Need Advice Please

[hms123]

I have been having symptoms of excessive sleeping & napping (over 12 hrs) and still feeling tired, fatigue, feeling very cold, tingling in hands & arms, forgetfulness, brain fog, dry eyes, exercise intolerance, diminished strength, etc.  My husband sent me to the dr.  My TSH was 4.54 (range .450 - 4.500) and T4, FREE(DIRECT) 1.12 (range 0.82 - 1.77).  My Dr. didn't think meds would help me feel better but prescribed synthroid .50 and said I could try it and see if it helps me feel better since my T4 is in the normal range and TSH is barely above the normal range.  I've read that if synthroid helps people with labs like mine feel better, a placebo pill would work just as good.  Is this true?  Should I try the meds?  Thanks, I just want to feel better.  

[hms123]

I wanted to add a follow-up in case anybody is going through a similar situation.  I decided to try the synthroid 0.50 and after a week feel dramatic improvement!  These symptoms are gone: tiredness, fatigue, feeling very cold, tingling in hands & arms, forgetfulness, brain fog, dry eyes, exercise intolerance, diminished strength.  I feel like I'm 20 instead of 80.  Praise the Lord!  If anyone with sub-clinical hypothyroidism is symptomatic and wondering if synthroid might help, please try it.  It has helped me tremendously and I pray it will do the same for you.

[hms123]

Thanks so much for your help.  :o)

[gimel]

If you can arrange for the testing, I think I would want to know the FT3 level before starting medication.  That gives you a good baseline of test results for when you were not feeling so good.  By the way, always get a copy of your lab test results and keep it for reference.  The doctor is required to provide a copy upon your request.

[hms123]

Thank you, you've all been so helpful.  Do you recommend having my FREE T3 levels along with repeat FREE T4 and TSH BEFORE OR AFTER starting on synthroid since the medication may alter my true levels???

[Barb135]

Your FT4 is pretty low in the range and I agree with gimel that you might have a conversion issue (converting T4 to T3); I had that happen to me also because my pcp refused to test FT3.  I ended up finding a lab that would do the tests without a doctor's order, just prior to my first appt with my endo, so I was able to take the lab report with me.  That was enough for him to prescribe a T3 med, and though it's taken a good year, I'm doing well.  

[gimel]

I went for years without treatment because my TSH was in the "normal" range, at 4.97 and T4 was within range as well.  It took me a long time to get a doctor to treat my symptoms with a therapeutic trial of Synthroid.  When I got my dosage adjusted properly, it made a huge difference in my energy level, metabolism, etc.  I took enough Synthroid that my T4 tests were all at the high end of the range, yet I continued to have lingering hypo symptoms.  Only after joining this Forum and finding out about the importance of FT3, and getting tested, did I find that my body was not converting T4 to T3 adequately, resulting in a FT3 that was low in the range.  Since getting my meds changed to include some T3, and now getting my levels properly adjusted, I feel best ever.

It's unfortunate that doctors use TSH as a diagnostic by which to determine medication and dosage, when it does not correlate well at all with hypo symptoms.  The very best correlation with hypo symptoms is with the most active thyroid hormone, FT3.  FT3 is four times as active as FT4, so you really need to be sure of your FT3 level.  In addition, the ranges for FT3 and FT4 are far too broad, because they have never been purged of suspect hypo patient data, like was done for TSH 7 years ago.  This drastically reduced the range for TSH from .5 - 5.0 down to .3 - 3.0.  

If the ranges for FT3 and FT4 were similarly corrected, by my calculations the result would be that the top half of the current ranges would essentially become the new "normal" range.  I believe this is why we hear from so many members here that continue to have lingering hypo symptoms until their FT3 is adjusted into the upper part of its current range and FT4 is adjusted to at least midpoint of its current range.

Along this line I think you will find this link to be of interest.

http://www.hormonerestoration.com/Thyroid.html

  

[Lori575]

It seems you are experiencing hypo symptoms, even if you are not far out of the range.  You have to go by how you feel, everyone is different as far as how they feel at different T4/T3 levels, etc.  I'm not sure what contradicting information you have heard, but if you are hypo, you need a medication to even out the levels, plain and simple.  I will say that it sometimes takes some tweaking of medication levels/brands to get you to your optimum level, but clearly you are not there.  Many of the symptoms you are having are not normal aging process symptoms.  I'd take the medication .....I have to agree with the doctor....don't believe everything you hear out there.

[hms123]

Thanks for your response.  I hope you've found the help you needed for your years of tiredness.  I'd love to hear what you've figured out helps you feel better.  No, I haven't started taking the medication because there is so much contradicting information out there.  Maybe I should have my labs rechecked first.  No, a Free T3 test wasn't done.  I'm confused, why it needs to be done if my free T4 was normal.  I read and understand what I'm reading but later forget or get confused about it all.  Do you think the medication would help me feel better since my FREE T4 of 1.12 (range is 0.82-1.77) is already in the normal range but TSH is only slightly elevated 4.54 (range 0.45-4.50); or are my symptoms normal signs of aging; I'm almost 39?  My M.D. doesn't think the medication will help me feel better though the med may bring my TSH in the normal range.  Is there anyone out there who has had a slightly elevated TSH and normal FREE T4 who has been helped by synthroid (more energy, clearer thinking, etc.)?    

[redheadaussie]

Hi there. Sorry you feel so lousy. I empathise, as I have had years of tiredness like you.
Just going on your TSH I would say you are hypo. The range at 4.50 and you just being over it is a misleading diagnosis of 'normal'   If I was at 4.54 I would be in bed 24/7, I am useless when I get to 2.00! Did they do a Free T3 test as well, as this will show what is going on in a broader picture.
  How long have you been taking the dose? It can take up to 6 weeks for any effect to be noticed. You many need more.
  Sadly a placebo will not work for thyroid levels. Be nice if it did!