I'm I on the right track?

[juliva]

Hi everyone, just wondering after keeping tabs on this forum for about a year now if I got it right as to my lab results and symptoms.  Here are my labs 8 weeks ago and Endo upped my meds at the time...

TSH 2.29   Ref. Range  0.40 - 4.50
T4 Free 1.1                  0.8 - 1.8
T3 Free 266                  230 - 420

I felt worse so went for more labs last week and to my surprise I was SHOCKED to find I'm now on the hyper side! Endo wants to keep me there so long as I'm not getting any heart palpitations. (must be they like to keep the TSH down with half a thyroid also?) Endo didn't test FT3 this time ;( so I'm not sure where that is at.

TSH 0.08
TF4 1.3

I'm thinking I'm tired because my TF4 could stand to be a bit higher or maybe my body just hasn't caught up to the new levels? I'm taking levothyroxin (levothyroxine) and can't help wonder.. If I find I'm still tired in the future I would think it's because of my mid range TF4 level and would fair better in the two thirds range but how do you get that level up without effecting the TSH? Would love to hear your input! Thanks!

PS. On a happy note It's been 10 months since right TT and this is a first reading that indicates my meds won :)

[goolarra]

Your FT4 is actually pretty low and doesn't look the slightest bit hyper to me.  A low TSH does not indicate hyperthyroidism if it is not accompanied by hyper symptoms.  Don't worry about the TSH...it's the least important of the tests.  Doctors put too much emphasis on it.  I think staying at the same dose for a while longer sounds reasonable if you're feeling pretty good.  Retest in 5-6 weeks, and see what's going on then (request FT3 then, too!).

[JennaMarie83]

goolarra, you seem to know what you're talking about with interpreting test results. Can you let me know what you think about mine? I have been taking Armour and I felt great, no hypo symptoms when I got my bloodwork taken last week.

TSH: 0.33
Free T3: 635 (230-420)
Free T4: 1.0 (0.8-1.8)

What is up with the low normal T4 but way high T3 (with no hyper symptoms)? Do you think it is low cortisol? I do get dizzy when I stand up after sitting down a while fairly often and have read that that is indicative of low cortisol.

I have lowered my dose from 2 grains per day to 1.5 grains per day and started taking cortisol in an effort to get my levels right.

[goolarra]

Good question...what IS up?  I'm amazed that you have no hyper symptoms since your FT3 is so high.  And your FT4 is quite low normal.  

Ordinarily, I'd say that the Armour has way too much T3 in it for you, and that that's what's causing the FT3 to skyrocker.  However, you feel good, and your TSH is good, so I really don't know what to say.

I don't know much about cortisol since it's never been one of my problems.  Dizziness upon standing can also just indicate low blood pressure.  

How long were you on the 2 grains of Armour before your recent decrease?

[JennaMarie83]

Haha exactly my thoughts when I saw the results - they seemed pretty crazy and I was stumped as to what was going on. I took 2 grains per day for about a year before I lowered it to 1.5 grains last Friday. When the doc first switched me over last year, he had me start out taking 1.5 grains in the morning then a half grain in the afternoon, but I had heart palpitations and trouble sleeping at that dose so I lowered it to 1 grain in the morning and 1 in the afternoon and had no hyper or hypo symptoms from then on, so I thought for sure that when I got my bloodwork done last week that everything should come back normal. I researched and found on the stopthethyroidmadness website that low cortisol can cause people to still have hypo symptoms even with FT3 in the upper range, so I thought maybe since I still wasn't having hyper symptoms with my FT3 so high, maybe that was the reason. One of the main signs they listed of low cortisol was low BP that causes you to get dizzy when you stand up.

I couldn't get in to see my doc until the end of august, so I will see what he thinks and maybe get him to order more bloodwork for me and see if my FT3 looks better on this lower dose. I'm just worried that my FT4 will go too low.

[JennaMarie83]

Sorry, wrote that wrong - I started out on 1.5 grains in the morning and 1 grain in the afternoon

[goolarra]

Of course, one of the problems with Armour is that is does have a lot of T3 in it compared to what our healthy thyroids would produce.  The ratio of T4:T3 in Armour is 4-to-5:1,  We produce about 20:1. Interesting...did you have labs between the time you started on the 2 grains of Armour a year ago and your recent decrease?  Did your FT3 creep up or is this a very recent phenomenon?

Did your doctor prescribe the cortisol?  

[JennaMarie83]

I only had bloodwork done last year after I had been on 2.5 grains per day (the FT3 was high then, so then I lowered it to 2 grains). Since I felt perfect, I didn't think I needed to go back for more bloodwork except for annual checkup. I got the cortisol from the doctor last year and took it for a few days, but then stopped because I didn't feel as good with it. I guess it's possible that when I was taking the cortisol, I was having the reaction of a normal person to too high a thyroid hormone dose, so then when I stopped the cortisol and stayed on 2 grains, I felt fine since my cells weren't actually getting the hormone as they should. Here's an excerpt from that website:

"But cortisol also plays an important role for you as a thyroid patient. Namely, it helps cell receptors receive thyroid hormones from the blood to the cells. On the other side of the coin, low cortisol can result in high amounts of thyroid hormones to build in the blood, making your free T3 and/or free T4 labs look high in range with continuing hypo symptoms"

That would explain my situation (had to go outside the range on the high end to get rid of hypo symptoms). And now that I'm on 1.5 grains and cortisol, I'm still feeling fine, so maybe my FT3 will go down into the normal range and I will be getting the amount I need to feel good. I guess I'll see next time I get bloodwork done.

[goolarra]

You should really have bloodwork done more often than once a year, at least until your meds seem to be really stable.  I'd do them again in five to six weeks and see if that FT3 is coming down at all. High FT3 can get you into trouble.  I know you're feeling good, and that's a real positive, but you've added the cortisol and reduced the Armour, so you really should have a look at the blood levels again soon.  If you start feeling either hyper or hypo in the meantime, have the tests sooner.  

[JennaMarie83]

Ok that's what I'll plan on - my appt. is on Aug. 31st, so that'll be just over 5 weeks after I lowered my dose. I'll get him to check my levels again then and see if they have improved. Thanks!

[stella5349]

I truly believe you are on the right track!!! - GOOD JOB!!

Yes - yes -- YES!!! - cortisol is a nasty little bugger and will throw you off with labs. IT will make you look way over the top on the active hormone (s) - but you will still feel like you need MORE meds...

NO - NO - NO...... You will need to drop (as you did) down on thyroid hormone and concentrate on adrenal repair.

VIT C - seasalt drinks - VIT B and D --- maybe HC - but I just didn't want to fall dependant on that for life if I could help it

My free labs have always been like yours - since taking in direct T3 - but I was feeling pretty horrible in the beginning until I worked on the adrenals. Took a year but I feel they are stabilized good now and I am back up to more thyroid meds then ever and feel fantastic...

I still have above the range on FT3 - and my ( non exsistant) TSH of 0.004. ( Big Deal on the TSH i say)  

I am mid point in the FT4 dept too.

I was just talking to a lady with a daughter born w/out a thyroid. I seriously think this poor child has adrenal distress too and her Armour is back firing a tad.

Dear Lord... 8 years old... my heart is just breaking....  

[JennaMarie83]

Ok so because of the Armour supply shortage and reformulation, I had asked for Westhroid - the pharmacy gave me Thyroid tab, a generic form of Armour instead. I have been on that for a few weeks now at the 1.5 grain dose and I am feeling hypo again, especially yesterday and today. I stopped Cortisol a couple weeks ago because I was already SOOO stressed with work and I don't think that was helping, plus I was worried about it lowering my immune system. I am going Friday for more bloodwork to see if the crazy high FT3 has gone down, and to see where the FT4 is. I have a feeling FT4 will be too low, since I am feeling hypo. I have a MUCH needed vacation next week, then I will see my doctor. I am curious to know what his interpretation of the bloodwork results will be. Can low FT4 cause this extreme fatigue even though my FT3 is high?

[magpieannie]

Hi! I am the mother of the 8 year old little girl that Stella was referring to. My daughters t4 was suddenly low normal on her last labs (due to changes in Armour I suspect) She too was becoming very fatiged with severe joint pain in ALL her joints. She has never had joint pain before,but her free t4 has never been this low before either. We have now switched to Naturethroid (1 month) and she is doing better.I'll do labs on 9/14 and will have results on 9/20. I'll keep you posted. Hopefully we are on the right track. I haven't persued the adrenal issue yet. She has had her Cortisol tested (last January) but it was only the blood test. It came back normal. We may look again with a better test. I'm trying to eliminate one issue at a time. Right now we are trying to figure out the best med. and optimal dose for her to be as close to symptom free as possible. Joint issues seem to slowly be improving. I think we are moving in a better direction now for sure! Hope that you are doing better at solving your personal thyroid puzzle. Good luck and God Bless!