Low TSH and low T4

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    I recently went to the doctors because I had sudden weight gain (#40 in 5months), sudden depression, fatigue, mood swings, hair loss, dry skin, swollen joints, digestive issues, memory loss, and more. My labs came back that my TSH is .14 and T4 is .9. My doctor said I had hyperthyroidism due to the TSH being low. She said to come back in 4 weeks for another blood tests. No treatment at this time. From what I’ve been reading though a low TSH and T4 is secondary hypothyroidism caused by a problem with the pituitary gland. In most cases caused by a tumor. I feel 4 weeks is to long to wait and that I have been misdiagnosed.



    Why are some doctors so….well, stupid? Don’t they learn anything in medical school? TSH is produced by the pituitary gland, T4 by the thyroid gland. Your T4 is low because the pituitary gland is not sending enough TSH to the thyroid. Most likely, your thyroid is normal, it is just not being stimulated properly. Only an incompetent doctor who knows nothing about the endocrine system would say something so idiotic as “you’re hyper because your TSH is low.” Unbelievable!
    You have already shown yourself to be smarter than your doctor by finding out that low TSH + low thyroid can mean a pituitary problem. An oversupply of cortisol, as in Cushing’s disease, can suppress TSH. Most doctors dont like to test for Cushing’s because it’s been drilled into their nonfunctioning brains that it is a rare disease. Researchers are finding it is actually fairly common. If you dont know of a good doctor you can see right now, you can order a cortisol saliva test online. Test your late-night cortisol. It’s supposed to be almost zero at night, so if it’s elevated you’ve got your answer. High night cortisol is often caused by a pituitary tumor or occasionally an adrenal gland tumor. That sounds scary, but they are nearly always benign. It is believed that one out of every 8 people walking around today has a pit tumor but either they never have symptoms or they are never properly diagnosed because of incompetent docs like your own. Good on you for doing your research, and good luck with your medical issue. You’re on your way to a proper diagnosis and a solution to your problem.



    I too had low T4 and low TSH I was told I had hypothyroisism. Put onto throxine. After 3 months the T4 was too high and the TSH was even lower. 0.02. So the thyroxine was increased. Changed doctor and had the dose adjusted but I believe I may have cushings. Due to have blood test next week. We will then see what happens. I am prepared to get a little ascertive this time around. Why do doctors not recognise this. Its all over the world. Strange.



    Adelthea17. Hello, I have a similar problem as the OP. My TSH is .479 and t4 is .96 tested today. I’m on 50 mcg synthroid. I’m experiencing worsening constipation and other symptoms haven’t improved. Is a pituitary issue my problem? If it was pituitary hypo would you just dismiss the TSH result and only pay attention to T4?



    There is plenty of research available about thyroid medicine, if you care to read about it.
    The stuff on the top right side of this page is a must read. Do it!

    TSH is a pituitary response only,which has its own system, including its own deiodenase. This fact is either ignored or not understood by the medical community who incidentally gets paid more the sicker you are.
    I too had the same problems 20 years ago, for about two years, until I figured out these guys are all wet and got on the interwebs
    and found answers fast.
    The healthy thyroid normally produces and exudes _other_ hormones too, gasp!
    Yet, commonly, only T4 (thyroxine) is substituted for hypothyroidism. I soon found out you also need T3, which worked so-so, but instantly lifted the brain-fog I had for 2 years, yet I still had problems, heart palpitations etc.
    The T3 helped some, I did not get enough of it, and got Atenonol to cope with the effects of T4, which effectively lowers the effect of both T4 and T3.
    The short answer is that the old school medication made from pig thyroid actually works. It is sold in the US under three different trade names, but the generic description is Thyroid-USP.
    Hypothyroidism is not like diabetes where the effects can be measured with a stick in the finger.
    Measuring intracellular concentrations of some thing from blood samples is both logically and practically problematic.
    Does low T4 indicate low supply or high absorption? Intestinal interactions have a HUGE effect on this hormone.
    The natural unmedicated “levels” of a healthy working thyroid is not the same as a medicated response. Much have been published here.
    Medical practice on average lags research by 22 years, quoting Dr. Holtorf. In thyroid care that number is probably 40 years.
    A study from 2011 showed that at least 20% of athyreotic patients are not restored by T4 monotherapy.

    “More than 20% of these patients, despite normal TSH levels, do not maintain FT3 or FT4 values in the reference range, reflecting the inadequacy of peripheral deiodination to compensate for the absent T3 secretion.”

    Moreover, the TSH “reference range” is also tainted by sick people. My medicated TSH is very low and raises some eyebrows,
    so I asked my medico, if it indicated hyperthyroidism, then why are my pulse and body temps low, and he agreed.

    There have been discovered specific genes responsible for this, it would make more sense to look for these markers.


    Thus what seems like a difficult problem, can actually be easily resolved.

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