Hashmotos and Optimal Labs

[RenKat]

Here is are my labs for the last few months.  My question is:  Is increasing the meds making me less hypo or more hper?  I have Hashimotos.  

In the past year and a half, with the addition of the t3 I was able to drop from 180 lbs back to my original weight of 140. I believe that weight gain was due to the increased synthroid given "to shrink nodules'.  
My optimal weight at 5'4' is 125-135.  

Here are my questions:  

Do the low numbers indicate I am still hypo, because it feels that way-sleeping in the afternoon, awakening exhausted and aching.
I am on a Vit D, but not on any other supplements, nor a calcium supplement   I can't take oyster shell based, due to having 1 kidney.

I was on 50 Levoxyl/15 Cytomel:
T3, Free: 3.2 (2.3-4.2)
T4, Free  0.9 (0.8-1.8)
TSH: 0.02      (0.40-4.50    

On April 16, 2013
He incresed the Levoxyl yo 75mcg/15 mcg Cytomel"
T3, Free ?
T4, Free 1.1
TSH: 0.2

May 20 2013 88mcg Synthroid/15 mcg Cytomel
T3, Free 3.7
T4, Free 1.1
TSH:  0.01

He has recently said to increase the Cytomel from 15 mcg to 20 mcg.  
I am now on 88 mcg Synthroid/20 mcg Cytmomel

[gimel]

Not sure I understand your question about the FT4.  FT3 largely regulates metabolism and many other body functions and correlates best with hypo symptoms.  FT3 is adjusted as necessary to relieve hypo symptoms.  Beyond being available for conversion to T3, T4 seems to have other functions also, so we like to see FT4 around the middle of its range.

[RenKat]

Thanks for the response, gimel.  I have labs again in a few weeks, and will request those additional things.  I have just been switched from 50,000 iu to 200 on the D, to prevent toxicitity.  I know its a remedial question, but the T4 being flagged as low, was that an indication that I was dropping more hypo?  I have been told both is the case, and am confused.

[Barb135]

"I take the 50,000 i.u. scriptural Vitamin D supplement, but sporadically, I confess."   Does that mean you have a prescription for vitamin D?  Have you been tested in the past and found deficient? Is that 50,000/week?  

I'm also curious as what you are considering "low numbers".  While your FT4 is low in the range, your FT3 is actually at 73.6% of its range. TSH should not even be considered, since you are on a T3 med.  Weight gain is caused from inadequate medication, not from the medication, itself.  Your weight loss was probably due to the increased T3 med.

Vitamin B12 deficiency can cause fatigue/exhaustion; magnesium deficiency can cause aching/sore muscles.

[gimel]

Your latest test results leave a little room for tweaking; however, I see nothing that stands our as the cause for your symptoms.  This makes me wonder if there are other possibilities at work here.  So in view of your symptoms, my suggestion at this time would be to request tests for Vitamin D, B12 and ferritin.  Hypo patients often find these to be too low in the ranges, with resultant symptoms that can mimic hypo symptoms.  I also think I would request testing for Reverse T3, just to verify.  There are reports that the best measure of tissue thyroid levels is the ratio of Free T3 to Reverse T3.  So let's verify that is okay.  If the additional tests reveal nothing of consequence, then we will continue from there.  

[RenKat]

Hi, gimel,

I may have missed your response.  

No I fasted, and I did not take either the t3 or t4 before the test.  

And I do not see testing for Vitamin D, B12 or the Ferritin-Only Calcium which is consistently 9.6 in the range 8.6-10.4.
I take the 50,000 i.u. scriptural Vitamin D supplement, but sporadically, I confess.

[gimel]

Pardon me if I am duplicating previous questions.  I just wondered if you took your thyroid meds before or after the blood draw for tests?  Also, since hypo patients are often too low in the ranges for Vitamin D, B12 and ferritin, if you have test results for those, please post, along with reference ranges.