Low TSH - Should I be concerned?

Dear eramsl,

Your TSH is indicative of being hypERthyroid, the tests that your doctor ordered are considered obsolete and of little use except for the free T4, your doctor should have ordered the antibodies tests to see whether you have an autoimmune disorder that is causing your hyper, so I think that you should perform the following tests TSH, Free T3, Free T4, antiTPOab, TGab and TSI antibodies, and to go to an Endo doctor with those tests results with you.

You don't have to have the hormones high to feel hyper, it is enough to have low TSH and normal Free T3/4 to be hypERthyroid.

Best,

UPDATE: I saw an Endocrinologist in October. He wanted me to get some additional blood tests in three months which I just had.

T3 Total: 97 ng/dL Normal 71 - 180 ng/dL
T4 Free Direct 1.07 ng/dL Normal 0.82 - 1.77 ng/dL

I have not heard from him yet but it looks like these results are good. I'll update again after I hear from him but from what I see online I have Subclinical Hyperthyropidism based on my low TSH result from September. I am guessing he will say it is fine and I should get it rechecked at my next yearly checkup in September. Is there anything I should request from him in the short term or does retesting at my next checkup make sense? I have no specific symptoms that I can tell.

UPDATE: Just receive email from my Doctor that my Thyroid studies are normal.

Post Edited (eramsl) : 1/19/2021 6:05:22 AM (GMT-7)

Hi Astroman,

I have low TSH too at 0.09. I was hypo for years and suddenly last week this TSH level went to 0.09. My doctor lowered my meds but did not want to stop it yet.

My issue now is Dry mouth that it wakes me up. Also have stomach sensitivities due to too much PPI and antibiotics. So everything seems to be a complex.

I have another blood test end of next month. But this dry Mouth seems to be tough that no remedies worked.

Somebody said...
When I met with him my understanding was that the T3 and T4 levels are what matters and the TSH is just an indicator that governs the T3 and T4 levels but that the actual TSH levels aren't that important by themselves

TSH remains the golden standard to diagnose and treat thyroid diseases, it is true that it is not a thyroid hormone but it is released by the pituitary and it is the hormone that controls the thyroid.

"TSH being "the gold standard", is wrong. It should not be and thus is why so many people being treated for thyroid issues do not feel well. This is what happened to me for years.

The t4 and t3 hormone levels need to be considered as well.

A smart Endo who has successfully helped patients symptoms, vs just a TSH value knows this and will to some extent find the patients levels where optimal symptom relief is achieved. And who's to say the pituitary is working correctly? - very limited options for testing that gland.

And for patients already on thyroid med, the longer they're on it, the further the TSH will be driven down, even if there are no hyper symptoms or high levels of T4 and T4."


My husband was given a script for the synthroid and tested - everything in range...so the Doc said that was a good amount....but he was still slightly symptomatic...and on his own...he bumped up the dose and felt better. His tests were still in range...but the Dr. refused to write a script for that amount. It's ridiculous....since his FT3 and FT4 were still in range...just a little 'higher' in that range.

He knows how he feels...and it's a shame that he can't get the amount he feels he needs.

I don't think our Endocrinologists are that great around here, either...