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

by

Published on

Reviewed by Jessica Montalvo, MD

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

Table of Contents

Thyroid Physiology  |  Mechanisms of Low T3 Syndrome  |  Low T3 Syndrome in Acute and Chronic Illness

 

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 liver—thyroid binding globulin (TBG), transthretin and albumin—carry 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 itself—most 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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427 Comments

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  1. 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.

  2. 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.
    Thanks!
    Kirsty

    • 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.

  3. 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!!!

  4. 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

  5. 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.

  6. 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.

  8. 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

  9. 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 .

    • Jerry,

      For what you are describing about your wife’s symptoms it sounds a lot more like hyperthyroidism than hypo.

    • Has she been tested for Lyme (the blood tests are awful) but start there, and have a GOOD ILAD Dr read the results. Good luck!

  10. 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

  12. 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?

  13. 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 ??

  14. hi iam from afghanistan i have pateint with below biochestry range
    TSH normal
    T4 normal
    T3 low

  15. 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.

  16. 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.

  17. 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 .

  18. 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.

  19. 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.

  20. 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.

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