I have hashimoto’s thyroid disease and currently take .88mcg Synthroid as well as 5mg cytomel. My thyroid bloodwork just came back showing that my TSH is low- 0.019=hyperthyroid. Even though my T3 is low. Okay well my Dr. doesn’t think that my synthroid dose should be reduced even though my thyroid is high and my blood sugars are becoming harder to control. Anyone else experienced higher blood sugar or other issues when their thyroid went hyper? I want to trust my Dr. but feel he is not giving me optimal treatment by just leaving me hyperthyroid until I return in 3 months. Any thoughts or suggestions?
You are not hyper if your T3 is low, you are actually hypo. Your TSH really doesn’t mean anything. Do you know what your Free T4 levels are? Your Free T4 should be about mid-way of the lab range & the Free T3 in the upper 2/3rds. My TSH is practically zero now that my FT4 & FT3 are almost where they should be. With Hashimotos, the TSH can swing alot from one day to the next so you should not even look at that.
But in answer ot your question, the thyroid can mess up your BS. When my thyroid went ouf whack last year, I had to practically triple the amount of insulin I was using and then I would have days that it would just come crashing back down. That has settled down now that I am close to optimal levels.
When I was first trying to figure out my (mis) diagnosis, I wondered if my thyroid was making my blood sugars go up. (I was hyperthyroid - Graves Disease - and then had my thyroid destroyed and take synthroid replacement). I did a lot of research and the conclusion I came to was that if my thyroid was off (mine can go both high and low) it could definitely affect my blood sugars. But that if was stable it was not. You 0.019 is VERY hyper! Mine was 0.087 once and my doctor said that was very high and immediately changed my doses. I find it very odd your doctor is leaving you at the extreme end of hyper and doing nothing. Having both diabetes and thyroid I would see an endo as soon as possible. I don’t know much about the T3 and if that is the factor that is making your doctor not act. There is a separate board on here for thyroid so you might want to post there. But I am shocked you are that hyper and your doctor is allowing it!
Wow, I really was out of the loop, Kelly! The TSH doesn’t mean anything??? That is the only thing I have ever checked and multiple doctors and endos altered my doses based on it. (My thyroid numbers after years of stability went totally out of whack after my diabetes diagnosis). You say “with Hashimotos the TSH can swing a lot from one day to the next”. Is that completely different than Graves disease in that respect. I’m really confused now. The alterations of meds based on my TSH seemed to work just fine. (Although I noticed that since my diabetes diagnosis I didn’t have the same symptoms of being hyper or hypo that I did previously). I’m very confused.
My doctor is an ENDO!lol That’s why I am soooo frustrated! I called literally everyday last week asking about my hyperthyroid leaving messages (they must think I’m nuts!) lol and when they finally called back all they said was “The Dr. said keep doing what you are doing, no change in meds is necessary.”
Do you have Hashimoto’s as well?? I’ve had a problem since I had my son 4 years ago with my thyroid swinging up and down and I just can’t seem to get a break! Is your TSH seriously almost zero!? Do you not have any hyper symptoms?? All of this is SO confusing! The Dr did not check my T4 this past time but 4 weeks ago I had labwork taken as well and the results were:
T3- 2.5 (four weeks later 0.58)
T4-1.05 (four weeks later they did not check)
TSH-0.46 (four weeks later 0.019)
And I am SO frustrated because I am having hypo and hyper symptoms. Should I just trust my Dr. for the next 3 months or what??
Unfortunately, alot of doctors only really look at TSH but someone that really understands thyroid won’t look at it. Not all endos get thyroid! It is also very hard to find good thyroid doctors!
I don’t know alot about Graves but I have Hahsimotos so have done alot of reading on that. For the first 10 years of being hypothyroid, my doctors also adjusted my meds based on TSH but things were not as bad as they are now and that doesn’t work for me anymore! My TSH is actually 0.03 and my FT4 and FT3 are “almost” where they should be. Back in the summer, my TSH was 0.08 with my FT4 being at the bottom of the range. That particular doctor did not bother to test FT3 but I still needed a bump in meds to get my levels where they need to be.
Yes, I have Hashimotos. Last Nov, m TPO was over 3000 on a scale of 0-9. In May, it was down to a little over 1300.
I have hypo symptoms, not hyper. I would trust your doctor since he is not looking at the TSH. One thing with Hashimotos is swinging between hypo & hyper symptoms - I never had that problem!
The reason a TSH level doesn’t mean much is that it’s merely a hormone produced by the Pituitary to signal the Thyroid that it needs to make more hormones, but it doesn’t tell you which hormones… AND, the Thyroid doesn’t make TSH. The Pituitary does. Antibody attacks on the Thyroid throw off the tests that measure TSH levels, and can give many false numbers, etc. And if your pituitary is not properly producing TSH, instead of the Thyroid not making enough hormones, imagine taking meds based on something that’s not broken? Thyroid medication is NOT intended to treat a high or low TSH… It’s intended to treat high or low T4 or T3. Many doctors don’t seem to understand that very well.
There are a NUMBER of things that could make the TSH moot. Doctors should rely on Free T3, Free T4, Reverse T3, antibody testing, and metabolic profile (like vitamin B, cholesterol levels, etc.), to really note how well the Thyroid is functioning. One could use a TSH to note if someone is responding to medication… (as it will get stabilized, as the hormones stabilize)… but it’s really not a great thing to rely on, on it’s own.
If you have Hashimoto’s, and you have a low T3, and a low TSH… ignore the TSH. Having antibodies throws off whatever numbers you might get from a TSH testing, and makes that an unreliable measurement for how well your thyroid is working. Your doctor should be testing you for Free T4, Free T3, and Reverse T3 to see if your Thyroid is even properly converting T4 to T3, at all. You are not Hyperthyroid. Is your doctor an endocrinologist? Also note, that in many cities, there will be different endocrinologists who specialize in Thyroid Illness, while others only specialize in Diabetes care, etc. If he is not open to more testing, it might be time to get a second opinion… empowered with some information on your condition.
We have a group here, for Hypothyroid Diabetics. You should check it out, if you haven’t, already. I have packed it full of information and threads that you can look up info, links from Doctors, etc, for referral, and knowledge. 
Since taking too high a dose of Synthroid is dangerous, I would either ask again, get a second opinion or, alternatively, just reduce the dosage myself temporarily to see if symptoms cease. The 88 mcg pill has a little line in the center of it. By cutting pill in half, the dosage becomes .44 mcg (we do this for my niece). I would test out a 3/4 dosage. Cut the pill in half; then cut one of the pills in half again. See if that helps. I think a reduction in medication is far less risky than taking too much. P.S. Once thyroid is regulated, on Synthroid (don’t use the generic), my niece does need a higher dose of insulin; perhaps ten percent more. If we forget her dose, we notice a drop in her blood sugars, necessitating reduciton of basals. If we think we have forgotten a dose accidentally, we do not then give it as it is safe to omit the dose but unsafe to give too much.
Also, note that Synthroid is NOT an appropriate medication for persons who are low in T3, especially if they are NOT converting properly from T4, to T3, and a doctor has not done the testing to know the difference. Synthroid works well for persons who are low in T4, only, because that means their thyroids are having no problems in converting to T3. You may need a different type of hormone replacement that has BOTH T4 and T3, such as Armour, or Thyrolar, etc.
Here’s a nice chart comparing thyroid medications, what hormones they have, and how well they work for most people. http://www.altsupportthyroid.org/treatment/hypomedcomp.php
So is 0.019 lower than 0.03?? I have Hashimoto’s as well.
Thanks so much for all of the WONDERFUL feedback, it means so much to me guys!! And I am on cytomel 5mg for my low t3. I’m pretty sure he’s a good endo he has been doing it for 40 years I guess I should just trust him but just hearing low tsh worried me of course because I do not want to be hyper. Everything you all have said makes a lot of sense, I never knew that TSH didn’t matter. Thanks so much!
I considered doing this but hesitated because my doctor said to take what I am taking now so I’m just confused as to what to do… If I did start cutting my meds I was worried what dosage to say I am on when I go back to the Dr because while cutting them I really will not know and if my thyroid levels are not normal they will not know what dosage to change it to…hmm…
Hey, you’re welcome!
If you are taking T3… than your doctor is probably more than likely relying on your T4 and T3 levels to make his decisions, and not on the TSH. So, I wouldn’t worry too much about it.
Also… yeah, being on thyroid meds may drive up blood sugars for some people for a while. Why? Because you’re finally metabolizing food properly, most likely… and also because some pills often have lactose, and sucrose, as fillers (which may have some minimal effect)… You may need to consider your insulin dosing into this, as others have had to adjust their basal more to deal with it, as well.
I don’t think you should lower your dosage BUT if you decide to do that, you need to be honest with him and let him know what you did and when you did it so he can time tests right.
Yeah I am diet/exercised controlled like you I have had Hashimotos thyroid since I was 10 years old.