symptoms & meds

[RenKat]

I have posted before, and am worse.  I was diagnosed with Hasmimoto's Thyroiditis years ago, and have been through many doctors and dosages of synthroid.  I was taking 100 mcg 6x weekly, but was just upped to 112mcg 6x weekly.  Levels had gone from 4.7 to 4.5  I also have fibromyalgia, hypoglocemia and one kidney.  I am dizzy, unfocused exhausted, achy, heavier and just really fed up with the push to take anitdepressants. I do not know where to turn.  Also, currently do not have an endo.

[RenKat]

Thanks for this information.  This forum is priceless, and the information passed along gives me hope that this will get settled.  I sincerely wish this for everyone.

I will be checking into Tirosint, and also, Gimel wrote about T-3, which I am assuming is Cytomel?  

I will be reporting the progress, and anything else I learn along the way.

Thank you again, for sharing your knowledge and the news that you are doing better with this thyroid issue.

[Barb135]

Okay, looks like you had a T3 uptake, not a regular T3 test... I'm not real up on the uptake test, but I don't think it's of much value any more, since the FT3 and FT4 have been shown to be the best indicators of thyroid levels.

The TSH range should be 0.3-3.0, but most labs are using outdated ranges, so that doesn't matter that much. Your TSH is definitely elevated, as is your TPOab.  

Looks like you're having the same issues that a lot of us have with our doctors.  Too many of them only look at TSH, not the whole picture.  I think you are doing well to look at other doctors.

You might want to look into the new T4 med that came out in May of last year - it's called Tirosint, which is a gelcap, rather than a pill.  The only ingredients are glycerine, gelatin, water and of course, the levothyroxine sodium; therefore, it's about as hypoallergenic as anything can get, plus being a gelcap, dissolves completely, so absorption should be much better.   I've been on it since August and I love it.

[gimel]

Check your email for doctor rec.

[RenKat]

Thanks for the reply.  
Here are the ranges:  
The T-3 uptake 37 (22-35%) H
T 4 Total: 9.6 (4.5-12.0 mcg/dl)
Free T-4 Index (T7) 3.6 (1.4-3.8)
On the lab slip, it doesn't indicate if its Free T-3 or not, but that is what I requested.  Not sure if Doc caught it all, as they often do not.  
I do not have the TSH range, but I know that last two labs were 4.5 and then the last tsh @ 4.7
I am giving the last hmo endo recently discovered a shot, next week, hopefully, and then, checking into paying out of pocket for a recommended Dr. Cosmos, a more homepathic, online rated thyroid/metabolism doc.  Dr. Lupo, who writes on this site, and is in Sarasota is way out of my price range.  Thanks to you, for your knowledge and time.

[Barb135]

Is that a Free T3 or total? It appears that it might be total, which is considered obsolete and not of great value.  What are all the reference ranges?  These vary from lab to lab, so must come from your own report.

I understand about the 100 mcg x 6; I alternate 75 and 100 taking a pill/day, to average 87.5; I just haven't heard of skipping a day like that.  I doubt that skipping one day really did much to lower the dosage, when spread over the entire week like that, anyway.  

Your TPOab is definitely elevated, indicating that you do have Hashi's, but you said you'd already been dx'd with that anyway, so this would simply be a confirmation.

Please post the reference ranges for your labs; that will tell us where you fall within the ranges and will help determine whether you are hypo or hyper.  

[RenKat]

Hey to all.  I got the labs, and a recommendation for an endo.  I have exhuasted the short list accepting my insurance in Tampa Bay.  But this is another issue to tackle next week.  
Here are the numbers:  T-3: 37  Free T-4: 3.6,  T-4 Total: 9.6  TSH 4.7, TPO: 158

The Ultra Sound tech reported the inability to currently measure the nodules, due to the density of the gland.  Further testing is in the future, I expect.

[RenKat]

Many thanks to both of you, for your responses.  I am waiting for the most recent lab work/ Ultra Sound done on Monday.  First, the 6x a week dosing was set up by previous endo and it was 100 mcg 6x to equal an 88 mcg average.  I have no idea the reasoning behind this.  My primary upped the dosage recently,prior to the new labs.
and ZI think that 112 mcg 7x weekly might be too much, as I feel edgy now, as it is.  Perhaps that anxiety is due to the"re-discovery" of nodules I thought went away.  I will post everything when I have it, and I am making some calls today (with those questions), to that center that is more homeopathic.  A friend that goes there, says they have been willing to treat with a coumpound of Low dose Naltrexone.  I just keep reading and searching, like the rest of us.  Thanks again, and any good news I might get, I will be more then happy to share.

[gimel]

Regarding that Endo that your Primary wants to recommend, there are two questions that I have found to sort out doctors as to whether they are prospects or suspects.  LOL

Usually I call the doctor's office and say that I'm looking to make an appointment, but would like to ask one of the nurses a couple of questions first.  I have found approach that to consistently work to get a nurse on the line.  Then I ask if the doctor is willing to treat a patient clinically by testing and adjusting free T3 and free T4 as necessary to relieve symptoms, without being constrained by resultant TSH.  If the answer is yes, then I ask if the doctor is willing to prescribe meds other than just T4 types.  If the answer to either is no, then you likely would be wasting your time going to that doctor.

[Barb135]

You said you went to your primary to order FT3, FT4, TSH, RT3, TPO and Thyroid AB -- If you've been diagnosed with Hashimoto's you would already have had TPOab done.

Did you get those tests done, and if so, do you have results that you could post, along with the lab's reference ranges, since these vary from lab to lab.  Having labs to look at would certainly enable members to comment more fully on your particular situation.

If the levels (4.7 and 4.5) are TSH levels, they are higher than they should be, indicating hypo; however, as gimel said...... TSH should never be used, alone, to diagnose or treat a thyroid issue.

I'm curious as to why you take 112 mcg 6x weekly; why don't you take it every day (7x weekly)?  

Hypoglycemia will cause the dizziness, inability to focus and exhaustion; exhaustion and inability to focus can also be caused by your thyroid condition. Are you on a special diet/eating plan to control your hypoglycemia?  You should be eating small amounts with protein and complex carbs, every couple of hours to maintain a constant blood sugar level.

Fibromyalgia is basically a set of symptoms, that the doctors can't find a cause for; that cause is often thyroid disease, and once the thyroid is treated properly, the symptoms are alleviated.

Will look forward to seeing those labs, with reference ranges.

[FTB4]

Where are you located?

[RenKat]

First, I hope that anyone who responded to my queries got thanked.  I don't always get proper notification through my email, on Forum activities, and I am not on the Forum everyday.  Thanks for any replies, esp Gimel, who seems to know alot.
I recently went to my primary, to order all the tests: Free T-3, T-4. Reverse T-3, TPO and Thyroid Ab.  No one seems to know anything about the Adrenal Saliva test... I remembered that the nodules we'd been tracking for 3 years, had eneded with an FNA Biopsy in 2009, where the tech said there were no nodules-that the thyroid was "deformed".  This had gotten lost in all the doctor shifiting and I never informed my Primary.
In retrospect, it is foolish that I acceptted that the nodules disappaeared, as foolish it was believing that increasing my meds would shrink them.  Doctors can "wing it", and the one I had surely did, playing with meds, that had me 30 lbs heavier, and near to a heart attack, not to mention my mental state.  Beware of endocrinologists!. Not all know the thyroid.
However, at the time, I'd had more then enough bad news and was ready for a rest from it all.  Presently, my  Primary ordered an Ultra Sound (my usual technician) made it very clear that nodules don't magically disappear, and mine did not.  
Medical doctors lie, big suprise.  Currently, we upped my 100 mcg 6x to 112 mcg 6x Weekly, and am waiting for all hardcopy to take to the second opinion doctor/homeopathic.  Primary claims she has an Endo that knows what he is doing and takes my insurance.  I am weary, wary and worried, frankly.  All the best to everyone out there, trying to solve this problem.  Thanks for this forum, for your support.

[RenKat]

Thank you, Gimel.  I spent the greater part of last night, on an incredible site that discussed the possibility of adrensal dysfunction, as well.  Absolute neccessity were the very tests you mentioned, as well as Adrenal Saliva testing and TPO, ThyroidAb.  The last two have been all but ignored, and not retested, since I was diagnosed 6 years ago with Hashimoto's.  Its gotten complicated finding a doctor that accepts my SSI insurance.  Spot on about Endo's.  I am scheduled for an out-of-pocket visit with someone that is more holistic in their approach, and uses Armour and Cytomel.  I surely hope for a better result, and will certainly share any good news I have.  Thanks again for responding.

[gimel]

Were you only tested for TSH?  If so, that is totally inadequate as a diagnostic for thyroid problems.  TSH is a pituitary hormone that is affected by many variables, including the time of day when blood is drawn.  At best it is an indicator to be considered along with more important indicators, which include symptoms and also the levels of the biologically active thyroid hormones, free T3 and free T4.  FT3 is the most important because it largely regulates metabolism and many other body functions.  Studies have shown that FT3 correlated best with hypo symptoms while FT4 and TSH  did not correlate very well at all.

So the first thing you need to do is to get additional testing done.  Test for FT3, FT4, TSH, Vitamin D, B12, iron/ferritin, and selenium.  While at the doctor's office you need to find out if the doctor is willing to treat you clinically, for symptoms, by testing and adjusting levels of FT3 and FT4 without being constrained by resultant TSH levels.  Also find out if the doctor is willing to prescribe meds other than T4 types. If the answer to either is no, then you will need to find a good thyroid doctor that will do so.  This does not necessitate an Endo.  They are frequently more rigid about their treatment protocol than regular MD's.