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


Published on

Reviewed by Jessica Montalvo, MD

Fatigue—like this man is experiencing—could indicate low T3 disorder.

This article is part of a special report on Thyroid Disorders. To see a comprehensive eBook on thyroid health, 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, and there is a growing realization among conventional medical practitioners that it’s an important issue. (1) However, many conventional practitioners aren’t sure how to address the condition, which leads to patients who don’t have a clear understanding of what’s causing their illness.

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.

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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

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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 and 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 acute 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:

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Join the conversation

  1. 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.

  2. 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.

  3. 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.

  4. 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.

  5. 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.

  6. 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

    • Are you taking selenium? This can help reduce antibodies. I take 200mcg selenomethionine every morning.

    • 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.

  7. 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?

  8. 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.

    • If you have your lab test results, I assume your doctor has discussed this with you? What did your doctor say?

    • 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.

  9. 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.

  10. 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.

  11. 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.

  12. 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.

  13. 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.

  14. 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 ?

  15. 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.

  16. 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.

      • Clarification: feeling fatigued from T3 is when taking the whole dose rather than dividing it.

    • 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.

  17. 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…

  18. 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.