Am I undermedicated or over medicated

[Extreme2001]

This is my recent blood work for thyroid!
TSH 0.082 LO Range: 0.178-4.530
Free T4 - 1.75 High Range: 0.80-1.73
T3 - 118 Range: 72-180
Free T3 - 3.3 Range: 2.0-4.7
As off 3/24/16

Previous Blood work on 2/29/16
TSH 1.100
Free T4 - 1.50
Free T3 - 2.8

Symptoms I'm having now are stomach issues; bloating, loss of appetite, stomach pressure. Really tired and body aches in legs with neck pain and tightness in throat where the thyroid is. One minute I'm hot then I become cold. Been having these issues for some time now, no matter what I've been perscribed. Doctor has me on Nature Thyroid 32.5 twice a day. Just don't no where to go from here. Feeling bad and losing a lot of time off of work. Any suggestions would be helpful. Due to give blood work at the end of this month. Also taking B-12, Vitamin D, magnesium, zinc supplements. Thanks Glen

[goolarra]

Believe me, I've been there with the symptoms!

I'm glad your doctor increased your meds.  You should start feeling better, but another increase may be indicated after your next blood work.  The NT has about 4.5 mcg of T3 in your 32.5 mg increase, so that should give you a jump start in a shorter time than increasing T4 would.

Good luck with the increase, and keep me posted on how it goes.  

[Extreme2001]

Thanks, will keep you posted

[goolarra]

FT4 is below range, not good.  FT3, though within range, is way too low in the range.  It's only 19% of range, which is way below the 50+% recommendation.  People on NT often have to have FT3 even higher than that, often 67+%.  

I think it's too early to start tweaking T3 and T4 meds separately.  You just plain need an increase at the moment.  As FT3 and FT4 get closer to targets, you may find that you have to add in a separate source of T4 to keep things balanced.  While your FT3 is low, it looks very good relative to your FT4.  

I doubt you're feeling much better...

[Extreme2001]

Doctor increased NT meds to taking two 32.5 pills in the morning and one in the afternoon, will retest blood work in two to 3 weeks. I just want to feel better hell I take 50%. Been on NT med for alittle over a month at 32.5 twice a day, hopefully bumping it up to 3 times a day will show some improvements. My symptoms now are legs cramps bad, loss of appetite, stomach bloating and a lot of gas pressure. Fatigue, no energy at all, hard time getting sleep. Always feeling bad but this is the worse. Making it very hard to get motivated for work or any task.

[Extreme2001]

Thanks, will post lab work next week when I get the results back.

[goolarra]

If your FT4 level has dropped significantly, then your thyroid is trying to work harder to make up the difference.  It's probably inflamed and swollen.  Some people find selenium helps that feeling of fullness or tightness in the neck.  Follow package directions, though, since selenium can be toxic in high doses, or eat a Brazil nut or two.  They're high in selenium, and a couple provide RDA.

For your other symptoms, you just might have to wait for your FT4 to come back up again.  OTC drops for dry eye might help.

I'll look forward to seeing your new labs.  Good luck in the meantime...hope you feel better.  

[Extreme2001]

Hey, goolarra
Just got my lab work back on my thyroid.
T4- 3.5 Low
Free T4 0.53 low Range: 0.80-1.73
Free T3 normal at 2.5 Range: 2.0-4.7
TSH High 44.020 Range:0.178-4.530

[Extreme2001]

What would cause a sore throat or swollen feeling in my neck where the thyroid is. Eyes feel really tired and dry. Stomach bloating an bulching with loss of appetite. I go this week to due blood work on the NT dosage I'm taking. Will update you when I get the results. Any suggestions on the other stuff I asked. Thanks,Glen

[goolarra]

I'm sorry; I thought the second set of labs was on NT.  So, your dose of Tirosint was obviously too high.  I can't comment on whether you're getting too much T3 and not enough T4 without seeing some lab work on NT.  

T3 can disturb sleep.  So, most people avoid taking in much past 3:00 pm (on a "normal" sleep/wake cycle).  Our own natural T3 goes down as the day wears on and during the night as well.

As flyingfool suggested, you can play with the timing that works best for you.

Headache on starting T3 isn't unusual.  However, after three weeks, it really should have resolved.  You've been on NT for 3 weeks, now, so your FT4 has probably dropped significantly with the lowering of T4 dose.    

[flyingfool]

The T4 takes 6 weeks to ramp up.  Similarly it takes 6 weeks to get out of the system.

Since it has only been half that long since the switch from a T4 only to the dessicated thyroid medication. You still likely have some residual T4 inyour system from the Tirosint.  Only time will tell.

Since the default profile in medhelp is to list as male, With hot and cold flashes if you are actually a female at age 55 as your profile states would not be unusual for a woman in menopaus.  Like I said the default profile is male so please don't get upset if I'm assuming you're actually female. But it would not be the first time that a female didn't change the default profile so is the ONLY reason I brought it up at all!  Obviously if you are male,  Disregard possible menopause being a possibility LOL!

[Extreme2001]

I am male..not a problem..

[Extreme2001]

I seem to feel worse in the afternoon after the second dose. That's where I get a little confused. I take it first thing in the morning on empty stomach then again around noon. That's like 6 hours then there's a long period until the next morning for my next dose. Like 18 hours. just seems like a long stretch.

[flyingfool]

Have your tried taking the 2nd dose at say 2PM instead of noon?

[goolarra]

We have to wonder why your FT4 has skyrocketed despite having cut your T4 meds considerably.  You were on 112 Tirosint (all T4), and 65 mg of NT only has 38 mcg of T4 (and 9 of T3).  You've cut your T4 intake by almost 2/3.  

Do you know the cause of your hypo, i.e. do you have Hashi's?  

How long ago were you diagnosed?

[Extreme2001]

Yes, I have Hashi. Probably had it all my life, but the doctor I'm seeing now checked my antibodies and said I had Hashimotos. He diagnosed me almost 2 years ago but were having a hard time getting things regulated. Never seem to get to a happy medium. He put me on Nature thyroid so we could move up or down in small dosages. I just never no if I'm getting too much or to little. I have a terrible headache now after my second dose which has been going on for a few days. Do you think I'm getting too much T3 and not enough T4.

[Extreme2001]

The last blood work I was on 112 tirosint. Haven't had my blood drawn on the nature thyroid yet. That will be in a couple of weeks.

[goolarra]

Don't worry about your TSH.  Once on meds, it often becomes unreliable, especially on meds with T3 in them.

Your FT4 is above range, which indicates overmedication.  FT3 is a little below midrange, which is on the low side and unusual for someone on NT (desiccated meds have a relatively high T3 content).

Was the 2/29 blood work before starting meds?

[Extreme2001]

Yes, I was on 112 tirosint.

[Extreme2001]

I've been on the nature thyroid for almost 3 weeks. Still have a week or two before doing blood work again.