TSH Tests Low after taking Nature-Throid

[Antisosa]

Long story short I needed to go to Defy medical because my doctor I normally see did not understand TRT / the correct blood test correctly. I got most of my labs through my primary physician to save money and I sent them to defy. When getting back my blood test for TSH, Free T3, Free T4.. My doctor told me they were little low but fine and not to do anything. I sent the same info to Defy and he said my Free T3 is low.


I got my TSH tested the other day and it is very low (0.014 with a normal range of 0.3-5.6). My primary doctor message me and asked if I am taking any thyroid medication.


Defy has put me on Nature-Throid, but my Normal doctor does not know that. I don’t really feel comfortable telling him about defy because it will "go against what he said".

I understand that TSH will be lowered once taking this medication, I just dont know how to respond to my Doctor now.. Any suggestions?

 

[Dr Justin Saya MD]

Long story short I needed to go to Defy medical because my doctor I normally see did not understand TRT / the correct blood test correctly. I got most of my labs through my primary physician to save money and I sent them to defy. When getting back my blood test for TSH, Free T3, Free T4.. My doctor told me they were little low but fine and not to do anything. I sent the same info to Defy and he said my Free T3 is low.


I got my TSH tested the other day and it is very low (0.014 with a normal range of 0.3-5.6). My primary doctor message me and asked if I am taking any thyroid medication.


Defy has put me on Nature-Throid, but my Normal doctor does not know that. I don’t really feel comfortable telling him about defy because it will "go against what he said".

I understand that TSH will be lowered once taking this medication, I just dont know how to respond to my Doctor now.. Any suggestions?

Honesty is always the preferred approach...at least from my perspective. You need a PCP that you can have an open and honest doctor-patient relationship with.

If being honest about your current situation causes a hiccup in that relationship, it may be a clue you should seek another PCP for future care.

 

[Vince]

I know many doctors freak out about low TSH, when someone it's on thyroid meds they shouldn't even be looking at the TSH.

 

[Antisosa]

What should they be looking at?
Also the Dr didn’t know I was talking any meds. Because there was a 2.5 month wait to get into an endo, I reached out to Defy.

 

[Vince]

SomeG, going off of what I see, I actually do suspect thyroid issues. Like Nelson stated already, we do need the free serum on both T4 & T3, plus you will want Reverse T3, and anitbodies (TPO & TgAb).

Here's my reasoning  ... Going on your Total T4 & T3, take notice with how far apart each lab is from the other within the respective reference range. Total T4 is at 30.6% of the ref range value, Total T3 is at 76.9% of ref. range value. Normal function would usually have both of these semi-close to each other. I suspect free serum levels will follow similar suit, but would want to know for sure.

Additionally, I suspect possible pooling with T3, meaning T3 isn't getting into the cells, it's just building up. The lab that will counter-check this will be Reverse T3 and the comparative ratio to FT3.

This is one KEY example of why TSH is misleading ... If FT3 is pooling, then the feedback loop is indicating that thyroid hormone levels are up, which in turn directs the pituitary to reduce the demand for further hormone production, which in itself reduces TSH levels.

This can be common with Hashis and other thyroid disorders, and evident when transport agents like cortisol, iron, ferritin, and in some cases electrolytes & D3 play a role with T3 productivity. With "transport agents", I am referring to specific hormones/elements/proteins that play a vital role with T3 getting into the body. Cortisol & Iron/Ferritin are usually the two key components that factor into this.

Your cortisol serum lab basically doesn't elaborate anything. There is so much variance between AM & PM, and the only effective way to really gauge it is with a 24 hour -4x saliva kit, which is the gold standard. The cortisol kit should also include a DHEA saliva lab for the sake of getting the adrenal overview with a DHEA/cortisol correlation analysis. The iron & ferritin should remain drawn with blood serum, and I would also include at least a TIBC with it.

My gut says your physician(s) won't buy into much of this, due to the fact that they are running these useless "index" labs. Those labs tell them virtually NOTHING!

And do me a favor,

double check that T3 lab. ​

You say "T3 was 32" .. Please confirm that this didn't say T3 Uptake??

If it did, then everything I've been saying at the top with the reference range comparisons was just an exercise. If it it is a T3, meaning "Total T3", then the reference range discussions stands, I would evaluate further ... I throw this out because when doctors start ordering some of these useless "index" thyroid labs, they usually throw that Uptake in as well. Sounds snazzy and important, but it's worthless!​

https://www.excelmale.com/forum/sho...e-questions-about-cortisol-thyroid-IgF-DHEA-S
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[Vettester Chris]

Honesty is always the preferred approach...at least from my perspective. You need a PCP that you can have an open and honest doctor-patient relationship with.

If being honest about your current situation causes a hiccup in that relationship, it may be a clue you should seek another PCP for future care.

Bingo, x2!!!

Antisosa, give Dr. Saya's advise some consideration. As other areas of your endocrine system improve, and other noticeable positive changes transpire, it will just put you in a position of having to cover it up. You might be surprised that he could have an open-mind, and if he's anything like my PCP, he might take notes with how your program is being administered. If he shuts all of it out and won't consider any of it, then his ego has probably got the better of him, and that's when you might want to evaluate and review what's "best for you"!!

 

[Antisosa]

I did message my dr back and let him know I went out of network because the endo was a 2.5 month wait. And no response yet. I honestly need this dr just for writing my prescriptions for TRT but other than that I’ve been doing all my research on my own/ defy medical. People who actually have knowledge on this space.