Low T3 Syndrome I: It's Not about the Thyroid! | Chris Kresser
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Low T3 Syndrome I: It’s Not about the Thyroid!

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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 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 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.

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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

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:

Research Spotlight: Health Coaching and Thyroid Health

Practicing Yoga Can Help Women Suffering from Hypothyroidism

Hypothyroidism is on the rise, affecting women disproportionately. One of the hallmarks of hypothyroidism is elevated TSH levels, and the disease is also often associated with poor lipid profiles and HPA axis dysregulation. Over time, hypothyroidism can contribute to coronary artery disease, obesity, and depression. To manage the disease, thyroid hormone medication is often prescribed, but long-term use can decrease bone mass and increase the risk of fractures.

Previous studies have shown that yoga can improve lipid profiles, diabetes, depression, anxiety, and more. A study from The Journal of Complementary and Integrative Medicine indicates that yoga may reduce the need for thyroid medications and therefore lead to better health outcomes.

Study Summary

The main objectives and findings of the article were the following:

  • In this pilot study, the researchers aimed to see if a long-term yoga program could improve TSH levels and lipid profiles.
  • 22 women, aged 30 to 40, with hypothyroidism completed a six-month yoga practice. Each session lasted one hour, and sessions were held four times per week.
  • At the end of the study, the participants had significantly reduced total cholesterol, LDL cholesterol, and triglycerides, and increased HDL cholesterol levels. Although TSH levels were not significantly different from baseline, they trended downwards, and seven of the 22 women were able to reduce their hormone medication dosage.

Key Findings and Significance

Excessive exercise can aggravate hypothyroidism symptoms, and many shy away from physical activity for fear of adverse outcomes. The findings of this study indicate that a slow movement exercise is beneficial for managing stress, improving metabolic profiles, and relieving some symptoms in women with hypothyroidism. Yoga incorporates exercise, awareness, and controlled breathing, indicating that even a meditation or breathing practice may have a place in hypothyroidism management.

Reference: Effect of 6 months intense yoga practice on lipid profile, thyroxine medication and serum TSH level in women suffering from hypothyroidism: A pilot study.

Health coaches support people who are trying to make big changes—like adopting a new diet or incorporating yoga into their exercise routine. How do they do it? By developing and honing skills like facilitating change and learning to listen. Find out more about becoming a health coach with the ADAPT Health Coach Training Program.

427 Comments

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  1. 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.

  2. 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!

  3. 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.

  4. 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

  5. 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.

  6. my T-4 serum =6.8, free T3 =1.9, T3( triiodothyronie ) serum =67,free thyroxine=1.77, TSH =1.380

    what do you think?

  7. 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.

  8. 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
    CBCcounts
    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

      Reference.

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

      results

      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…

  9. 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!

  10. 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,

  11. 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?

  12. 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 !

  13. 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!

    • Your dose is too low, you have suppressed your own production but not added back enough. You need a higher dose.

  14. 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?

  15. 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.

  16. 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 !

  17. 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!

  18. 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,

        Farrah

    • 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]

        Bless,

        Farrah

    • 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.

      • Try acupuncture or an infrared sauna for a while!

        Good luck.

        I hope you get better as well and rest up.

        Farrah

      • 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?

  19. 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 !

  20. 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!

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