Aa
Does anyone else sit on the couch all day or is it just me?
I was diagnosed August 1, 2010 with silent thyroiditis.
My stats are (Range: TSH 0.40 - 4.50 // Free T4 0.8 - 1.8)
08/01/10 TSH 0.03
08/09/10 TSH 0.01
09/23/10 TSH 0.41
10/28/10 TSH 1.36 -- T4 0.96
12/6/10 TSH 3.80 -- T4 0.92
12/28/10 TSH 0.99
02/11/11 TSH 2.45 -- Free T4 1.1
*****PUT ON 25 MCG of SYNTHROID*****
03/28/11 TSH 4.18 -- Free T4 0.9
*****PUT ON 50 MCG of SYNTHROID*****
04/28/11 TSH 0.6 -- Free T4 1.1
06/06/11 TSH 1.23 -- Free T4 1.2
06/14/11 *****PUT ON 25 MCG of SYNTHROID, 5 of CYTOMEL*****
07/07/11 TSH 2.91 -- Free T4 0.9
T3 Uptake 34 (Range 22-35 Percent)
Free T3 2.9 (Range 2.3-4.2 pg/mL)
Ferritin 51 (Range 10-154 ng/mL)
07/14/11 *****PUT ON 50 MCG of SYNTHROID, 10 of CYTOMEL*****
Here are my stats. Can anyone offer any advice or opinion on my situation? I am starting to worry because I have recently had my meds doubled and I still am on the couch. During the first four days of taking the 5 mcg of Cytomel I felt a lot better. However, I had also been on the 50 mg of Synthroid and I know it takes a while to build up.
Any thoughts?
My stats are (Range: TSH 0.40 - 4.50 // Free T4 0.8 - 1.8)
08/01/10 TSH 0.03
08/09/10 TSH 0.01
09/23/10 TSH 0.41
10/28/10 TSH 1.36 -- T4 0.96
12/6/10 TSH 3.80 -- T4 0.92
12/28/10 TSH 0.99
02/11/11 TSH 2.45 -- Free T4 1.1
*****PUT ON 25 MCG of SYNTHROID*****
03/28/11 TSH 4.18 -- Free T4 0.9
*****PUT ON 50 MCG of SYNTHROID*****
04/28/11 TSH 0.6 -- Free T4 1.1
06/06/11 TSH 1.23 -- Free T4 1.2
06/14/11 *****PUT ON 25 MCG of SYNTHROID, 5 of CYTOMEL*****
07/07/11 TSH 2.91 -- Free T4 0.9
T3 Uptake 34 (Range 22-35 Percent)
Free T3 2.9 (Range 2.3-4.2 pg/mL)
Ferritin 51 (Range 10-154 ng/mL)
07/14/11 *****PUT ON 50 MCG of SYNTHROID, 10 of CYTOMEL*****
Here are my stats. Can anyone offer any advice or opinion on my situation? I am starting to worry because I have recently had my meds doubled and I still am on the couch. During the first four days of taking the 5 mcg of Cytomel I felt a lot better. However, I had also been on the 50 mg of Synthroid and I know it takes a while to build up.
Any thoughts?
I just received this message from Dr. Lupo, the expert here at MedHelp, who is an endocrinologist. The antibodies test was done a couple weeks ago.
Dr. Lupo said:
With the negative anitbodies, it is not clear this is a long-term thyroid problem. The pre-medication TSH of 2.45 was essentially normal. Your lethargy may be due to relative changes in thyroid status but usually the TSH levels are much worse (higher) in these cases. Titrating the medications may help, but looking for other causes would also be recommended. Fatigue is a very common, nonspecific symptom and may not be thyroid related.
http://www.medhelp.org/posts/Thyroid-Cancer--Nodules--Hyperthyroidism/Still-lethargic-after-Silent-Thyroiditis-treatment---Why/show/1563100?personal_page_id=1125541#post_7096580
I am so confused. What do you think?
Dr. Lupo said:
With the negative anitbodies, it is not clear this is a long-term thyroid problem. The pre-medication TSH of 2.45 was essentially normal. Your lethargy may be due to relative changes in thyroid status but usually the TSH levels are much worse (higher) in these cases. Titrating the medications may help, but looking for other causes would also be recommended. Fatigue is a very common, nonspecific symptom and may not be thyroid related.
http://www.medhelp.org/posts/Thyroid-Cancer--Nodules--Hyperthyroidism/Still-lethargic-after-Silent-Thyroiditis-treatment---Why/show/1563100?personal_page_id=1125541#post_7096580
I am so confused. What do you think?
Yes, I do think there will be a real difference in how you feel once your numbers are really right for YOU. Will that be in a few weeks? I'm less certain of that. You may find you need another adjustment or two before you get to your optimum dose. Unfortunately, there's no way to hurry this. If you try to, you usually end up costing yourself more time (by swinging hypo to hyper) in the long run. You make a change; you wait 4-5 weeks; you repeat until you get it right.
It looks like you're taking your Cytomel (and your T4) properly. Actually, unlike T4 meds, Cytomel doesn't have to be taken on an empty stomach.
I've been pondering your labs. Your FT4 looked much better on 50 mcg of T4. It's probably unfortunate that you cut back to 25 mcg when you added the 5 mcg T3. The rule of thumb is to cut back that much IF YOU WANT TO KEEP THE OVERALL DOSE EQUAL. However, your FT4 at the time wasn't high enough to cause concern, so perhaps the addition of the 5 mcg T3, with no change to the T4 would have been a better option. However, that's water under the bridge at this point, and you're back up to the 50 mcg of T4.
I wonder if it might be worthwhile to repeat the antibody tests. Were the results you posted quite a while ago? The diagnosis of silent bothers me a little for several reasons. You are coming up on a year with no sign of resolution of this "temporary" condition. Your thyroid function seems to continue to deteriorate. You have nodules. I have read that a small percentage of people with Hashi's don't have antibodies. I have to confess that this kind of baffles me...Hashi's is an autoimmune disease, so if there are no antibodies, how can it be? I often wonder if they don't mean that a small percentage TEST negative for antibodies.
Be patient. It took me over a year to get from my initial dose to the dose I've been on for over two years now, so I know how frustrating it can be. Your doctor seems to have you on a four-week schedule for labs, which is great. If I were you, I think I'd pursue the current course of meds with the goal of getting FT4 to midrange and FT3 to upper third (or close). If you're still on the couch then, it will be time to figure out what else might be going on. Also, if you truly do have silent, your thyroid function should start to think about returning before too long...
It looks like you're taking your Cytomel (and your T4) properly. Actually, unlike T4 meds, Cytomel doesn't have to be taken on an empty stomach.
I've been pondering your labs. Your FT4 looked much better on 50 mcg of T4. It's probably unfortunate that you cut back to 25 mcg when you added the 5 mcg T3. The rule of thumb is to cut back that much IF YOU WANT TO KEEP THE OVERALL DOSE EQUAL. However, your FT4 at the time wasn't high enough to cause concern, so perhaps the addition of the 5 mcg T3, with no change to the T4 would have been a better option. However, that's water under the bridge at this point, and you're back up to the 50 mcg of T4.
I wonder if it might be worthwhile to repeat the antibody tests. Were the results you posted quite a while ago? The diagnosis of silent bothers me a little for several reasons. You are coming up on a year with no sign of resolution of this "temporary" condition. Your thyroid function seems to continue to deteriorate. You have nodules. I have read that a small percentage of people with Hashi's don't have antibodies. I have to confess that this kind of baffles me...Hashi's is an autoimmune disease, so if there are no antibodies, how can it be? I often wonder if they don't mean that a small percentage TEST negative for antibodies.
Be patient. It took me over a year to get from my initial dose to the dose I've been on for over two years now, so I know how frustrating it can be. Your doctor seems to have you on a four-week schedule for labs, which is great. If I were you, I think I'd pursue the current course of meds with the goal of getting FT4 to midrange and FT3 to upper third (or close). If you're still on the couch then, it will be time to figure out what else might be going on. Also, if you truly do have silent, your thyroid function should start to think about returning before too long...
Somehow that is NOT an option for me....Gotta work...or I wouldn't have a house to put the couch in that I would sit on...
Thyroid ultrasound was completed one year ago, and I am getting another one in a week or so. There were a few small nodules, but nothing "problematic" according to the doctor.
I take my Cytomel 5 mcg in the morning when I first wake up along with my 50 mcg of Synthroid. I take it with at least 8 ounces of water and wait at least 1 hour until I eat or drink anything besides water.
I then take the next 5 mcg of Cytomel around 3:00 p.m., making sure I have not had anything besides water for at least two hours, and then I wait one more hour until I allow myself to eat.
TPOab resulted in:
THYROID AB (ATA,TPO)
THYROID PEROXIDASE AB <10 (RANGE: <35 IU/mL)
THYROGLOBULIN AB <20 (RANGE: <20 IU/mL)
GLIADIN AB (IGG) 3 (RANGE: <11 U/mL)
Interpretation: Negative
I was not postpartum at all, not even remotely close.
Do you think I will feel better in a few weeks? I am sick of this debilitating misery! Do you think there will be a real difference in how I feel when my numbers are better? If you have any advice/criticism/anything, please let me know.
Hope you are doing better than I am!
I then take the next 5 mcg of Cytomel around 3:00 p.m., making sure I have not had anything besides water for at least two hours, and then I wait one more hour until I allow myself to eat.
TPOab resulted in:
THYROID AB (ATA,TPO)
THYROID PEROXIDASE AB <10 (RANGE: <35 IU/mL)
THYROGLOBULIN AB <20 (RANGE: <20 IU/mL)
GLIADIN AB (IGG) 3 (RANGE: <11 U/mL)
Interpretation: Negative
I was not postpartum at all, not even remotely close.
Do you think I will feel better in a few weeks? I am sick of this debilitating misery! Do you think there will be a real difference in how I feel when my numbers are better? If you have any advice/criticism/anything, please let me know.
Hope you are doing better than I am!
Well, you're right. As of the 23rd when you posted your original question, you'd only been on the 50 mcg of synthroid for nine days, so you have a ways to go before the 50 mcg hits its full potential.
On your labs on 7/7/11, your FT4 was just about bottom of the range...mid-range is what you want to shoot for with FT4. So, you have quite a bit to go to get there, and the increase to 50 mcg of T4 was definitely a good move.
FT3 is also considerably below the upper third of range target. Once again, the increase in Cytomel seems a reasonable move.
I'd suggest you give it a little while. The 50 mcg T4 won't stabilize for a few more weeks. At that time, you should have FT3, FT4 and TSH tested again, re-evaluate symptoms and adjust meds again as necessary.
How do you take your Cytomel?
Have you had both TPOab and TGab run? What about a thyroid U/S? Were you postpartum when diagnosed with silent?
Sorry for all the questions...can I plead brain fog???
On your labs on 7/7/11, your FT4 was just about bottom of the range...mid-range is what you want to shoot for with FT4. So, you have quite a bit to go to get there, and the increase to 50 mcg of T4 was definitely a good move.
FT3 is also considerably below the upper third of range target. Once again, the increase in Cytomel seems a reasonable move.
I'd suggest you give it a little while. The 50 mcg T4 won't stabilize for a few more weeks. At that time, you should have FT3, FT4 and TSH tested again, re-evaluate symptoms and adjust meds again as necessary.
How do you take your Cytomel?
Have you had both TPOab and TGab run? What about a thyroid U/S? Were you postpartum when diagnosed with silent?
Sorry for all the questions...can I plead brain fog???
quackducker,
what exactly are you taking? your post was a little confusing to me.
Thank you
what exactly are you taking? your post was a little confusing to me.
Thank you
quackducker, thank you so much for your story. I am glad you are seeing light at the end of the tunnel. Please keep us updated on your progress.
May I ask what are your current drugs and dosages?
May I ask what are your current drugs and dosages?
I felt like crap as soon as I had to cut down my Armour and add adrenals. HypO big time, and I couldn't figure it out. I was totally debilitated and useless and . . . well, you know!
Two weeks ago, (after slowly raising it) I got up to T3 only 50 mcg per day (also, HC) and suddenly, instead of having worse side effects, they went away and I feel terrific. I'll bet I was too cautious and I just needed more.
I can't explain it, I just want you to know there might be a future. I wasn't sure 3 weeks ago!
Two weeks ago, (after slowly raising it) I got up to T3 only 50 mcg per day (also, HC) and suddenly, instead of having worse side effects, they went away and I feel terrific. I'll bet I was too cautious and I just needed more.
I can't explain it, I just want you to know there might be a future. I wasn't sure 3 weeks ago!
That is horrible, Danie, I am so sorry for what you are going through. Unless you've been through this, you have no idea what we all go through.
I have spent a year almost confined to my bedroom. I have moments of activity here and there, but for the most part, I have no life. I still cannot understand why you can't get on disability with hashi's. I couldn't even begin to make it through a job interview much less work. It's not for lack of trying to find help either... sigh. I hope you find some relief.
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