addressed?

    Any suggestions would be really appreciated. Thanks so much for reading this. Renee

    • first of all, you need to make sure your Ferritin levels are good, like over 100 if possible, but I bet yours is bottomed out. if you need iron, try Ferramax or Proferrin. AND you probably need to take some Progesterone, get some good quality cream such as Emerita Pro gest and take 20 mgs twice a day. your symptoms sound like mine , which ended up being Estrogen dominance (zero progesterone) this will help you tremendously, especially with the anxiety and energy. and it will help your thyroid hormones work better. I was able to reduce my meds by 1 full grain.

  123. Hi,

    A year back, my wife was diagnosed as having papillary carcinoma of thyroid.

    The oncology doctors (surgeons) were/are of the opinion that the complete thyroid gland needs to be removed.
    But, there is no pain whatsoever, there is no problem in breathing/voice/swallowing.

    she prefers natural/alternate therapy to any kind of surgery. she has been taking wheat grass juice, Green Tea, grapes juice, etc. regularly in her diet.
    the recent sonography of the throat does not show any deterioration in the condition.
    Even the prominent swelling on her throat has now visibly reduced.
    But, still the onco-surgeons are sticking with their decision to operate at the earliest.

    the recent blood test (TSH) for thyroid shows TSH: 0.98, T3: 4.55 & T4: 6.66, her haemoglobin count is also always low (8.4).
    is this due to papillary carcinoma of thyroid ?

    Thanks & Regards,
    Raghu Iyer

  124. Hi Doc!
    I live in Phoenix Az. Had a total thyroidectomy in september 2012. I am currently on 137m Synthroid and absolutely miserable. I have seen 4 doctors (2 of which are endo) and they ALL refuse to accept t3 as an excuse for my inability to tolerate my medication. They refuse to test for t3 levels and will not change my meds. Can you refer a doctor in Phoenix who shares your views? My TSH is in range as well as my t4.Thank you so much and have a great day!

    • Just saw your post and wasn’t sure if you still need a doctor in Phoenix. I see a Naturopath in Scottsdale named Dr. Yu Rhee Hyun. She is great and was referred to me by three separate people. Hope this helps!

  125. Having the reverse T3 tested looks like a good idea. Other co-factors for conversion from T4 to T3 need to be at the right levels. A good site to learn about this stuff is “Stop the Thyroid Madness”. From memory it may be things such as ferritin, selenium and the B vitamins such as B12 and folate in particular as they are necessary for methylation. One of the basic starting points is being gluten-free. This site below explains why:

  126. Hello, I’m here cause I honestly feel that I cannot trust nor respect doctors in my country anymore… Im a 30 yr old female and was diagnosed with hypothyroidism since I was 14 yrs old. I was like a guinea pig each doctor giving me different dosages and different comments and I have lost hope on getting back my beautiful hair nor slim body or high energy..Im embarrassed even to admit that I feel stupid and my comprehension is slow.
    Im constantly emotional, depressed and sensitive and it causes me embarrassment public. I have been taking thyroxine and recently changed to euthyrox (levothyroxine sodium).
    In the 16 years I started from 50mcg and went up to 175mcg. Then 150mcg 5days 175mcg 2days and gradually decreased now I have been on 100mcg for the past 6 months and gained 8kg while I have been on a moderate diet/moderate activity..
    Just found out about RT3! I will try to see if I can have it checked.. What other medicines equivalent to cytomel because it’s not available in my country. Today’s lab results confused me so if u can help me please
    TSH 0.29 mlu/l (lab Normal value 0.27-4.20)
    FT3 3.1 pmol/l (lab Normal value 3.0-7.8)
    FT4 17.2 pmol/l (lab Normal value 9.1-19.2)
    In my understanding this means my doctor would lower my dosage but it still doesn’t make sense to me since I’m so tired, constipated and feeling Depressed the whole time let alone the weight gain and hair loss with every brush and shower..
    Are there lab tests u recommend that my doctors are neglecting?
    Would really appreciate the help.. Until I find a doctor who treats patients like humans and not just numbers on a piece of paper..
    Thank you

    • I would just stop fighting the doctors and get my hands on Cytomel, Cynomel, Tiromel or some such thing from mymexicandrugstore, and twiddle the dosage until you feel good.

  127. Hi, I used to have Cushing’s disease and had to have the entire pituitary removed in 2003. I am on all pituitary replacements and produce no TSH now. My T3 is 2.7, and Free T4 is 1.10…this month. I cannot seem to loose all the weight nor gain all my muscle back after Cushings. I want to try Armour instead of Synthroid but doctor will not prescribe. Am I producing enough T3?? For several years prior to this year I produced hardly any T3. Not sure but I was low on Vit. D, and have been told to supplement, and now have it at 38. Any advise would be helpful.

    • Im pretty similar
      Tsh 1.6 t3 2.8

      I had low vit d …got it up to normal and hasn’t made a difference i cant lose the weight either. I’ve tried everything and so frustrated too 🙁

      The weird thing is my t3 was 3.1 and lowered after put in trearment armour

  128. My daughter is 18 and was diagnosed with PCOS and insulin resistant at 16 and asked to reduce weight ASAP. We tried everything from high protein diet to 1200 cal diet but were not successful in droppint even 1 pound. Then we came across a natural diet which guaranteed weight loss even for PCOS patients. It was totally natural no medications just diet restrictions. We saw no harm in doing it just willpower as it was very strict. She lost 40 pounds on that diet in 3 months and then was on transition. Her T3 was fine before the diet. But since then she has been feeling Very Cold, hands turn blue and very weak. At first we thought it was because she lost so much weight but now her T3 was tested and was low. TSH and T4 are in normal range. T3 is going more down but endocronologist did all the testing and as all glands are normal they are refusing to treat her T3. She is alwasys tired, depressed, cold, brain fog, cannot concentrate in college etc. Natropathy suggested Cytomel or Armor Thyroid but nobody is willing to prescribe Armor Thyroid and with Cytomel 5 mg her heart beats go up. The endo suggested to stop Cytomel as it will be harmful BUT he has no solution for her low T3 and her other symtoms. What is your suggestion and since her T3 most probably got messed up because of the diet which was in August 2010 two years ago. How do we correct that problem.

    • That is a brilliant monster! The hospitals where I go have only a short little bed, or a recliner which doesn’t help enough. The shortie bed is ok because it makes me raise my legs which actually helps. I think that’s why I’ve also not fainted (so far) at the dentist – the bed tilts the head down below the legs.

    • yeah, and the weird thing was the outpatients department where the Blood Test Centre is sited paid for it, not the lab…Don’t know how we got that lucky!

  129. Hi Christine

    Good luck with your tinkering of the thyroid meds. As a phlebotomist, I just want to reassure you that if you lie down flat, you shouldn’t faint when you have your blood drawn. All the best.

  130. On Synthroid only, my tsh is 1.5, ft4 1.8 (lab range 0.7-2.5), and ft3 2.5 (lab range 2.5-6.5). I feel good enough relative to the misery before treatment, but only if I live like 70, taking it easy. If I try to exercise, I have days of rough recovery, feel hypo again. I used to be very fit and ran, now I can only stroll. I want to exercise again – could the addition of a little Cytomel help? If so, do I adjust my Synthroid down at all? If I drop down or go up by even a little, I don’t sleep well and get the “fuzzy” feeling.

    Another question – I faint from needles, so I’ve been using blood spot mail-in lab. The numbers have correlated well to how I felt finding my way to the best Synthroid dose. Are these results valid and reliable, and do they correlate well to venous draw?

  131. I have a low RT3 ratio 3.2. I have a doc who knows the right labs to draw and kindly agreed to prescribe ERFA Thyroid even tho he hadn’t known of it, at my suggestion. However, 2 wks on the med I started having fairly severe chest pain, so I stopped it. I had 2 office visits, $120 ea to get the ERFA Rx and now doc will only talk to me if I pay another $120, which seems exploitive to me. I asked stopthethyroidmadness folks who said I had to have an iron test and a saliva test for accurate cortisol level, correct these levels and then start an NDT. Otherwise I’d always have a reaction to NDT. I need help and support in order to navigate these hoops. Can you recommend a doc in my area Morgantown WV 26501 -1-1/2 hrs from Pittsburgh, PA who really understands this issue?

    My worse symptoms are depression/hopelessness, brain fog and dryyy skin. I was diagnosed with a goiter, tho fairly normal TSH in ’95, Synthroid 5 yrs, Naturethroid 5 yrs (great), reformated westhroid and naturethroid didn’t work, severe hair loss. Quickly became hyper on Armour…no med for last year, TSH 3.8 and have depression and progressive brain fog.

    • Did u get an answer about a dr to go to for thyroid in morgantown or Pittsburgh area?? I have been looking also.

      • I would love to know of a doctor in the Morgantown, WV area as well. Or if you could share the name of the doctor that is willing to prescribe Nature Throid or Armour as I’ve not had success in finding one who is willing to do so. Thanks!!

    • The Stop the thyroid madness people know their stuff and have helped a lot of people. You should spend some time on their website and educate yourself well. Sadly there are not enough doctors or endo’s who are educated to help you. Dr. Kessler is the exception, this site is very good.

  132. Any advice would be greatly appreciated. I am a 41 year old female with hypothyrodism. I curently take 75mcg levothyroxine, TSH level is 3.28. However, my T3 level is 28. I continue to have symptoms of hypothrodism. My doctor says that everything is ok because my TSH is within range, however, I am tried of freezing all the time and tring to lose weight with no success.

    • That’s one of the lowest T3 levels I’ve ever even heard of. Definitely not okay or normal. I would seek out a second opinion.







    SERUM FREE T4 LEVEL (XAERR) 15.2 PMOL/L (10.3 -23.2 )
    SERUM TSH LEVEL (XAELV) 3.25 MLU/ L (0.4 – 5.5 )


    AST SERUM LEVEL 15 IU/L (0.0 – 30.0)
    SERUM TOTAL PROTEIN LEVEL 71 G/L (66.0 – 83.0)
    SERUM ALBUMIN LEVEL 44 G/L (35.0 – 52.0)
    SERUM GLOBULIN LEVEL 27 G/L (22.0 -42.0)



  134. Dear Dr.Kresser,

    I would very much apprceciate if you would look in to the symptoms /blood test results in my email and give me your opinion of what I should do.Thank you so much.





    5.3mmol/L (2.5-6.1) PLASMA GLUCOSE,FASTING;-


  135. Chris,

    Could you please clarify what do you consider normal for TSH, Free T3, Free T4
    I think my Free T3 is low (3.7) but it’s within the lab range…(2.8-7.1 pmol/L)
    Thank you!

  136. hi, i was hoping for a reply to my post, why my free T3 is 183 ref. range 210 to 440 and all the rest are within range. thank you. taking small dose of cytomel but it gives me strange side affects. ANY advice or reason free t3 is so low?

  137. Hi Doc!
    I am suffering from Vitiligo, I was told that one auto-immune disease puts you at the risk of developing other auto-immune diseases so I got my Thyroid profile done and it came out as :
    T3,Total 0.60 ng/ml (Reference Range 0.60-1.81)
    T4,Total 8.20 ug/dl (Reference Range 5.01-12.45)
    TSH 3.99 uIU/ml (Reference Range 0.35-5.50)
    Do I need to worry? Looking forward to your advice. Thanks!

    • A TSH of 4 indicates thyroid hypofunction, and you’re at the bottom of the range for T3. My guess is you’re having trouble converting T4 to T3; I covered the possible reasons for that in this article and elsewhere.

      • Thanks for getting back to me,Sir!
        I’m really worried. If you could please suggest me what should I do next.

  138. i was diagnosed hypothyroid based ‘only’ on high tsh back in 07 when menopuase hit, only symptoms then were severe hot flashes but i was put on synthroid and i took it until about a year ago when i started feeling sick and i had hair changes, skin, muscle loss, eyebrows, you name it, i was a ‘fit’ 57 yr. old but felt like i was dying slowly. i decided to quit taking the med. and some things felt better but symptoms remained so went and had new labs and all numbers are within range except free t3 and i’m hoping some one here can help me? free t3 is183 ref. 210-440. dr. tried me on armour, i had a bad reaction so synthroid and cytomel, bad reaction, and then, just cytomel, i can’t take it so????? i don’t know what to do now. thanks.

  139. I am a 42 yo female who had a complete thyroidectomy (hasimoto’s thyroiditis) in 2003. Had a total hysterectomy in 2009. Wow, my life/health have never been the same. I have read, researched, experimented with everything I can find and pay for.

    Question: I have tried compounded slow release T3, cytomel, along with Armour. I do not seem to tolerate cytomel well (nervousness, heart palpitations, etc.) even in very small doses (2.5mcg) yet cannot really tell a difference with compounded SR T3 (even at 12.5mcg). I am currently experimenting with adjusting my Armour dose between 2 – 3 grains along with following Dr. Wilson’s Adrenal Fatigue protocol. I am also on BHRT. It is convoluted to be attacking all aspects of this hormonal trinity but nothing seems to be working and I can’t tell what is creating the symptoms.

    Ok, question: my TSH is still super suppressed, my free T3 is low, my free T4 is low. My FSH is high, my estrogen, progesterone, testosterone is low! Not sure what to do. Recently added some Tyrosine and Phenylalanine and Glutamine for energy and to decrease depression.

    Any suggestion? Should I even look at my TSH since I don’t have a thyroid gland. should I keep increasing my Armour dose to increase T3 and T4? Yet why do I have hyper like symptoms when I do? Adrenal Fatigue creating that? What about female hormones as they interplay into the whole hormonal orchestra. Help!

    • Hello Jennifer and Chris:

      Here are a few resources that I have found helpful; I am about to begin a protocol with LDN. Each of these resources may lead to more questions as well as some answers, such as the role of adrenals, in stabilizing on synthetic hormones, bio-identical hormones, or NDT. I have Hashimoto’s. I am currently on a T3 replacement only as years of Synthyroid at 200 mcg as well as Armour never alleviated the disabling symptoms of autoimmune disease.




    • Jennifer Im here because Im trying to learn more about t3 ( I had thyroid cancer so now have no thyroid. 200mcg synthroid and I feel depressed, tired, weak..36y.o. male)
      I was having constant anxiety/depression/brain fog and I asked my Dr to test my testosterone. He said it was in the “normal” range. So I took it to a hormone specialist and he laughed and said “ya its normal if you were in your 70’s”
      I went on testosterone injections and in two weeks everything changed.
      Im telling you this because he even prescribed my wife testosterone cream and I couldnt believe the change in her.
      She went from being tired, no energy, no sex drive etc to being happy, energetic, fat loss, always wanting sex lol…..
      I havent been on trt for a few years now because I couldnt afford it anymore and Im back to having no energy, memory problems, brain fog, lack of focus, no sex drive….
      You might want to look into it, but you need to find a hormone replacement clinic as your normal DR most likely wont prescribe a woman testosterone

    • you should read the books from Stop the Thyroid madness to gather some important information for your symptoms and what to treat first. The sttm website is also a very good source of info online and a way to get help fast!

    • I wonder if some of you have hypopituitarism. You would have hypothyroid symptoms and your labs show very low TSH and low free T3. This bloodwork would be done when your not on thyroid meds. I was diagnosed 9 years ago. They say it’s rare but I think most docs just don’t consider it or maybe have never seen a patient so don’t consider it or maybe dont know how to diagnosis it. Therefore people go for long periods of time trying to find answers.

  140. Hi Doc,
    I’m a 30 year old female that has been On synthroid for seven years. This past July I got extremely tired for weeks straight and saw my endo . My tsh on .112 was .8 and my t3 was 71. she increased my synthroid from .112mg to .125mg. In sept I got my levels checked again and my tsh was 1.5 and t3 was 76. Tidies the opposite of what we expected to happen, but I was feeling better and had more energy. In dec I got sick and my pcp thought I had bronchitis, I got a dose of steroids and antibiotics. I felt better after a few weeks, however since then my anxiety levels have been worse than ever. I have had several panic attacks and went to my psychiatrist. Although I have been on zoloft for 10+ yers she recommended I increase it to 125mg QD. For the last two months I have been taking 125mg zoloft and .125mg of synthroid. My panic and anxiety is still frequent. Have you ever seen or heard of anyone’s TSH levels going up by increasing synthroid? Or seen any patients T3 levels go down with increased synthroid? Do you think I should get another opinion?
    Also, I started taking singular in dec. Do you think that may effect my anxiety levels?

    • Katie,
      I would! I’ve been dealing with all of this since I got Mono a few years ago. You can read my story on my website. Keep in my site isn’t fully developed yet.

  141. Hello, Doc

    I have been on Tirosint for almost 9 months… raising the dosage from 25 to 75mcg as my levels had wavered and I kept hitting the wall of fatigue! I am at that point again with my TSH and T4 at good levels but T3 very low now. I exercise intensely every other day (lifting, boxing, boot camp) and walk/cycle/jog all alternate days. I eat really healthily…perhaps not enough calories actually…and have one hellova time just losing a few pounds! My Doc wants to add another med to help raise the T3 and I am not game. Any thoughts about how to help the T3 go up, how to boost my energy, and how my exercise and eating can actually result in weight loss? Thanks for any insight in advance!!

    • Just some ideas from my recent reading. If your TSH and T4 are at good levels, and the T3 is low, then why not just take a T4/T3 supplement? If that works, then you were having difficulty making T3. It is also possible your body could be reverse T3 dominant or for some other reason have problems making the T3. Have you had total and free T4/T3 tests? A thyroid microsomal antibody test? Tirosint seems to be just T4. I have heard that high stress (high cortisol – perhaps overtraining?) can inhibit T4 conversion to T3.

  142. Is it safe to take iodine supplements of 12.5 mg with synthroid to raise free T3? I was thinking I may have iodine deficiency and ordered it. Then, my lab tests came back showing TSH and T4 normal, but the free T 3 lower which prompted my dr to increase my synthroid dosage.
    your article is very well written.looking forward to next follow up.
    Oh and I realized that I,too, was on a low carb diet before I took the lab tests. Makes you wonder about the metabolism effects.

  143. I began researching Low T3 syndrome after coming home from the doctor today. My blood work results were received by my doctor and we met to review the findings. My TSH and T4 numbers all fell within the normal range. However, my T3 came back 0.00. I am a healthy 30-year old woman, somewhat overweight, but I do not have any known chronic disease. I’m interested to see the changes I experience once I begin treatment for this condition.

  144. Hi Paul,
    yep, you are right: correlation doesn’t equal causation. But I didn’t rush back to carbs, only after a year after the symptoms started and after gaining those 15kgs I increased some carbs and subjectively I feel better. Also I haven’t put on weight since adding carbs. I also read the post written by Paul Jaminet (http://perfecthealthdiet.com/?p=4383) and I get even a stronger feeling that I shouldn’t go zero carb. But, time will tell, I guess. Since no one else will… 😉

    Hope you’re getting better, Paul!

  145. I’m SO looking forward to the rest of the series since this might directly fit to my case… Been on a thyroid medication now for six months (recently switched from T4 to Thyroid) but I suspect this kind of scenario talked about this post might be the case. It’s subclinical but the symptoms are obvious. It’s not autoimmune either and my other blood work is really quite excellent (including ferritin, B12).

    So please, please get the next ones out soon! I’m feeling hopeful 🙂

    Ps. About the carbs&thyroid issue; I read Nora Gedgaudas’ book Primal Body Primal Mind in February 2010 after which I ditched the rest of my already low carb diet’s carbs. She really recommends like a zero carb, just leafy greens and “the less insulin we secrete the longer and healthier we live”. Well, that didn’t seem to do me any good (also started eating with just three times a day and did IF regularly). My problems started couple of months after and they’ve only now, over a year later started to get a bit better with the mentioned thyroid medication, adding carbs (berries, fruit, a little sweet potato – still very, very moderate since it’s not easy to go from a almost zero carb to eating more carbs, mentally) and some other stuff like herbal support.

    Anyway, just received Nora’s new version of Primal body primal mind and skimmed trough it; it still recommends a very low carb diet and I’m just wondering whether it’s me or is it really the best thing for everybody… Don’t really know what to do. I just do a lot better eating more often, a bit more carbs, no IF.

    • My T3 crashed too after going low carb. But, was it less carbs, more protein or more fat? Is rushing back to carbs the best approach – I did and I gained weight. I have upped my T4 and T3 and am trying vlc again – checking T3 later this month.

  146. Chris, How does one know what kind of Hypothyroid autoimmune disease they have (Hashimoto’s, Ord’s, Graves’) and/or iodine deficiency)? I was diagnosed a year after I gave birth to my one and only child was born, in Dec. 1983, (my was then age 36). I was put on Synthyroid & never felt normal until I asked my Dr. to prescribe me ARMOR in Nov. 2010 & also started eating Paleo Diet Feb. 2011, now I finally feel the most normal for me since I was in my mid 20’s. I am looking forward to learning more about this topic! Thank you so much for expanding on thyroid disease.

    • You get your thyroid antibodies tested: thyroid peroxidase (TPO) & thyroglobulin (TG) if you suspect Hashimoto’s or Ord’s and Thyroid Stimulating Immunoglobulins (TSI) if you suspect Graves’

        • The antibody tests are not 100% accurate. If my patients have signs and symptoms of Hashimoto’s, I treat them as if they do have it and watch how they respond.

          • I am also on Plaquenil 200 2/d. Could carbs make my T3 drop? Will it hurt if my T3 is low when the other thyroid markers are ok?

        • Hi Sheila,

          Initially, Graves is related to hyperthyroidism. However, after medication treatment, many of us end up hypothyroid with the FT4 and FT3 looking “normal” but being too low to feel good, and the TSH on they very low end. Unfortunately the doctors look at the TSH and label us as hyper, when in fact you are hypo if you look at the thyroid hormones. I’m finding it next to impossible to find a doctor who is really knowledgeable about treating Graves.

  147. The rT3 that you bring up very popular subject at the moment especially in regards to leptin resistance. If you have high rT3 usually marker for leptin resistant (as per Dr Kruse). Hopefully you address leptin when talking about rT3. High rT3 from calorie restriction.

  148. Thank you for addressing T3 issue. I have been diagnosed with “Reverse T3 Dominance”, and I hope you will be addressing this as well, especially how keep in in check/ preventing reoccurances.

  149. The problem for a lot of people – including myself – is in taking thyroid medication with any T4 in it whatsoever. Those with a poor free T3/reverse T3 ratio need to be on T3-only medication. Many cannot simply add T3 to their T4 regimen or take dessicated thyroid as it will make their problem worse due to the T4 converting to reverse T3 instead of T3 and thereby blocking the thyroid hormone receptors. They are then hypothyroid on a cellular level.

    All doctors should be running a free T3 along with a reverse T3 test and understanding what to do with the resulting ratio of free T3 to reverse T3. It will catch many with thyroid hormone resistance that will never be diagnosed through the TSH, free T4 and free T3 alone.

      • You can get your own reverse T3 tested if you are having trouble finding a doctor who will order it. There are online labs you can pay for, print out the lab order, and take the sheet to your nearest lab for a blood draw.
        Also, I would fire a doctor that refuses to order it and find one who will. Even if he/she isn’t sure how to interpret it. Unfortunately, most doctors do not order the reverse T3 as part of the standard thyroid panel as, surprisingly, they are not up-to-date on thyroid disease diagnosis, testing, and treatment. The free T3/reverse T3 ratio is key to have done if you have any chronic health issues. The TSH indicates thyroid hormone levels in the pituitary, but does not indicate whether one has hypothyroidism in the rest of the bodies’ tissues and is therefore quite far from a gold standard test. Free T3 and Free T4 alone do not show what is going on in the tissue level. People with fibromyalgia, chronic fatigue syndrome, leptin/insulin resistance, depression, dieting, obesity, and other chronic health issues should be checking this ratio. If the ratio is off, one will need T3 only treatment in most cases. Even Armour will not cut it, as the T4 will convert to too much reverse T3 and block the thyroid hormone receptors, keeping one hypothyroid.

        • great information thankyou so much. I have suffered with depression,severe fatigue ,trouble sleeping, muscles aches ect. im on synthroid and think thats what is making me sick. what do u think about natural hormones. I will know check with my Dr abut mt t-3 level is and make sure a reverse t3 was done. what ussually is the cause of depresssion and sever fatique ,any ideas. thank you so very much andrea

          • andrea,

            T3 is key in depression and muscle aches. When I got off T4 and went onto dessicated thyroid, the muscles in my neck and back that had been stiff released within a day. There are also more and more studies to say that brain fog is cleared by T3 therapy. Look into dessicated or synthetic T4/T3 therapy.

    • I am 56 and had hashimoto’s as well as papillary thyroid cancer with follicular and small area of tall cell variant.
      My thyroidectomy was in 2011. I am on synthroid 137 mcg and atenolol 50 mg. i recently started on cymbalta. I went on it a few months after my thyroidectomy and then went off and two months ago back on 30 mg. i had never in the past suffered depression although i woukd have periods of anxiousness. When i get the low feelings, my sense of smell gets incredibly heightened.
      I also have leg and muscle cramps. My tsh was last 0.13 total t4 11.4 free t4 3.2. T3 total 123. T3 uptake 28. Thyroglobulin <0.2

      Are these labs a bit off. Would i feel better if my t3 were higher?
      I am startimg with a new doc at cleveland clinic and looked at the lab orders and he is not even requesting t3
      I want to feel normal, lose 15 pounds and stop having muscle spasms and cramps. Calcium and magnesium have always been normal as have K levels

  150. At the end of your article you bring up rT3, which is most interesting. I have been looking into rT3 dominance and its ability to shut down even normal levels of T3. The point about stress is very important, as we are talking about emotional, as well as physical stress. I have read that even a lack of exercise – strenuous exercise – can also apparently result in higher rT3 levels.

    Looking forward to your future articles.

  151. Awe…..way to leave us hanging!!! I am extremely interested in this topic because I have been on Armour Thyroid for 2 years after my alternative healthcare practitioner found my Triiodothyronine, Free Serum levels to be at 2.5pg.mL. The “lab limits” were 2.3-4.2 but she said the level was low and could be causing some of the nervous system disturbances I was experiencing. This view concurred with a very informative article by Dr. Joe Mercola in which he promoted the use of Amour Thyroid for low T3. However, I later went to an ND who wasn’t thrilled to know I was taking it. So now I’m confused and waiting on the edge of my seat for the rest of this article!

    • My T3 was tested twice and I reported 2.6 and 3.0, with lab ranges from 2.0-4.4. (My TSH is between 0.5-0.8, and T4 1.1-1.7. Never tested me for Rev T3, even though I show very obvious clinical hypothyroid symptoms). I didn’t realize these number could be interpreted as “low”. Just curious, what kind of nervous system disturbance are you experiencing?

  152. Looking forward to learning more. BTW, I am a hypothyroid whose T3 dropped badly (with TSH <1) when I switched to low-carb approach. I have remained substantially low-carb, but have increased my T4 & T3.

    I am interested in the Broda Barnes / William McK Jefferies view that the conversion of T4 to T3 and the uptake of the T3 in the cell is, to some extent, dependent on adequate cortisol levels – levels of which can become depressed in a chronically un(nder)treated hypothyroid.

    I have noticed some papers showing some benefit from supplemental T3 in heart failure patients. The most recent (a review) being: Thyroid Replacement Therapy and Heart Failure http://bit.ly/rsAaNN

  153. I would also love to know the relationship with iron. The STTM group says low iron will make you unable to tolerate Armour or any synthetic T3. In my experience, Synthroid gets me to about 90% of where I want to be. When I add in T3, I have some issues and have to go super slow (but it’s the only thing that will budge my weight.) My iron is very low (although I am never anemic) and I’ve been taking so much iron for almost a year now, but my iron levels hardly move. To give you an idea, I take about 200 mg iron bisglycinate and 10 mg ferritin each day and my ferritin has gone from a 22 to a 36. Why would it be so hard to raise iron? I want to take my T3! Thanks so much for this series!

    • B-12 shots have kept my iron at a normal level. Without them my iron goes way down. Drs believe I have connective tissue autoimmune disorder. T3 is half of what it should be, but others ok with 88 mg levothyroxine daily.

    • Wow, It seems like you are talking about me. I was given by my doctor some T3 pills. I have to admit i did not take my iron for whole month and now it has been very hard to make it go up. I cut the T3 dosis in half just because of my schedule, could it be possible that it also affects the iron in your body? Scary. I am losing weight with all the treatment the doctor gave me.

  154. Thanks for this article, Chris! This is exactly the problem I have been facing. Even with T3 supplementation in addition to Armour, my T3 levels continue to go down and my TSH is below range. I have been working on eliminating candida and healing my gut in hope that my thyroid function will improve. Do you know how iron plays into this as I have difficulty getting my iron levels where they need to be. Thanks!

    • Iron needs adequate thyroid hormone in order to “hold/stick”, and the thyroid needs adequate iron so it can be taken into the cells, versus pooling in the blood. Armour contains T4 and it may be that you have a reverse T3 issue blocking thyroid hormone from getting into the receptors and need to be on a T3-only medication should there be too much T4 being converted into reverse T3. It may be that you would do better “ramping up” iron and T3 together, slowly. Candida should greatly improve once your body temp comes up to normal (ie, you are treating your hypothyroidism adequately). Candida thrives in a low-temp body and will be hard to eliminate while actively hypothyroid.

  155. Always enjoy your articles, Chris and am already looking forward to this one, although my own research into this topic tells me that we (or rather the pharma-financed medical research) knows nothing about NTIS beyond its clinical manifestation in really critically ill patients – part of the establishment even still deny its existence and exacerbate the problem of hundredthousands of patients by propagating T4 treatment and TSH diagnostics as the treatment and diagnosis techniques of choice.

Leave a Reply

[if lte IE 8]
[if lte IE 8]