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Lab Questions
Hello,
Here are my last few cycles of levoxyl. Could someone help with a few questions?
Reference range for FT3: 1.71-3.71 FT4: .7-1.48
75 mcg
FT3: 2.0
FT4: .7
tsh: 24.52 (.35-4.94)
88mcg
FT3: 2.0
FT4: .9
TSH: 8.19
100mcg
FT3: 2.3
FT4: 1.0
TSH: 5.94
112mcg
FT3: 2.2
FT4: 1.0
TSH: 3.32
Questions:
1) In my latest labs why was there no increase in frees when dosage was increased?
2) Does it seem as though I am converting well enough?
3) A new symptom of high blood pressure has popped up in this last cycle. Is this common? Never had it before.
4) Where should I go from here?
I have posted before while on a synthroid/cytomel combo and an armour regimen. I started over again because I was having terrible trouble (breaking out all over and itching) with both regimens. Levoxyl has agreed with me as far as that goes. My remaining symptoms are constipation/bloating, anxiety, and occasional joint pain.
Thanks
Here are my last few cycles of levoxyl. Could someone help with a few questions?
Reference range for FT3: 1.71-3.71 FT4: .7-1.48
75 mcg
FT3: 2.0
FT4: .7
tsh: 24.52 (.35-4.94)
88mcg
FT3: 2.0
FT4: .9
TSH: 8.19
100mcg
FT3: 2.3
FT4: 1.0
TSH: 5.94
112mcg
FT3: 2.2
FT4: 1.0
TSH: 3.32
Questions:
1) In my latest labs why was there no increase in frees when dosage was increased?
2) Does it seem as though I am converting well enough?
3) A new symptom of high blood pressure has popped up in this last cycle. Is this common? Never had it before.
4) Where should I go from here?
I have posted before while on a synthroid/cytomel combo and an armour regimen. I started over again because I was having terrible trouble (breaking out all over and itching) with both regimens. Levoxyl has agreed with me as far as that goes. My remaining symptoms are constipation/bloating, anxiety, and occasional joint pain.
Thanks
COMMUNITY LEADER
You have been very patient - more so than most.
Thank you for posting the ranges. Your FT is down to 38% of its range and your FT3 is down to 45% of its range. Are you still taking the selenium?
You can try increasing your Levoxyl and see what happens, but I'm not sure what's going on, except that you do have Hashimoto's, so it's possible that your med increases aren't keeping up with thyroid destruction, though you should be on enough meds to have suppressed your own thyroid by now, unless your thyroid "was" spurting before and it's not anymore.
I wonder if you'd do better to increase cytomel instead. You could easily go to 5 mcg in the morning and 5 in the afternoon; or even 7.5 in the morning and 5 in the afternoon.
My FT3 dropped once, when I increased my T3 med, also; don't know why, but when I increased my dosage again, my level came back up. My FT4 also dropped when I added T3 med and/or increased T3 dosage.
I'd asked about vitamin D and ferritin last year... did you ever get those tested? I know you want to get your thyroid hormones level without supplements, but that's not always possible, because both vitamin D and iron are necessary for the proper metabolism of thyroid hormones, so if your levels of either/both of those aren't high enough, that could be a problem.
You could also have some type of thyroid hormone resistance going on, but your levels were coming up nicely, then suddenly went down, so we'll see about that later.
Thank you for posting the ranges. Your FT is down to 38% of its range and your FT3 is down to 45% of its range. Are you still taking the selenium?
You can try increasing your Levoxyl and see what happens, but I'm not sure what's going on, except that you do have Hashimoto's, so it's possible that your med increases aren't keeping up with thyroid destruction, though you should be on enough meds to have suppressed your own thyroid by now, unless your thyroid "was" spurting before and it's not anymore.
I wonder if you'd do better to increase cytomel instead. You could easily go to 5 mcg in the morning and 5 in the afternoon; or even 7.5 in the morning and 5 in the afternoon.
My FT3 dropped once, when I increased my T3 med, also; don't know why, but when I increased my dosage again, my level came back up. My FT4 also dropped when I added T3 med and/or increased T3 dosage.
I'd asked about vitamin D and ferritin last year... did you ever get those tested? I know you want to get your thyroid hormones level without supplements, but that's not always possible, because both vitamin D and iron are necessary for the proper metabolism of thyroid hormones, so if your levels of either/both of those aren't high enough, that could be a problem.
You could also have some type of thyroid hormone resistance going on, but your levels were coming up nicely, then suddenly went down, so we'll see about that later.
Hi Barb
latest reults: 137 levoxyl. 7,5 cytomel 5 in moring 2.5 afternoon.
did not take meds morning of test.
ft4 1.00 .7-1.48
ft3 2.6 1.71-3.71
tsh .094 .35-4.94
symptoms are the same. cant see why ft3 dropped when adding cytomel. No change in ft4. I think I should up my dose of levoxyl. Would you agree? Any thoughts as to why I cant get to where I need to be. Ive been very patient this last year moving slowly but frustration is setting in.
latest reults: 137 levoxyl. 7,5 cytomel 5 in moring 2.5 afternoon.
did not take meds morning of test.
ft4 1.00 .7-1.48
ft3 2.6 1.71-3.71
tsh .094 .35-4.94
symptoms are the same. cant see why ft3 dropped when adding cytomel. No change in ft4. I think I should up my dose of levoxyl. Would you agree? Any thoughts as to why I cant get to where I need to be. Ive been very patient this last year moving slowly but frustration is setting in.
COMMUNITY LEADER
It's not unusual for FT4 to drop a bit when adding more T3 to the mix. I've had that happen and it only takes a short time for it to level out again. It's good that your symptoms are easing, so you don't have to keep FT4 right at the 50% mark... we don't all need the exact same things; we just don't want to get too far out of balance.
Your FT3 is at 54% with these labs, assuming the ranges are staying the same and your FT4 is at 38% of the range, again, assuming that the ranges are the same as before (it would be helpful it you posted ranges with labs each time so I don't have go back so far to look and ask to make sure they're the same, in case you have to go to a different lab and since ranges vary lab to lab, plus labs change their ranges from time to time).
Did you take your T3 medication prior to the blood draw? Typically, it's best to have the blood draw as early as possible in the morning, then take T3 med "after" the blood draw, because taking it prior can cause a false high...
If you're still having bloating, you may need a higher dose of of Levoxyl or you may need to change some things in your diet... taking probiotics can also help prevent bloating and constipation.
1) Your labs are not "horrible" and it doesn't seem that you have a lot of symptoms, so I might let things settle out for a bit and retest.
2) Yes, I think you made the right move, with 2.5 mcg increase in T3
4) Probably not to worry a lot about the < 50% FT4, just yet, but if it doesn't come up by the time you retest in 6 weeks, I'd want an increase in Levoxyl.
Your FT3 is at 54% with these labs, assuming the ranges are staying the same and your FT4 is at 38% of the range, again, assuming that the ranges are the same as before (it would be helpful it you posted ranges with labs each time so I don't have go back so far to look and ask to make sure they're the same, in case you have to go to a different lab and since ranges vary lab to lab, plus labs change their ranges from time to time).
Did you take your T3 medication prior to the blood draw? Typically, it's best to have the blood draw as early as possible in the morning, then take T3 med "after" the blood draw, because taking it prior can cause a false high...
If you're still having bloating, you may need a higher dose of of Levoxyl or you may need to change some things in your diet... taking probiotics can also help prevent bloating and constipation.
1) Your labs are not "horrible" and it doesn't seem that you have a lot of symptoms, so I might let things settle out for a bit and retest.
2) Yes, I think you made the right move, with 2.5 mcg increase in T3
4) Probably not to worry a lot about the < 50% FT4, just yet, but if it doesn't come up by the time you retest in 6 weeks, I'd want an increase in Levoxyl.
Hi Barb
doctor put me on 137 mcg levoxyl and 5 mcg cytomel. Constipation got worse. After I had labs done i immediately went to 7.5 mcg cytomel. Endo later agreed to prescibe that amount. Last labs:
ft4 1.0
ft3 2.8
tsh .245
Afte a few days on the 7.5 cytomel i am pretty much back to where I was before. constipation now functional but bloating remains.
1) What do you think of the labs
2) Did I make the right move with the 2.5 mcg increase.
3) the ft4 is now below 50% . should i worry
doctor put me on 137 mcg levoxyl and 5 mcg cytomel. Constipation got worse. After I had labs done i immediately went to 7.5 mcg cytomel. Endo later agreed to prescibe that amount. Last labs:
ft4 1.0
ft3 2.8
tsh .245
Afte a few days on the 7.5 cytomel i am pretty much back to where I was before. constipation now functional but bloating remains.
1) What do you think of the labs
2) Did I make the right move with the 2.5 mcg increase.
3) the ft4 is now below 50% . should i worry
COMMUNITY LEADER
If you took T3, 4 days before you had labs, it would have been out of your system by the time you had the blood draw.
T3 is fast acting, which means it's into your system, peaks and is neutralized within a few hours, which is why you noticed it wearing off in the late afternoon when you took the whole dose at once. Splitting 5 mcg will only give you 2.5 mcg at a time, so you probably won't notice much as effect to start with, but it's best to do it gradually, anyway.
If your endo balks at the TSH, simply explain that you don't want it to go any lower, but that you want your FT levels to shift in a different manner i.e. the FT4 to be lower (mid range) and the FT3 to be higher (upper half to upper third) for a better balance. If he's a good endo, he'll let you do it; if he doesn't, he's not worth keeping.
I went through the same thing you're going through and once I explained to my endo, what my goal was, he went along with me and as long as my levels stay within that goal range, he doesn't bother me about my TSH, which lives between < 0.01 and 0.01 - can't get any more tanked than that... lol
You're at the point where you're getting close; you're going to have to make small changes and give them plenty of time to take effect or you'll risk tipping the scale too far one way or the other.
You might be okay at the 137 mcg of T4 if you get up to 10 mcg of T3. It's customary to decrease T4 by 20-25 mcg for every 5 mcg of added T3, but if you do that, you're going to be too low, I think. Run the 137 mcg T4 and 10 mcg T3 by your doctor and see if he'll go for it.
T3 is fast acting, which means it's into your system, peaks and is neutralized within a few hours, which is why you noticed it wearing off in the late afternoon when you took the whole dose at once. Splitting 5 mcg will only give you 2.5 mcg at a time, so you probably won't notice much as effect to start with, but it's best to do it gradually, anyway.
If your endo balks at the TSH, simply explain that you don't want it to go any lower, but that you want your FT levels to shift in a different manner i.e. the FT4 to be lower (mid range) and the FT3 to be higher (upper half to upper third) for a better balance. If he's a good endo, he'll let you do it; if he doesn't, he's not worth keeping.
I went through the same thing you're going through and once I explained to my endo, what my goal was, he went along with me and as long as my levels stay within that goal range, he doesn't bother me about my TSH, which lives between < 0.01 and 0.01 - can't get any more tanked than that... lol
You're at the point where you're getting close; you're going to have to make small changes and give them plenty of time to take effect or you'll risk tipping the scale too far one way or the other.
You might be okay at the 137 mcg of T4 if you get up to 10 mcg of T3. It's customary to decrease T4 by 20-25 mcg for every 5 mcg of added T3, but if you do that, you're going to be too low, I think. Run the 137 mcg T4 and 10 mcg T3 by your doctor and see if he'll go for it.
Hi Barb
I was taking 5 mcg t3 (all at once) on a couple weekends to see if it would help. That would mean I did take some about 4 days before labs. It did have positive affects. For the past 2 days i have not taken any levoxyl. Only the 5 mcg of cytomel. I have some 137 levoxyl left over from before should I immediately start taking that too along with splitting the cytomel. I did notice it would wear off in the late afternoon/early evening. Oh, andbytsh coma I meant that if the endo saw one more lab report with a suppressed tsh he probably would not allow any more rx's that would allow my frees to move. I know the tsh has nothing to do with symptoms. Its below range now and I'm clearrly hypo. So with only one more lab to run I'm hoping i can eliminate the rest of my symptoms (mainly bloating and slowdigestion), so that I wont have to fight about the tsh with the endo.
I was taking 5 mcg t3 (all at once) on a couple weekends to see if it would help. That would mean I did take some about 4 days before labs. It did have positive affects. For the past 2 days i have not taken any levoxyl. Only the 5 mcg of cytomel. I have some 137 levoxyl left over from before should I immediately start taking that too along with splitting the cytomel. I did notice it would wear off in the late afternoon/early evening. Oh, andbytsh coma I meant that if the endo saw one more lab report with a suppressed tsh he probably would not allow any more rx's that would allow my frees to move. I know the tsh has nothing to do with symptoms. Its below range now and I'm clearrly hypo. So with only one more lab to run I'm hoping i can eliminate the rest of my symptoms (mainly bloating and slowdigestion), so that I wont have to fight about the tsh with the endo.
COMMUNITY LEADER
Sorry I missed your post yesterday...
I'm not sure what you mean by "TSH coma"... TSH is only an indicator of thyroid status -- it neither causes nor alleviates symptoms, so it should not enter into any decision when it comes to determining medication dosage. The only thing that really counts is symptoms, guided by FT3 and FT4.
Assuming that the lab ranges haven't changed, your FT4 jumped from only 38% of the range on the last labs to 77% on this lab... That's too high for FT4. Rule of thumb is for FT4 to be about mid range.
Again, assuming the same lab ranges, your FT3 only went from 40% of the range to 44%, which is minimal compared to the FT4 jump.
I totally agree that you need the T3 med and that you should get him to prescribe 10 mcg and start at 5 mcg. T3 med should be split into 2 daily doses - one taken first thing in the morning, the second taken around noon/early afternoon. For this reason, be sure you get the prescription written for "5 mcg twice daily" to be sure you get 5 mcg pills which are more easily split than 10 mcg pills.
It's customary to decrease T4 med when adding a T3 med, in most cases, and with your FT4 as high as it is, you really need to back off on that - at least back to the 150 mcg dose, maybe to the 138 mcg dose. Adding T3 is going to keep your FT4 higher, because you won't be converting as much.
In answer to your questions:
1) I do not think you have a flawed plan, as long as you decrease your T4 med to bring down the FT4 level - to high FT4 can cause other issues, which you don't need.
2) T3 med is fast acting and you'll know relatively quickly how you're going to react, so you're probably safe in adjusting in a couple of weeks. You've already been taking some, so you have a pretty good idea. How much/how often have you been taking it?
3) You are correct that your TSH is not likely to come up. Many of us on thyroid replacement hormones have suppressed TSH; T3 med is likely to suppress it even more.
Were you taking any of the T3 med when you had these labs? If so, how long before? That could have affected, both the FT4 and FT3 levels.
I'm not sure what you mean by "TSH coma"... TSH is only an indicator of thyroid status -- it neither causes nor alleviates symptoms, so it should not enter into any decision when it comes to determining medication dosage. The only thing that really counts is symptoms, guided by FT3 and FT4.
Assuming that the lab ranges haven't changed, your FT4 jumped from only 38% of the range on the last labs to 77% on this lab... That's too high for FT4. Rule of thumb is for FT4 to be about mid range.
Again, assuming the same lab ranges, your FT3 only went from 40% of the range to 44%, which is minimal compared to the FT4 jump.
I totally agree that you need the T3 med and that you should get him to prescribe 10 mcg and start at 5 mcg. T3 med should be split into 2 daily doses - one taken first thing in the morning, the second taken around noon/early afternoon. For this reason, be sure you get the prescription written for "5 mcg twice daily" to be sure you get 5 mcg pills which are more easily split than 10 mcg pills.
It's customary to decrease T4 med when adding a T3 med, in most cases, and with your FT4 as high as it is, you really need to back off on that - at least back to the 150 mcg dose, maybe to the 138 mcg dose. Adding T3 is going to keep your FT4 higher, because you won't be converting as much.
In answer to your questions:
1) I do not think you have a flawed plan, as long as you decrease your T4 med to bring down the FT4 level - to high FT4 can cause other issues, which you don't need.
2) T3 med is fast acting and you'll know relatively quickly how you're going to react, so you're probably safe in adjusting in a couple of weeks. You've already been taking some, so you have a pretty good idea. How much/how often have you been taking it?
3) You are correct that your TSH is not likely to come up. Many of us on thyroid replacement hormones have suppressed TSH; T3 med is likely to suppress it even more.
Were you taking any of the T3 med when you had these labs? If so, how long before? That could have affected, both the FT4 and FT3 levels.
Hi Barb
it was decided to alternate between 150 and 175 mcgs levoxyl for a 12 mcg increase. here are the results:
FT4 1.3
FT3 2.6
TSH .16
The way I look at it I have one more shot at this before endo puts me in the TSH "coma". I think I can get him to prescribe 138 mcg levoxyl and 10 mcg cytomel. I'll have 2 maybe 3 months to play with this combo with the refillshe gives with every rx. I would like to start with 5 mcgs and see how I feel, then adjust if needed. He will probably think my tsh will increase with this rx but I'm thinking it wont with the t3 addition. 138 mcgs is where I started to get symptom relief but FT3 wasnt high enough. I have some leftover cytomel from an old regimen and have taken 5 mcgs for a few days and it has has positive affects. My questions are:
1) Do you think this is a flawed plan
2) How long should I wait to adjust from 5mcgs if needed
3) Am I correct in assuming the TSH will not come up
I have an appt. with endo this coming wed.
it was decided to alternate between 150 and 175 mcgs levoxyl for a 12 mcg increase. here are the results:
FT4 1.3
FT3 2.6
TSH .16
The way I look at it I have one more shot at this before endo puts me in the TSH "coma". I think I can get him to prescribe 138 mcg levoxyl and 10 mcg cytomel. I'll have 2 maybe 3 months to play with this combo with the refillshe gives with every rx. I would like to start with 5 mcgs and see how I feel, then adjust if needed. He will probably think my tsh will increase with this rx but I'm thinking it wont with the t3 addition. 138 mcgs is where I started to get symptom relief but FT3 wasnt high enough. I have some leftover cytomel from an old regimen and have taken 5 mcgs for a few days and it has has positive affects. My questions are:
1) Do you think this is a flawed plan
2) How long should I wait to adjust from 5mcgs if needed
3) Am I correct in assuming the TSH will not come up
I have an appt. with endo this coming wed.
COMMUNITY LEADER
I responded to your comments last night, but apparently, it didn't post for some reason... I'm very sorry for that.
You can take selenium on and ongoing basis, so long as you take only the recommended amount (200 mcg/day)... I've been taking it for about 7 yrs now and have had no adverse effects. Since it seems to be helping you with conversion, it would appear that your body actually needs it.
No - as it sits right now, you would not be able to decrease your T4 by 25 mcg if you added in T3, but that's not always a necessity... since your FT4 is already low, you'd probably be okay just leaving it at your present dose and add a small of T3.
Since you took T3 already and noticed a positive effect, you already know how your body will, likely, respond.
In my opinion, you'd be safe to leave your T4 at your current 150 mcg and add T3, beginning at 2.5 mcg/day, gradually increasing to 5 mcg, split into 2.5 mcg X 2/daily. The T3 is going to boost up your FT3, so you won't need to convert as much, which should help bring up your FT4 again. You should retest in about 5 weeks and always be read to back off on the T3 med in case you have any adverse side effects.
Always be sure to ask your doctor to write the script for T3 med for 5 mcg tablets; that way you can split them much easier to get smaller dosages than if you have higher dosage pills.
You can take selenium on and ongoing basis, so long as you take only the recommended amount (200 mcg/day)... I've been taking it for about 7 yrs now and have had no adverse effects. Since it seems to be helping you with conversion, it would appear that your body actually needs it.
No - as it sits right now, you would not be able to decrease your T4 by 25 mcg if you added in T3, but that's not always a necessity... since your FT4 is already low, you'd probably be okay just leaving it at your present dose and add a small of T3.
Since you took T3 already and noticed a positive effect, you already know how your body will, likely, respond.
In my opinion, you'd be safe to leave your T4 at your current 150 mcg and add T3, beginning at 2.5 mcg/day, gradually increasing to 5 mcg, split into 2.5 mcg X 2/daily. The T3 is going to boost up your FT3, so you won't need to convert as much, which should help bring up your FT4 again. You should retest in about 5 weeks and always be read to back off on the T3 med in case you have any adverse side effects.
Always be sure to ask your doctor to write the script for T3 med for 5 mcg tablets; that way you can split them much easier to get smaller dosages than if you have higher dosage pills.
lab ranges are the same. i havent had feritin and vitamin d tested for quite some time. Im getting confused again with these current labs. Had I not supplemented selenium it probably would have come down to another increase to get the t4 back up. Id rather just get the things in ranges without taking all the supplements. I dont even know if your supposed to supplememt selenium for the long term. As it sits do you think the lower t4 would compensate for decreasing by 25 mcgs and then go ahead and ajust t3 with cytomel. and if so should i stop the selenium and see how it comes out after 5 weeks. Also should note that over the weekend I took some old cytomel i used before, cut in in half for 2.5 mcgs and within half hour felt a positive affect. I meet with endo on wed., hes pretty good. said last time were going to go on how you feel from here on out so i think hes open to trying things but at this point i dont know what to try.
COMMUNITY LEADER
Are the lab ranges the same as before? If so, your FT4 has dropped from 51% of the range to 39% and your FT3 went from 39% to 55%.
There is no 162 mcg dosage so you'd have to talk your doctor into letting you alternate 150 mcg and 175 mcg for an average of 162.5... you could try that, and see if it helps, since you're taking the selenium, but we don't want you to stay on a roller coaster either, so if that doesn't help equalize things then I'd recommend going to a small amount of T3... As close as you are, it won't take much.
Have you had ferritin and vitamin D tested as well?
There is no 162 mcg dosage so you'd have to talk your doctor into letting you alternate 150 mcg and 175 mcg for an average of 162.5... you could try that, and see if it helps, since you're taking the selenium, but we don't want you to stay on a roller coaster either, so if that doesn't help equalize things then I'd recommend going to a small amount of T3... As close as you are, it won't take much.
Have you had ferritin and vitamin D tested as well?
I forgot to add that I added 200mcgs selenium and 1000 iu of vitamin e in the 4 weeks prior to these labs. Looks like the selenium did help in conversion
Hi Barb,
Latest Labs:
TSH .6
ft4 1.0
ft3 2.8
I remained on 150 mcg levoxyl due to not being able to get into my endo until the 18th. That means I was on 150 mcg for about 10-11 weeks. As u can see ft4 went down a little and ft3 jumped. Maybe its goodI didnt add cytomel. Thing is that I still have lingering symptoms. Bloating is bad. Constipation and anxiety has improved a lot over the last few months but remains a bit.
I feel that I am close so my question is would it be prudent to move up another 12 mcg or should I sit on it another month. My thought is that I make the move since I have probably gotten everything there is to get out of the 150 dose. Let me know what u think.
Latest Labs:
TSH .6
ft4 1.0
ft3 2.8
I remained on 150 mcg levoxyl due to not being able to get into my endo until the 18th. That means I was on 150 mcg for about 10-11 weeks. As u can see ft4 went down a little and ft3 jumped. Maybe its goodI didnt add cytomel. Thing is that I still have lingering symptoms. Bloating is bad. Constipation and anxiety has improved a lot over the last few months but remains a bit.
I feel that I am close so my question is would it be prudent to move up another 12 mcg or should I sit on it another month. My thought is that I make the move since I have probably gotten everything there is to get out of the 150 dose. Let me know what u think.
COMMUNITY LEADER
Since you should be adjusting your T4 dosage, as well, and that will take the usual 4-6 weeks to take full effect, you should still wait several weeks to retest in order to make sure everything has stabilized. Of course, if you get the doctor to give it to you and you don't feel right, by all means try to get tested sooner to find out what's going on.
Everyone reacts differently to T3 med. Some say it hits them right away, but it didn't do that with me. I was on it for quite some time before I could even tell I was on it. Technically, it gets into the system quickly and is out again within a few hours. As long as I'm thinking about it, if you do get your doctor to give it to you, be sure you don't take it on the morning of a blood draw until after you have the blood draw or you'll a false high result.
Everyone reacts differently to T3 med. Some say it hits them right away, but it didn't do that with me. I was on it for quite some time before I could even tell I was on it. Technically, it gets into the system quickly and is out again within a few hours. As long as I'm thinking about it, if you do get your doctor to give it to you, be sure you don't take it on the morning of a blood draw until after you have the blood draw or you'll a false high result.
Thanks Barb. One more question. How long should I wait to get tested again if doctor agrees to add cytomel.
COMMUNITY LEADER
I think you've hung in here quite well and if you still have hypo symptoms, I wouldn't wait any longer to ask for a T3 med... Your FT4 is at 51% of the range, which is just above the mid range point, while your FT3 is only at 39% of the range.
It's customary to decrease T4 med by 20-25 mcg for every 5 mcg T3 added, so you could try decreasing to 125 mcg T4 and add 5 mcg T3 and see how it goes. You're at the point where you're "tweaking" now, so you'll have to make very slight changes. If your FT4 drops too far, you might want to go to 137 mcg T4 instead... yeah, you really are tweaking now and it's going to take tiny changes to get it right.
T3 is, typically, taken in multiple doses each day to keep levels stable, and if you're only on 5 mcg, that means you'll have to split a very tiny pill, which can be a pain in the rear... I did it for a while. OR you can simply take the single pill a little later in the day - did this for a while, too as it was easier than carrying around a split pill while I was working that, all too often, ended up as powder before it was time to take it.
At any rate, you have to get your doctor to agree to give it to you, then we can decide how you're going to take it... lol
As for supplements, selenium has been shown to help with the conversion of FT4 to FT3, so you can try that. 200 mcg/day is the recommended dosage. Remember all vitamins/minerals should be taken at least 4 hours from thyroid hormones, since they can interfere with absorbance of the hormones.
In addition, adequate ferritin and vitamin D stores are necessary for the metabolism of thyroid hormones, so if you haven't had your levels tested, this is a good time to do so.
You should also understand (and make sure your doctor does too) that if you start on a T3 med, most likely, your TSH will become suppressed and should not be a concern. TSH is often suppressed when adequate amounts of thyroid hormones are being taken... Don't let your doctor freak out if this happens...
It's customary to decrease T4 med by 20-25 mcg for every 5 mcg T3 added, so you could try decreasing to 125 mcg T4 and add 5 mcg T3 and see how it goes. You're at the point where you're "tweaking" now, so you'll have to make very slight changes. If your FT4 drops too far, you might want to go to 137 mcg T4 instead... yeah, you really are tweaking now and it's going to take tiny changes to get it right.
T3 is, typically, taken in multiple doses each day to keep levels stable, and if you're only on 5 mcg, that means you'll have to split a very tiny pill, which can be a pain in the rear... I did it for a while. OR you can simply take the single pill a little later in the day - did this for a while, too as it was easier than carrying around a split pill while I was working that, all too often, ended up as powder before it was time to take it.
At any rate, you have to get your doctor to agree to give it to you, then we can decide how you're going to take it... lol
As for supplements, selenium has been shown to help with the conversion of FT4 to FT3, so you can try that. 200 mcg/day is the recommended dosage. Remember all vitamins/minerals should be taken at least 4 hours from thyroid hormones, since they can interfere with absorbance of the hormones.
In addition, adequate ferritin and vitamin D stores are necessary for the metabolism of thyroid hormones, so if you haven't had your levels tested, this is a good time to do so.
You should also understand (and make sure your doctor does too) that if you start on a T3 med, most likely, your TSH will become suppressed and should not be a concern. TSH is often suppressed when adequate amounts of thyroid hormones are being taken... Don't let your doctor freak out if this happens...
Hi Barb
FT3 2.5 (1.71-3.71)
FT4 1.1 (.7-1.48)
TSH .82
These are my results after 5 weeks on 150 mcg levoxyl. I would suspect that you would advise to stay at the 150 and see what happens. Let me know if different. Though both frees moved again, symptoms did not improve. I was wondering how long I need to go until cytomel is considered. Also would like to know if there are any supplements that help with conversion.
Thanks
FT3 2.5 (1.71-3.71)
FT4 1.1 (.7-1.48)
TSH .82
These are my results after 5 weeks on 150 mcg levoxyl. I would suspect that you would advise to stay at the 150 and see what happens. Let me know if different. Though both frees moved again, symptoms did not improve. I was wondering how long I need to go until cytomel is considered. Also would like to know if there are any supplements that help with conversion.
Thanks
Thanks for everything Barb. I feel I'm getting close and will be carefull not to go overboard. I did that once on an armour regimen and I surely dont want to go there again. I was not on the same planet at that point. I'll post again in about 6 weeks. God Bless!
COMMUNITY LEADER
Merry Christmas to you... and Happy New Year.
You're right, your FT3 is coming up nicely, though it does have a way to go, yet. I'm happy to hear that symptoms are improving. You should be aware that symptoms can continue to improve, even after you hit that 5-6 week mark when the med reaches full potential. It does take time for your body to get well, even after that.
To answer your questions:
1) No, your FT4 is right close to the mid point, which is where you want it, so I don't see a concern with that, yet, as long as FT3 continues to track upward.
2) I do agree that another 12 mcg to 150 mcg is the next step. But you can also hold at 137 mcg for another 5 weeks and see if your FT3 continues to track up as I noted above.
3) I do agree that you're okay with just the Levoxyl, as long as your FT3 continues to track upward and symptoms continue to improve. If either of those stop, then addition of a T3 component may be in order.
4) As I noted above, rule of thumb is to have FT4 at about mid range (50%). Using your lab's reference range, again, as noted above, that would be 1.09. Your FT4 is at 1.0, so you're basically, right there with just a "tad" to go, which is why I'm not worried, yet that it hasn't moved.
Rule of thumb for FT3 is upper half to upper third of the range. Using the range your lab uses (1.71-3.71) mid range would be about 2.7 and the upper third would be around 3.0-3.1.
To hit the rule of thumb, which is where most of us find that we feel best, you should try to get your FT4 to about the 1.09-1.1 area and your FT3 to about 2.7 - 3.1, but even at 3.1, you'd have room to increase if symptoms weren't alleviated, though you'd have to extremely careful not to tip the scale the other way and go hyper, which is worse than being hypo.
You're already very close on the FT4, so you're mostly concentrating on the FT3. It's coming up nicely and your symptoms are improving, so you're definitely on the right track.
You're right, your FT3 is coming up nicely, though it does have a way to go, yet. I'm happy to hear that symptoms are improving. You should be aware that symptoms can continue to improve, even after you hit that 5-6 week mark when the med reaches full potential. It does take time for your body to get well, even after that.
To answer your questions:
1) No, your FT4 is right close to the mid point, which is where you want it, so I don't see a concern with that, yet, as long as FT3 continues to track upward.
2) I do agree that another 12 mcg to 150 mcg is the next step. But you can also hold at 137 mcg for another 5 weeks and see if your FT3 continues to track up as I noted above.
3) I do agree that you're okay with just the Levoxyl, as long as your FT3 continues to track upward and symptoms continue to improve. If either of those stop, then addition of a T3 component may be in order.
4) As I noted above, rule of thumb is to have FT4 at about mid range (50%). Using your lab's reference range, again, as noted above, that would be 1.09. Your FT4 is at 1.0, so you're basically, right there with just a "tad" to go, which is why I'm not worried, yet that it hasn't moved.
Rule of thumb for FT3 is upper half to upper third of the range. Using the range your lab uses (1.71-3.71) mid range would be about 2.7 and the upper third would be around 3.0-3.1.
To hit the rule of thumb, which is where most of us find that we feel best, you should try to get your FT4 to about the 1.09-1.1 area and your FT3 to about 2.7 - 3.1, but even at 3.1, you'd have room to increase if symptoms weren't alleviated, though you'd have to extremely careful not to tip the scale the other way and go hyper, which is worse than being hypo.
You're already very close on the FT4, so you're mostly concentrating on the FT3. It's coming up nicely and your symptoms are improving, so you're definitely on the right track.
Hi Barb
Merry Christmas!
My latest labs: 138 mcg levoxyl
FT3 2.4
FT4 1.0
TSH 2.7
This is after 5 weeks . I have an endo appt. this week so i had to get blood drawn a little early. As you can see my FT4 hasnt moved since august. However my FT3 did take a nice jump and symptoms did improve somewhat (anxiety better but still there, constipation better but still there.)
1) Should I be concerned about the lack of movement in FT4.
2) I think going up just another 12mcgs to 150 is the next move. would you agree or would that not be enough.
3) At last increase my endo wanted to add some t3 but I wanted to just stay with the levoxyl. I think the same would be prudent if he suggests this time also since there was a jump in t3 this time. Would you agree also.
4) Could you give me the target numbers (not %) based on the ranges above. I'm not sure if I'm doing correct math.
Thanks
Merry Christmas!
My latest labs: 138 mcg levoxyl
FT3 2.4
FT4 1.0
TSH 2.7
This is after 5 weeks . I have an endo appt. this week so i had to get blood drawn a little early. As you can see my FT4 hasnt moved since august. However my FT3 did take a nice jump and symptoms did improve somewhat (anxiety better but still there, constipation better but still there.)
1) Should I be concerned about the lack of movement in FT4.
2) I think going up just another 12mcgs to 150 is the next move. would you agree or would that not be enough.
3) At last increase my endo wanted to add some t3 but I wanted to just stay with the levoxyl. I think the same would be prudent if he suggests this time also since there was a jump in t3 this time. Would you agree also.
4) Could you give me the target numbers (not %) based on the ranges above. I'm not sure if I'm doing correct math.
Thanks
COMMUNITY LEADER
If you have a thread of your own going, it would be easier if you keep posting on that one. It's always easier to keep your own comments together so we have all your information in one place and don't have to keep asking you the same questions.
Hi Barb. Should I be posting on this site instead of the other one I've been posting on?
COMMUNITY LEADER
Sorry, had to go get a tooth pulled yesterday, so wasn't online much.
The failure to increase your frees is most likely due to the antibodies continuing to destroy natural thyroid hormone production. You're taking the med correctly, so that isn't an issue.
There is no common dosage for when you level out. It just depends on what your body needs. For instance, I'm on 100 mcg Levoxyl and 10 mcg T3, but there are many others, about my size, who may be on much less, or more, T4 and either no T3 or maybe more T3 than I'm on. We've seen people on as much as 300-350 mcg of T4.
You have a long way to go yet as far as T4 med is concerned and your FT levels seems to track up equally, so I'd suggest you stay on that for a while, but there are other things that can be done to improve your symptoms.
As for your symptoms, are you still having the constipation/bloating, anxiety and joint pain? For the constipation/bloating, I must suggest a probiotic and digestive enzymes. Those seem to help me more than most other things, including laxatives. Of course, make sure you eat plenty of fiber (veggies, whole grains, etc) and avoid those things that tend to constipate (dairy, in my case). Exercise also helps.
Taking B vitamins can help with anxiety. Magnesium can help with the joint pain; it might also help with the anxiety. Calcium can also help with anxiety as it tends to have a calming effect.
Since you seem to be having trouble getting your thyroid levels up, you might ask your doctor to check vitamin D and ferritin. I've read that vitamin D is necessary for the proper metabolism of thyroid hormones, those that seems to be controversial. Ferritin is an iron storage hormone and seems to be most useful in the conversion of FT4 to FT3. With your FT4 at (almost) the mid point, you can use the conversion help. Selenium has also been shown to be helpful in the conversion of FT4 to FT3.
While most multi-vitamins contain these vitamins/mineral, they don't contain therapeutic doses. I find it easier to take them individually. In the case of vitamin D and ferritin, I recommend getting tested prior to supplementing.
All vitamins/minerals should be taken at least 4 hours from any thyroid hormone medications. Since you're taking your thyroid med in the morning, you could take some vitamins/minerals with lunch, some with dinner and some at bed time... yeah, I know - seems like a lot of pills to be popping every day.
The failure to increase your frees is most likely due to the antibodies continuing to destroy natural thyroid hormone production. You're taking the med correctly, so that isn't an issue.
There is no common dosage for when you level out. It just depends on what your body needs. For instance, I'm on 100 mcg Levoxyl and 10 mcg T3, but there are many others, about my size, who may be on much less, or more, T4 and either no T3 or maybe more T3 than I'm on. We've seen people on as much as 300-350 mcg of T4.
You have a long way to go yet as far as T4 med is concerned and your FT levels seems to track up equally, so I'd suggest you stay on that for a while, but there are other things that can be done to improve your symptoms.
As for your symptoms, are you still having the constipation/bloating, anxiety and joint pain? For the constipation/bloating, I must suggest a probiotic and digestive enzymes. Those seem to help me more than most other things, including laxatives. Of course, make sure you eat plenty of fiber (veggies, whole grains, etc) and avoid those things that tend to constipate (dairy, in my case). Exercise also helps.
Taking B vitamins can help with anxiety. Magnesium can help with the joint pain; it might also help with the anxiety. Calcium can also help with anxiety as it tends to have a calming effect.
Since you seem to be having trouble getting your thyroid levels up, you might ask your doctor to check vitamin D and ferritin. I've read that vitamin D is necessary for the proper metabolism of thyroid hormones, those that seems to be controversial. Ferritin is an iron storage hormone and seems to be most useful in the conversion of FT4 to FT3. With your FT4 at (almost) the mid point, you can use the conversion help. Selenium has also been shown to be helpful in the conversion of FT4 to FT3.
While most multi-vitamins contain these vitamins/mineral, they don't contain therapeutic doses. I find it easier to take them individually. In the case of vitamin D and ferritin, I recommend getting tested prior to supplementing.
All vitamins/minerals should be taken at least 4 hours from any thyroid hormone medications. Since you're taking your thyroid med in the morning, you could take some vitamins/minerals with lunch, some with dinner and some at bed time... yeah, I know - seems like a lot of pills to be popping every day.
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