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HELP! Do you think I will feel better if I get my FT3/FT4 mid-range or ...
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HELP! Do you think I will feel better if I get my FT3/FT4 mid-range or higher?

I started back on Synthroid 13 days ago.  I do not feel better.  I feel an anxiety running through my veins.  I feel very unsettled.  I know my body more than anyone else does, and I just have this feeling that there is not a chance in hell that this stuff is going to make me feel better - I fear it will just make me feel worse.  

Then, I have read about adrenal fatigue.  I had a saliva cortisol test and was low cortisol in evening and night, so two out of the four.

I AM SO MISERABLE.  I am so worried I will never live a normal life again.  I read that people feel best when the free t3 and free t4 are in the top half of the range.  Mine are in 20% of the range (FT4) and 26% of the range (FT3).  I am so worried I will try to jack up my FT3 and FT4 with thyroid meds, pump my body with thyroid meds even though my body is already not liking them already, and I will still not be better.  

Can anyone help me?  I feel so hopeless and worried I will never be normal again.

Anyone have any suggestions on what to do?

Here are my most recent labs:

02/06/12

TSH 2.79 (Range: 0.40 - 4.50)
Free T4 1.0 (Range: 0.8 - 1.8) (20% of the range)
Free T3 2.8 (Range: 2.3 - 4.2) (26% of the range)
Reverse T3 20 (11-32)
Thyroid Antibodies (ATA, TPO) NONE

02/15/12 *****PUT ON 50 MCG of SYNTHROID*****

02/27/12 *****PUT ON 62.5 MCG of SYNTHROID*****

I am just still not well. When I look at the symptoms of adrenal and thyroid issues, I feel like many of my symptoms appear to be adrenal. For example, I get adrenaline surges at night. I also wake up with lower back pain right near the adrenals.

I have thought about getting on HC (hydrocortisone), but it scares me that I may become dependent on it or never be able to get off it.

Has anyone here been on it? How long were you on it, how much, and when did you get off? How much were you on and what labs told you you needed it? What were those levels?

Here is my history with cortisol testing if anyone's interested. I have done a 24 hour saliva cortisol test which showed low evening and night cortisol.

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) <-------- FERRITIN

07/14/11 *****PUT ON 50 MCG of SYNTHROID, 10 of CYTOMEL*****

08/04/11 TSH 0.36 -- Free T4 0.9

08/12/11 *****PUT ON 50 MCG of SYNTHROID, 15 of CYTOMEL*****

08/22/11 TSH 0.07 -- Free T4 1.1 -- Free T3 3.3

08/26/11 *****Discontinued Thyroid Medication*****

10/06/11 TSH 2.97 -- Free T4 1.0

10/28/11 TSH 1.71

12/22/11 TSH 2.25 (Range: 0.40 - 4.50)

Free T4 1.0 (Range: 0.8 - 1.8)

Free T3 3.1 (Range: 2.3 - 4.2)

Thyroid Antibodies (ATA, TPO) NONE

________________________________________ ___

24 HOUR SALIVA TEST RESULTS (Date: 10/30/2011):

DHEA is 485.72 pg/ml **HIGH** (range of 106-300 females)

Cortisol Morning is 16.43 nmol/L **WITHIN RANGE** (range 5.1-40.2; optimal range 18-35)

Cortisol Noon is 4.96 nmol/L **WITHIN RANGE** (range 2.1-15.7; optimal range 6-12)

Cortisol Evening 1.12 nmol/L **LOW** (1.8-12; optimal range 4-8)

Cortisol Night <0.28 nmol/L **LOW** (0.9-9.2; optimal range 2-6)

________________________________________ ___

Cortisol Testing (Date: 11/16/2011):

A.M. Cortisol --- 22.7 HIGH (Range: 4.0-22.0 mcg/dL)

Cortisol, LC/MS/MS, SALIVA --- 0.04 (Range: 10-11 PM: < OR = 0.09)
Related Discussions
14 Comments Post a Comment
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Avatar_n_tn
anyone have any advice?
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Avatar_m_tn
Yes. Number 1 I think you are making WAY too many change WAY too fast!

#2) T4 meds take up to 6 weeks to stabilize

#3) I think that Cytomel might have been a good idea but I think they started you out on too high a dose and then increased it shortly there after. Many people have a hard time adjusting going from zero to 10 mcg of Cytomel and then only 2 weeks later jump again to 15 mcg.! wow.    Then on top of that only a few weeks later stopping EVERYTHING all together! Wow again!  The only reason that can explain that is your Dr got freaked out by the low TSH.  But your FT3 just finally got to the upper 1/3 of the range where many people start to feel fine and he pulled you off!  What really happened was that by taking the T3 medication you suppressed your TSH with the T3 medication which is fairly common but Dr's seem clueless about.   Now you're back put on 50 and then only 2 weeks later it is upped again when it takes up to 6 weeks to stabilize???

#4) many people take quite a while for their body to adjust to actually getting hormone.  And as you say you were pretty low Thyroid of what may be a long time which could have effects on adrenals.  Thus BOTH things your body is trying to adjust to. And with switching meds all over the place your body has no clue how to react.

#5) you are still only 20% and 26% of the range of FT4 & FT3 respectively.  So there is plenty of room for improvement. And sometimes it takes a while to stabilize and symptoms can lag behind blood labs by a few weeks some times.

#6) the cortisol tests even when stated as "within range" were also sort of low within the range.  The latest cortisol test shows MASSIVE swing between the morning AM & PM results.  Again going on and off and changing meds and dosages every 2 weeks has almost assuredly put you on a roller coaster ride! Your body has no idea how to react with that many changes that quickly. For awhile I think you were getting tested every 2 weeks and changing doses every 2 weeks.  Granted T3 med acts fast but wow that is a lot of change!

Finally, you should try to relax.  Thyroid issues can usually always be worked out and you can feel normal again.  But it takes time and patience.  The best approach is usually slow and easy.  Bouncing around the way you have I think is exacerbating your situation.  Also stress can affect the conversion process as well as adrenals and also increase the creation of Reverse T3 etc.  Your mind is extremely powerful. And if you have your mind made up that the medication won't work than that just adds stress and you are being your own worst enemy.

How powerful is a human mind?  There is a proven case where a railroad worker got trapped in a "refrigerated car" and couldn't get out.  He tried everything and he was absolutely convinced that he would freeze to death.  He was desperate and ended up carving into the wood floor a note to his family of how cold he was and that he believes that he is going to freeze to death and just wanted to tell them that he loved them.  The next day other rail road workers found him dead.  The interesting thing was that the refrigeration unit was broken and the temperature in the rail car never went below 50 degrees.  This man LITERALLY thought himself to death.  And the autopsy showed that he died of freezing even though the temp was never below 50 degrees let alone freezing.  THAT is how powerful a human mind can be.  So I'd recommend that you start thinking more positively that the medicine will eventually work once you work up to the correct dosage.

Just my thoughts and opinions.
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Avatar_f_tn
I have to agree with flying fool. I think u need to relax and let the meds work and your mind settle. Your labs from feb. 6 are perfect! I'm on my third week of synthetic (75 mg), and starting to feel less tired and depressed. My TSH was 8.5 and my antibodies were over 2600. If I can relax, you can...
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Avatar_f_tn
I agree with your comments.  Until you've really given the meds a chance to work, you don't know what they'll do.  

However, I have to disagree with you that 2/6 labs are "perfect".

FT3 and FT4 ranges are very flawed.  The original "normal" population contained many people who had hypo symptoms, but were not diagnosed hypo, and many asymptomatic Hashi's.  As a result the lower parts of both ranges are questionable.

Symptom relief should always be the number one priority in treating hypo, but we find that many people are just not comfortable until FT4 is about midrange and FT3 is upper half to upper third of range.

Many doctors adjust their patients meds until their labs are just into the very bottom of the range, leaving their patients still very hypo.  They'll tell patients with NeedSomeHelp's labs that their symptoms are not thyroid related, and usually this is the furthest thing from the truth.

We all have a personal range, within the population range (usually) at which we are each comfortable, and that varies from person to person.  Person A can be very hyper at the same lab values that make person B very hypo.  That's why symptoms have to drive treatment.  
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Avatar_f_tn
Wow, amazing that you could get the doctors to go to such fine tuning with  the specifics of your case. I see an endocrinologist who winces as me asking to get my T3 or T4 checked in addition to my TSh.  And that is post thyroid cancer.  On the other hand, I really feel you should be getting some type of sense of relief by this point.  I have taken brand synthroid for over 25 years. Throughout those years there has been an occasional pharmacy error when they filled me a generic. Blood work showed the generic had no effect at controlling my thyroid issue.  When I was on the generic I would start feeling like my life was out of control within a week, it was so odd it just kind of came over me for no apparent reason.  I am very sensitive to med changes (don't know if this is a blessing or not).  Anyhow, the point of my comment is to make sure if the doctor has you on Brand Synthroid that that is what the pharmacy is filling for you. I have discoverd it is very important to have the medication be the same every time. (My endocrinologist does support this) You must be sure you are getting  no substitutions or apparent similar drugs.  Always check your pills before you leave the pharmacy. Wishing you Wellness!!!
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649848_tn?1357751184
"02/15/12 *****PUT ON 50 MCG of SYNTHROID*****

02/27/12 *****PUT ON 62.5 MCG of SYNTHROID***** "

Were you "put on" (indicates you just started it) 50 mcg on 2/15/12 or had you been on it for a while (that's what it looks like to me) and increased to 75 mcg on 2/27/12? What about the cytomel?  Are you still taking that, or has it gone by the wayside? If so, when? That's a very important part of your medication so should not be left off of med dosages.

It takes 4-6 weeks for a T4 (synthroid) med change to reach full effect; why did your doctor adjust your dosage after only 12 days?

Would you please clarify your medications and dosages as of 2/6/12, 2/15/12 and 2/27/12.  Also, do you have labs that would support an increase in med(s) on 2/27/12?  If so, please post them, along with reference ranges.
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Avatar_m_tn
Looks like you might be permanently hypothyroid.
Silent thyroiditis can take up to 18 months to fully recover,Its possible for silent thyroiditis to re-occur within that time,thus possibly doubling the recovery time.
and because your thyroid is worn out from 1st hyper phase you may have no thyrotoxicosis the 2nd time,only hypothyroid.
Just speculation but it has to happen to some one I'm sure.
Ive had silent thyroiditis for the past 5 months now just going into hypo phase.
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Avatar_m_tn
I know exactly what you going through,its the worst
thing Ive ever had by far.
Don't feel hopeless trust me when I say that
NOTHING lasts forever.
You will feel normal again.
I keep saying this to myself,keeps me from giving up.
I will try and avoid synthroid at all cost if I have to take thyroid i'll take armour.
its natural and contains t3 , t4 and some other stuff that a thyroid makes, because its taken from animals thyroid.
Sythroid is only t4 and makes countless people feel crap.
also there is a transition period when taking hormone 4 to 8 weeks until blood levels stabilize.
Just hang on there normal will come.

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Avatar_m_tn
Armour may be made fro pig thyroid but is not natural. It is still somewhat manipulated by man.

Also you are right that it contains T3 and T4.  And also T1 and T2. But T1 7 T2 have not been proven to do much of anything measurable.

Also the T3 to T4 ratio for pig thyroid is DRAMATICALLY more than human Thyroid.  I believe that pig thyroid has about 5 times more T3 than what the human Thyroid puts out.

I am not knocking Armour or any Natural Dissected Thyroid (NDT) product. I'm only trying to point out the difference.

Some people need the T3 boost which makes NDT a good choice.  Others don't need this boost.

Still others nee to add T4 in addition to NDT because they  need to bring their T4 levels up and taking a higher dose of NDT pushes them Hyper.

Then there are others who need to add additional T3 to NDT because their FT4 levels are fine but still need a boost of T3.

The bottom line with all of this is that each person needs to do what works for THEM.  and just because a particular medicine does not work for one person while another one does.  Doesn't make the first drug useless or crap nor does it make the other drug a wonder drug that everyone should use.

You really need to know where your blood labs are at and what you are trying to achieve and then pick the drug or drug combination that will work to achieve that goal. It may be different for different people.
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Avatar_m_tn
Thank you for info.
So a person could have right amount of t4 but have t3 toxicosis on armour.
I think i'll try avoid hormone...
  
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649848_tn?1357751184
Many people do very well on Armour, just as many people do very well on synthetic T4 or T3 meds.  It's all a matter of what works best for the individual.  

You can't live without hormones, so there's no avoiding them.  Like the rest of us, you have to find one that works for you and stick with it.

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Avatar_m_tn
I know you cant live without hormone but this post is about silent thyroiditis which is self limiting and resolves on its own.
Its not caused by an overactive thyroid gland its caused by destruction of the thyroid gland so preformed t4 gets released causing toxicosis followed by hypothyroidism until the thyroid repairs itself.
hormones are usually not prescribed to silent thyroiditis patients.
So I can try to avoid them if I am able.    
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Avatar_m_tn
Actually this post was NOT stated or about silent thyroiditis.  It was started by a women who was having trouble stabilizing her thyroid problem and medication.  Nowhere was there a mention of "silent thyroditis" as I could tell.

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649848_tn?1357751184
Silent thyroiditis is not caused by destruction of the thyroid.  Destruction of the thyroid is caused by an autoimmune disease, either Hashimoto's or Graves Disease, neither of which "resolve on their own" like silent thyroiditis does.
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