Another advice question on testing

[Brucergoldberg]

I take my t4 at night,  and then my t3 during the day as needed.      112 at night, and by the end of the day i have ingested 10 mg t3.

The doctor i see has me test before taking the t3.  But i don't really understand how that can be an accurate test because don't i want to know what my labs are when i am awake and functioning?

Next test he said to do after i took some T3.

What do you guys think the most accurate way is on the t3?

[Brucergoldberg]

ok and i agree.  when i feel run down and whacky,  i take the t3 and it seems to make the feeling more intense, not the opposite.  stupid a$$ disease

[goolarra]

I really don't think your FT3 or FT4 will change that much depending on time of day, but you can try it...

[deb62gee]

You sound about like what I've been going through. This is where we can show that "ranges" have nothing to do with anything, because if my  FT4 and FT3 are anywhere near what yours are, my TSH is at 0.01 or 0.02. Yours is at 2.60. What do we have to do to make doctors understand that all of those numbers are individual as to what is normal and what isn't?

I am getting the hitting a wall in the afternoon happening to me right now, yet I cannot add even a little T3 or T4. When I do, I get extremely emotional - either crying or ready to tear someone's head off. I think you should test when you feel like you do now to see where those numbers are. And TSH should change when the other numbers change. TSH is actually at the highest at around 4:00 am, so it should be very low in the afternoon, unless you are in need of some T4 or T3. It would be very interesting to be able to test all through the day (like every couple of hours) so that we can see how the numbers correlate to how we feel. I also wonder if taking T3 (more than a normal thyroid would produce) inhibits conversion of T4 by the body. Sort of like when someone takes corticosteroids how that can shut down the adrenals.

[Brucergoldberg]

i feel whacky around 1 pm start feeling run down, ears start ringing etc.   should i test when i feel all my whacky symptoms come on as opposed to first thing in the morning>?   i know tsh will probably be the same, but would ft4 and ft3 possibly change?

[goolarra]

No.  four weeks is fine.

[Brucergoldberg]

is 4 weeks too soon?

[Brucergoldberg]

what is the minimum someone should wait to get a true true reading?   feeling like crapola again...

[goolarra]

Technically, that's called a phantomectomy, better known as an exorcism...

[Brucergoldberg]

its weird.  I feel like i did when i was on too much naturethroid back in 2011.   my thyroid area is sore.   should i go have a phantom total thyroidectomy?

[goolarra]

People with amputated limbs have phantom pain in the lost limb...

[Brucergoldberg]

I'm just going to add on to this post.  since changing doses, i get these weird phantom pains where my thyroid was.  almost like a sore throat but in the thyroid area.   how is this possible?

[Brucergoldberg]

haha.    people confuse me with gilbert gottfried.   but he's much better looking.

[goolarra]

Yes, you should have corrected him...

That's quite the visual!  LOL  But he has a great personality...

[Brucergoldberg]

oy…   whats funny is my endo is from another country.  he tries to use sayings and he said "what came first, the chicken or the fish"   should i of corrected him?

I have been the same weight my whole life pretty much.  Then the last month i noticed my pants wouldn't stay up.   8 pounds since dec 26 is quite a bit.  I don't need to lose weight, i need to gain weight.  Nothing good about a balding, skinny jewish guy with no thyroid.=

[goolarra]

Haven't you heard?  The chicken came first.  Without the chicken, the egg couldn't exist...

As far as the weight loss is concerned, it's possible that you might have lost some, but less than 8 lbs, if you were overmedicated, but the weight loss just exacerbated the effect of the overmedication.  

[Brucergoldberg]

i just started doing that recently.    I made a mistake on the december quote.   My doctor gave me the slip so i checked some extra stuff off on there.   this is what it was:
back in december i was tested 10 weeks on 137 / 10 t3

t4 free   1.4   0.8-1.8
t4 free  (not dialysis)    2.3   .8-2.7
tsh 2.60    .4 - 4.5
free t3  dialysis 229   210-440   unmedicated
TPO   12  LOL

you know whats truly ironic about this whole thing is,  i personally think your body gets accustomed to your dose, even if its the wrong one.   I think I'm on too much t4 still and when i take the t3 it hits me really hard.  However, if i try to cut back a little on the t3, about 5 pm i feel like a truck hit me.   SO its like going from a 7 to a 10 on the crap-o -meter if i don't finish the whole 10 mg of t3 by days end.

I guess my plan for now is to stay on the 112/10 for 8 more weeks, get retested.  If the ft4 is still high I am going to ask to be put on 100/10.   Which mind boggles me.

also, this guy says i lost 8 pounds last month.  he said he doesn't know if the weight loss is because i was on too much t4 and it made me lose weight, or if since i lost weight I'm on too much t4.   what came first, the chicken or the egg?

[goolarra]

The two FT4s, one by immunoassay and one by direct dialysis, are kind of interesting.

With immunoassay, you're at 60% of range, but with direct dialysis, you're at 79%...big difference.  

I was just wondering if a little food might slow down the T3 getting into your bloodstream a little, so you didn't get such a spike.  Not the truck driver's breakfast, you understand, just a little of something, probably protein.    

[Brucergoldberg]

the dialysis  is a package.    you get t4 free dialysis,  free t3  dialysis, t3 total (whatever)

the time before he accidentally added ft4 regular as well so that was interesting.

this time, this is what we got from 125 t4 /  10 t3

Tsh  .54   ranges .4  to 4.5   too much for me
t4, free   1.5  .8  to 1.8
free t3 dialysis   228      210-400  unmedicated

back in december i was tested 10 weeks on 137 / 10 t3

t4 free   1.4   0.8-1.8
t4 free diaslys    2.3   .8-2.7
tsh 2.60    .4 - 4.5
free t3  dialysis 229   210-440   unmedicated
TPO   12  LOL

so the ft3 is consistent on both tests, but in DEC on 137 i felt really really hyper.   He dropped me to 125 and in feb i tested again, again feeling hyper.   He dropped me again to 112  and I'm started to feel a drop better.

His opinion was that my ft4 was a drop high and that because i was on the t3,  i needed to drop the t4 down a hair.  I couldn't be on that much t4 and just add t3 and expect to feel the same.

I like the t3 since i dose my t4 at night.  SO I've been trying to find the right place for both the t3 and the t4.  I have a feeling I'm going to end up at 100/10 when all is said and done.  

[goolarra]

It might be an interesting exercise to see what your FT3 level is a few hours after taking your first dose.  As long as your doctor knows better than to slash your T3 meds when he sees the spike, you should be okay.  You just have to be careful what you let some of these doctors see...

So, are you saying you have both FT3 by immunoassay and FT3 by direct dialysis?  Is there a difference in the results?

I'm glad you feel a little better on the reduced T4.  

Have you ever tried T3 in more than 2 doses?  How about taking it with a little food?

  

[Brucergoldberg]

so how can they tell what I'm feeling after i take the stuff?

like for example,  my doctor uses the ft3   and the ft3 with dialysis.

I know the stuff is hitting me like a rocket ship.  But untested my results are like:

229    ranges  220 - 340  or something.  But this is unmedicated.    

also since dropping from 125 to 112 just 4 or 5 days ago, i can really feel the difference,   i don't feel 100%  but  a lot of the agitation has gone away.

[goolarra]

The recommendation has always been not to take T3 before a blood draw.  It spikes so fast that it can really elevate your FT3 level.

Since no T3 has been the rule, doctors are fairly "used to" seeing results before T3, so they can freak (a technical term) if they see a spike.

Also, ranges are not based on a huge whack of T3 going into the blood stream all at once, like they do when you take your T3.  T3 is supposed to be converted slowly, on demand.

I think this is a little like testing for diabetes, lipids, etc.  You fast so you don't have to guess how to adjust the numbers for whatever the patient had eaten prior to the test.  Same with T3...how much DOES 5 mcg spike FT3 level after 2 hours or 3 hours, let me think, was it 2 or 3?  Oh wait, I had to wait at the lab for an hour.  Maybe it was more like 4.  It levels the playing field.