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low TSH, low FT4

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I asked about this situation last week for myself. I have a friend in a

similar situation.

She's on Tap for hyperthyroidism. Her endo refuses to do a TSI but it

seems unlikely she has GD. All through her treatment - about a year -

she really felt no symptoms, even when her FT4 was at 0.8. The only

symptom she had to begin with was itching and maybe a little extra

energy.

Finally, after 4 months at 5 mg. (reduced gradually from a starting point

of 20) she's starting to feel muscle pain/weakness. Her numbers went from

a TSH of about 1.0 and FT4 of 0.8 (and again, remarkably no symptoms) in

July to a TSH of 0.3 and the FT4 the same last week. The question for you

detectives out there is - what's happening?

My detection uncovered that she's been taking her multi not just more

regularly but doubling up, and she never realized that her multi had

iodine (150 mcg. of course). This could explain her possibly going hypER

over the course of the month. BUT, it begs a few questions:

1. The TSH reflects what was going on about 6 weeks ago, before she

started doubling up, so so much for that theory?

2. Might she be feeling the muscle pain, etc., because she's hypO after 4

months at 5 mg.? Would a low FT3 confirm this?

3. Then why the low TSH?

I realized that these are essentially my questions, minus the fact that

I've been avoiding supplemental iodine. Hopefully I'll be in touch with

my endo within the week and have some answers for her. Unfortunately, her

endo is a quack. He refuses to do a FT3 and she's finally coming to terms

with the fact that she has to fire him. But if anybody has suggestions

about bloodwork she should ask for with explanations to run by her GP,

it's possible that her GP might be amenable to running the tests if she

can't get into a new and decent endo practice soon.

Thanks for any help, take care, Fay

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