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Increased Synthroid but seem to be going backwards
Hi,
I am finding working out the meds to be tricky and appreciate any feedback regarding the following:
My synthroid was increased from 100 to 112 in May and I am also on 5. mcg's of leothyronine (t-3)
but I am still having fatigue, sluggishness, muscle fatigue even when I swim.
In May (when I was on 100 mcg of Synthroid and 5 mcg of leothyronine), my lab results were the following:
Free t-3: 3.4 (range 2-4.5)
Free t-4: 1.11 (range 0.82-1.77)
On July 29, 2016 (On 112 Synthroid and 5 mcg t-3)
Free t-3: 2.90 (range 2-4.5)
Free t-4: 1.12 (range 0.82-1.77
The free t-4 barely budged even though the Synthroid was increased. I wonder what would be the next move with this-- increase the Synthroid or see if I can tolerate 10 mcg's of Leothyronine (twice a day).
I wonder if there is reverse t-4/t-3 (?) being created or I just do not have enough Synthroid on board, as I am also a higher weight.
I am finding working out the meds to be tricky and appreciate any feedback regarding the following:
My synthroid was increased from 100 to 112 in May and I am also on 5. mcg's of leothyronine (t-3)
but I am still having fatigue, sluggishness, muscle fatigue even when I swim.
In May (when I was on 100 mcg of Synthroid and 5 mcg of leothyronine), my lab results were the following:
Free t-3: 3.4 (range 2-4.5)
Free t-4: 1.11 (range 0.82-1.77)
On July 29, 2016 (On 112 Synthroid and 5 mcg t-3)
Free t-3: 2.90 (range 2-4.5)
Free t-4: 1.12 (range 0.82-1.77
The free t-4 barely budged even though the Synthroid was increased. I wonder what would be the next move with this-- increase the Synthroid or see if I can tolerate 10 mcg's of Leothyronine (twice a day).
I wonder if there is reverse t-4/t-3 (?) being created or I just do not have enough Synthroid on board, as I am also a higher weight.
I know Barb will be responding further to your post. I just wanted to give you some useful info that you can use to dispel your doctor's false concern about the suppressed TSH result. You can find the info in Item no. 10, page 13, in the following link.
http://www.thyroiduk.org.uk/tuk/TUK_PDFs/diagnosis_and_treatment_of_hypothyroidism_issue_1.pdf
http://www.thyroiduk.org.uk/tuk/TUK_PDFs/diagnosis_and_treatment_of_hypothyroidism_issue_1.pdf
2 Comments
Thank you, Gimel. Helpful information but the HMO that I belong to is not responsive. So I consult with an outside physician and pay for extra labs.
Right now the modest change I've made is to increase my t-3 from 5 mcg every day to 5 mcg on on one day and 10 mcg every other day (taking the second pill before 2 PM to ward off insomnia issues which t-3 can cause).
Right now the modest change I've made is to increase my t-3 from 5 mcg every day to 5 mcg on on one day and 10 mcg every other day (taking the second pill before 2 PM to ward off insomnia issues which t-3 can cause).
The article you referenced is interesting and will take me awhile to process as it is 38 pages long--but these two paragraphs are interesting--the second about the damage when our L-t3 levels are too low. (I skipped some of the quote)
"In summary L-T4 monotherapy remains the treatment of choice due to its long half-life and the convenience of a single daily dose, and the assumption that T4 is largely converted to T3 as needed. However, there is rapidly accumulating evidence that L-T4 monotherapy does not invariably assure adequate levels of FT3, even when the medication dose is adjusted to bring FT4 and TSH back within their respective reference ranges. Some hypothyroid patients find this inadequate and report continuing hypothyroid symptoms. If treated adequately with a combination L-T4 plus L-T3 therapy, numerous studies show that a majority of those patients prefer that to L-T4 monotherapy. . . ..
In addition to the direct benefit of achieving adequate FT3 levels, some studies have concluded that low FT3 levels are risk factors for artery calcification and major adverse cardiac events (MACE) 67, 68.
"In summary L-T4 monotherapy remains the treatment of choice due to its long half-life and the convenience of a single daily dose, and the assumption that T4 is largely converted to T3 as needed. However, there is rapidly accumulating evidence that L-T4 monotherapy does not invariably assure adequate levels of FT3, even when the medication dose is adjusted to bring FT4 and TSH back within their respective reference ranges. Some hypothyroid patients find this inadequate and report continuing hypothyroid symptoms. If treated adequately with a combination L-T4 plus L-T3 therapy, numerous studies show that a majority of those patients prefer that to L-T4 monotherapy. . . ..
In addition to the direct benefit of achieving adequate FT3 levels, some studies have concluded that low FT3 levels are risk factors for artery calcification and major adverse cardiac events (MACE) 67, 68.
I got other test results back from a different lab. They won't test free t-3 but the results are from this lab (taken 5 days after the prior lab)
Free t-4 : 1.1 (range 0.8-1.5)
Total t-3 : 98 (range 58 to 159)
and TSH .20 (range .35 to 4.0)
prior test 5 days earlier with different lab
(On 112 Synthroid and 5 mcg t-3)
Free t-3: 2.90 (range 2-4.5)
Free t-4: 1.12 (range 0.82-1.77
My tsh is low and I'm not sure what to do as far as bringing my free t-3 and free t-4 up. I'm supplementing with iron as you recommended Barbara, but my iron levels were good as we tested those, too. It's been more than a year since I've been working to balance this and I'm not there yet. I think my regular doc will also see that low TSH number and then perhaps reduce my medication, which I won't go along with.
Free t-4 : 1.1 (range 0.8-1.5)
Total t-3 : 98 (range 58 to 159)
and TSH .20 (range .35 to 4.0)
prior test 5 days earlier with different lab
(On 112 Synthroid and 5 mcg t-3)
Free t-3: 2.90 (range 2-4.5)
Free t-4: 1.12 (range 0.82-1.77
My tsh is low and I'm not sure what to do as far as bringing my free t-3 and free t-4 up. I'm supplementing with iron as you recommended Barbara, but my iron levels were good as we tested those, too. It's been more than a year since I've been working to balance this and I'm not there yet. I think my regular doc will also see that low TSH number and then perhaps reduce my medication, which I won't go along with.
COMMUNITY LEADER
Both your FT3 and FT4 are too low in the ranges. Your FT4 is only at 32% of range and the recommended is mid range. FT3 is recommended to be in the upper half to upper third of its range and yours is only at 36% of the range.
Had you taken your medication just prior to either of the blood draws?
How long had you been on the 112 mcg of Synthroid when you had the July labs? It's not unusual to get a bit worse before getting better, when med dosages are adjusted.
Have you had ferritin levels tested? Iron is necessary for the conversion of FT4 to the usable FT3.
Had you taken your medication just prior to either of the blood draws?
How long had you been on the 112 mcg of Synthroid when you had the July labs? It's not unusual to get a bit worse before getting better, when med dosages are adjusted.
Have you had ferritin levels tested? Iron is necessary for the conversion of FT4 to the usable FT3.
1 Comments
Hi Barb,
I have been n this dosage since May 14--so that's a good time (over 8 weeks) for the blood levels to have stabilized.
I always take my lab tests before I take my morning medicine.
I can ask the doctor to test my ferritin. and also supplement. But I don't seem to be on the right dose.
I have been n this dosage since May 14--so that's a good time (over 8 weeks) for the blood levels to have stabilized.
I always take my lab tests before I take my morning medicine.
I can ask the doctor to test my ferritin. and also supplement. But I don't seem to be on the right dose.
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