How does FreeT3 effect heart palpitations?

[windih]

I have been taking 120mcg Armour, my last labs 8/11 were TSH <0.01 and the Internist cut my Armour to 60, with no others labs requested.  My prior labs requested by PRN were on 6/10/11  TSH 0.03, FreeT3 5.5 and FreeT4 1.31. Since cutting my Armour, I have palpitations, tired and my hands tremble. I have been on thyroid meds for 3 yrs now and still no one has me regulated. Does it ever get better?

[goolarra]

I take atenolol for tachydardia.  When I was first on thyroid meds (before atenolol), my tachycardia had gone wild...I was having episodes 20-30 times a day.  I started taking atenolol once it was obvious that I had to do something in order to be able to get on a therapeutic dose of thyroid meds.  The atenolol helped immediately, but once I'd been on a stable dose of levo for about a year, the tachy disappeared completely.  So, yes, in my experience, a stable dose is the best thing you can do for heart issues.

[windih]

Thanks for the advice.  It was a forehead thump, of course I shouldn't take my meds before my labs.  I will have to trust my PRN Naturopath, my Internist comments were "I don't know why FT4 and FT3 were ordered.  Armour is barbaric."  Pretty much counts him out.  Does any one else take Atenolol for palpitations? Will they stop, if/when I get stablized?

[Super_sally888]

You should not take your armor the morning before the draw (take it after).  If you take it before it will make your FT3 look high.   Also armor will suppress your TSH, and you should therefore be looking at FT3 and FT4 for optimising your dose.

Agree that you need an increase in meds to get your FT4 up.   Take it slow and increase with very small dose only. There is time to adjust.

If you do find that your FT3 is high and your FT4 is low, you can add a small dose of T4 med to mix.

As an example: I curently take 250 mcg of dessicated and 100 mcg of thyroxine.

[windih]

I had taken my meds prior to each draw until this time.
June '09 my TSH was 14.0
Aug - 8.43
Oct - 9.37             med 1.5 gr Armour
Mar '10 - 1.44 lab range .45 - 4.5
Jul       -   .67 lab range .55 - 4.78 meds inc to 2 gr
Dec     -   .01  same lab  meds cut 1gr am and .5 gr @ 2pm
Jan '11 - 4.07 same lab meds inc to 2 gr
May     - 2.27 same lab  meds inc 2.5 gr
Jun      -   .03 same lab  meds dec 2 gr
Aug     - < .01 same lab

Yes, I think the TSH can be thrown out. I'm listening to my PRN, taking 1gr in the am and half @ 2pm. Take new labs in 2 mths.

[goolarra]

Had you taken your Armour before your blood draw on 6/10/11?  How about before the other two draws?

I agree with flyingfool that your meds are being adjusted in very large increments.  Bear in mind that once on meds, TSH often becomes unreliable to the point of having to be ignored.  Since your TSH hit rock bottom on 6/10/11 and has remained low even though your FT3 and FT4 have both plummeted, it seems that you can no longer rely on it .

I also agree that an increase is in order, but wonder if the increase should be more conservative.  It's often best to increase in smaller increments and to keep moving in the same direction (increasing in your case) rather than overcompensating, swinging hyper, ovecompensating the other way, swinging hypo, etc.  Thyroid meds dosing is a bit of an art.  When you get close to an optimal dose, very small changes in meds can make a world of difference.  

I'm betting you've never found a stable dose because of the big swings in meds.  

Were you on 120 mg prior to the 5/10/11 labs as well?

[windih]

Yes, sorry it is a typo, FT4 is .99

[flyingfool]

Is that a typo on your FT4 results?  Should it be 0.9 or is it really 0.09?

If it is not a typo, you are SEVERELY low on FT4.

Most people seem to get symptom relief when their FT4 is midrange AND their FT3 are in the upper 1/3 of the range.

you definitely need an increase in your meds.

I'm not sure too much about dosage levels of Armour.  But on a percentage basis.  The increase that you list would be a 50% increase from what you are at now.  As a percentage basis that seems like a big jump.  But maybe not.

[windih]

New test results are in.  TSH .06 lab range 0.55 - 4.78
                                    FT4 .09 lab range 0.80 - 1.76
                                    FT3 2.6 lab range 2.3 - 4.2
My Naturopath PRN says to increase my dose from 1 gr Armour to 1 gr in the morning and 1/2 in the afternoon.  She thinks my headaches and edema may be viral and totally unrelated.

[goolarra]

You might also check those FT3 and FT4 ranges with the lab.  Labs frequently update their ranges...just wondering if they might have changed equipment or methodology between those labs and have a new range.  My lab has been changing quite often recently.

[windih]

Yes, I can go earlier and will set it up.

[goolarra]

6/10/11 labs - FT3 is obviously quite high, well above range.  At the same time, your FT4 looks really, really good at just above midrange.  This would seem to indicate that you might not need all the T3 that's in Armour and might benefit more from either straight T4 or supplementing the Armour with some T4.  

However, your 5/10/11 labs make me wonder what's going on.  Were there any meds changes between the two lab?  Any meds or supplements added or d/c'ed, not just thyroid meds?  Diet or lifestyle changes?  Do you have Hashi's?  Do you have nodules?  The change from 5/10 to 6/10 is dramatic.  On 5/10, your FT3 was actually quite low in the range and so was FT4.  This fast a change, especially in FT3 levels, without a meds increase, is quite unusual.

Can you have your blood drawn again before two weeks?  I think I'd ask the doctor to run everything sooner and make sure to run FT3 and FT4.  

[windih]

FT3 range was 2.3 - 4.2 with mine at 5.5, FT4 0.80 - 1.76 mine 1.31, TSH 0.55 - 4.78 mine <0.1.  It has been 6 wks on the new dose, I go for labs in two weeks.  I always use the same lab.  In the last couple of weeks, I have begun to experience burning (feels like swelling) in my feet and hands. Yes, they are normally cold.  My compounds are Biest 80/20 1.25mg x 2 per day, Testosteron 2mg and Progesterone 30mg.

Labs taken on 5/10/11, TSH 2.27, FT3 2.8, FT4 0.93 witht the same ranges as above.

[goolarra]

Yes, it does get better, and yes, thyoid meds do affect heart palps.  But if your doctor is testing nothing but TSH and cutting your meds in half based only on TSH, you are not going to get better fast.  TSH often becomes suppressed and and a very unreliable indicator of thyroid status once patients are on meds.

What were the ranges on the FT3 and FT4 from your 6/10/11 labs?  FT3 and FT4 should be ordered every time you have labs...a doctor who doesn't is going to keep you sick.  Ranges vary lab to lab so have to be posted along with results.

How long has it been since your dose was lowered?