Hypo/adrenals?

[dessie111]

Hi Dr Lupo,
I need some help understanding this disease that I may or may not have??  when I first went to endo he told me I was not hypothyroid and that little by little we will wean off synthroid??  Was started on syn in the first place because my labs showed low/subclinical hypo--some would probably not even treat, but I was having major symptoms, well went back a couple months ago, Tsh was .85??  and my Free T3 was 2.1, so Doc decided to start me on low cytomel on top of my 50mcg of synthroid?? Well had terrible response to it, I was taking 5mcg twice aday and my hair starting breaking off, night sweats, fullness in my throat, etc, labs showed now I was hyper came back at .32, but my Free T3 only moved up minimally went to 2.5??  About a month ago, d/c my cytomel and kept me on syn--50mcg and 75 everyother day--Well just had labs done again--and now my TSH is 2 which is up??  and my Free T3 is 215???  
So what is going on??  Am I hypothyroid or what am I??   I am a very strange case that my TSH being 2 which is clinically normal--gives me symptoms--I am feelling a bit sluggish and I am gaining weight again--and retaining water??  Doc told me to stay on this dose for another month and then re-check labs and come back and see him--well don't want to wait that long to fix this?  Thinking of switching Docs, getting another opinion--

Now to add to the equation--when my T3drops quite a bit, usually when I am low carbing it to get off some of the body fat--but this time I am actually trying to increase calories and carbs to up my metabolism and trick the body a bit, but it is not playing fair?? I am getting so frustrated--my Doc tells me I am a very confusing case because the more he ups my meds my tsh drops but my Free t3 does not move Cortisol levels am vary between 9-12

I have also noticed that when I exercise minimally my free t3 stays around 2.4-2.5 but when I exercise everyday including running my Free t3 drops to 2??  I am so confused!!

[Larkenn]

Not everyone can convert T4 to T3.  Your doctor should know this.  You should be taking a separate T3 treatment with the synthroid.  Armour is the best tho.

[stacey555]

I am not a doctor but I do know alot about this stuff I have the same thing.  Vert low tsh in range t4 and low t3 which only comes up if I take slow release natural t3.  If you take synthroid or t4 and you are not converting to t3 it is probably your adrenals.  You need to find a doc that will do a 24 hour cortisol saliva test and treat your adrenls with glandulars or low cortisol and give you natural t3 or armour which is t3 and t4.

[dessie111]

Yeah I am sure it probably has something to do with it, but I can tell now when my TSH is up or my meds are not adusted properly, because I do retain water, but the weird thing is I store body fat on my lower back--and Doc keeps adjusting to see what my Freet3 will do not so much my TSH because that it ok, even though I am very symptomatic with the slightest change--he now has me alternating 50/75 every other day and for the last two days I have been sweating profusely--it is the craziest thing, but I have also started back exercising 6 days a week, and well just had my cortisol retested yesterday and it came in at 6.8 in the am reading---not good, so might be adrenal insufficiency vs hypo--so I don't know, husband thinks I may need to go ahead and come off the syn--and try and heal the adrenal glands, but does not think there is a true cure for that???

[1ph]

Do you think that  increasing calories and carbs has increased the fluid retention and weight gain?
It sure does with me:-)
We are all individuals but, after a dose change , it takes me almost three months to see the effect in my blood work. When i had doctors who were checking monthly, it just confused matters and caused a constant adjusting of medicine dosages.

[Mark Lupo, M.D.]

Often patients are put on thyroid meds for borderline labs or simply b/c of symptoms.  The levels you mention are all essentially in a normal range and some of the symptoms may be relative to changes in medication and usually patients adjust to these after about 6 weeks.  So unless there is evidence of true thyroid disease (abnormal ultrasound, positive thyroid antibodies and a TSH that is consistently -- repeated 6 weeks apart -- elevated to at least >4 (preferrably higher)  with symptoms) I suggest to patients to try to come off the medication b/c it is not likely to benefit them and there is no  point in taking a medication lifelong that they do not need.  

Your cortisol levels are normal.