Aa
Please help with labs
I have Hashimoto's and am hypothyroid.
I have been taking Tirosint 100 and Cytomel 10 for about four weeks and just had my labs done this past Saturday. Dr. just called and thinks we should cut back on meds. I asked if we could wait until I see him on Monday. I still have many hypothyroid symptoms and feel so upset about this. Please help.
Labs taken this past Saturday November 5, 2011
test result range
TSH 0.06 0.40-4.00
FT4 1.0 0.6-1.6
FT3 3.4 210-440
I have been taking Tirosint 100 and Cytomel 10 for about four weeks and just had my labs done this past Saturday. Dr. just called and thinks we should cut back on meds. I asked if we could wait until I see him on Monday. I still have many hypothyroid symptoms and feel so upset about this. Please help.
Labs taken this past Saturday November 5, 2011
test result range
TSH 0.06 0.40-4.00
FT4 1.0 0.6-1.6
FT3 3.4 210-440
COMMUNITY LEADER
Sounds like your doctor is another "keeper", for the simple fact that he was willing to listen and accept the literature you took him. I do hope he will take time to read and absorb it.
I totally agree with goolarra. I would resist any changes at all right now. Your labs are relatively good, but you still have room for improvement, plus you've only been on the combination for a short time, so I think you need to give your body time to heal and get used to the med.
When I started taking cytomel, I didn't get a big "feel good rush" right away, and I still don't on a daily basis. I had been on it for several months before I actually started feeling "well" and over a year before most of my symptoms were gone. Even though many people (mostly those who don't have it) don't think being hypo is a big deal, it is -- you've been ill, and like any illness it takes time to get well. I've been on T3 med for 2 yrs, and even today, it seems that it "builds" gradually as the day goes on - I don't get an immediate reaction from it.
I totally agree with goolarra. I would resist any changes at all right now. Your labs are relatively good, but you still have room for improvement, plus you've only been on the combination for a short time, so I think you need to give your body time to heal and get used to the med.
When I started taking cytomel, I didn't get a big "feel good rush" right away, and I still don't on a daily basis. I had been on it for several months before I actually started feeling "well" and over a year before most of my symptoms were gone. Even though many people (mostly those who don't have it) don't think being hypo is a big deal, it is -- you've been ill, and like any illness it takes time to get well. I've been on T3 med for 2 yrs, and even today, it seems that it "builds" gradually as the day goes on - I don't get an immediate reaction from it.
Thanks goolarra!
I'm hoping he doesn't change anything too.
He took a close look at my symptoms list and talked to me about a few of them. I also think he'll read some of the articles or at least the highlighted parts.
I talked to him about the correlation between my increased FT3 levels my improved symptoms and and the possibility that I'm a poor converter. He said that's possible. I pointed him to my labs from December 2010 where my FT3 was below range while other numbers where in range and that I had a lot of symptoms then too.
I'm hoping he doesn't change anything too.
He took a close look at my symptoms list and talked to me about a few of them. I also think he'll read some of the articles or at least the highlighted parts.
I talked to him about the correlation between my increased FT3 levels my improved symptoms and and the possibility that I'm a poor converter. He said that's possible. I pointed him to my labs from December 2010 where my FT3 was below range while other numbers where in range and that I had a lot of symptoms then too.
I hate to throw another option into the mix, but here goes. Of course, any meds change decision will have to be made after seeing your next labs, but I wouldn't expect your TSH to go up much To tell you the absolute truth, "I" wouldn't lower either if I were you. Your current FT4 is a little on the low side. FT3 isn't too bad (it's upper half of range), but there's certainly plenty of room there for it to go up. I think your doctor has to stop being so concerned with your TSH. FT3, FT4 and symptoms are much more important than TSH, and all those are looking pretty good, but have plenty of room for improvement.
Thank you all for your help and support!
My doctor is willing to keep me on Tirosint 100 and Cytomel 10 for another six weeks and retest.
He also took all the literature I gave him about T3 suppressing TSH and took a close look at my very long symptoms list which I divided into sections: no improvement, improvement and no longer a symptom.
I asked what we can do if TSH is still supressed and he said we can lower Tirosint to 88 and add an additional Cytomel 5 (for a total of 15).
Would it make more sense to do that or to leave Tirosint at 100 and lower Cytomel to 7.5 or to 5?
My doctor is willing to keep me on Tirosint 100 and Cytomel 10 for another six weeks and retest.
He also took all the literature I gave him about T3 suppressing TSH and took a close look at my very long symptoms list which I divided into sections: no improvement, improvement and no longer a symptom.
I asked what we can do if TSH is still supressed and he said we can lower Tirosint to 88 and add an additional Cytomel 5 (for a total of 15).
Would it make more sense to do that or to leave Tirosint at 100 and lower Cytomel to 7.5 or to 5?
I have Hashi's like sissaphus (that's an autoimmune disease characterized by elevated TPOab and/or TGab), and I was gluten free for about a year for reasons other than thyroid. Like LazyMoose, i saw no improvement in antibodies, labs or symptoms.
I agree that scientific proof is in order...perhaps you could post your antibody tests from before and after goint g/f?
I agree that scientific proof is in order...perhaps you could post your antibody tests from before and after goint g/f?
Per your profile, your comment was posted the same word for word three times to three different people, one was in the thyroid 'Dr' forum. And you joined this forum this month.
Your comments do look similar to past money making intentions posted here.
This is not really the intent of Med Help.
By the way, I went gluten free at one point in my life, it did nothing for my hashimoto symptomatically, physically or lab-wise.
Best wishes.
Your comments do look similar to past money making intentions posted here.
This is not really the intent of Med Help.
By the way, I went gluten free at one point in my life, it did nothing for my hashimoto symptomatically, physically or lab-wise.
Best wishes.
"The interesting thing about thyroid problems is this: they are mostly caused by an autoimmune disorder; your own immune system starts destroying your thyroid. I know, it sounds weird and unlikely and probably your doc didn't tell you this"
What???
I know I have an autoimmune disorder that's causing my hypothyroidism. The doctor did tell me this. I said so at the beginning.
I've also been had a complete gluten serum workup done. I've also eaten enough brazil nuts to get my selenium way above the upper range.
I won't be messaging you.
Some of us are suffering here and trying to help each other find answers and get proper help. Not sell it.
Obviously, I'm sorry if I'm wrong about your motive.
What???
I know I have an autoimmune disorder that's causing my hypothyroidism. The doctor did tell me this. I said so at the beginning.
I've also been had a complete gluten serum workup done. I've also eaten enough brazil nuts to get my selenium way above the upper range.
I won't be messaging you.
Some of us are suffering here and trying to help each other find answers and get proper help. Not sell it.
Obviously, I'm sorry if I'm wrong about your motive.
The post from molonese sounds very much like the approach recommended by a book that we have previously discussed and dissected. There was no scientific proof that dietary changes and supplements can eliminate Hashimoto's. There are some supplements that have been shown to have a beneficial effect in reducing the level of the thyroid antibodies, but not eliminate them.
Most of what was being proposed previously involved extensive testing related to antibodies. A large part of the approach was based on going gluten free, on the unproven basis that gluten causes the autoimmune system to produce thyroid antibodies. It was never specified as to how that related to there being two different thyroid antibodies. TPO ab and TG ab. The proposed treatment also included special supplements that were only obtained through the author of the book. It was very easy to get the impression that the main object of the whole thing was money for the practitioners, most of whom seemed to be chiropractors, rather than medical doctors.
Sorry, but unless some conclusive scientific data are presented, count me as continuing to be skeptical.
Most of what was being proposed previously involved extensive testing related to antibodies. A large part of the approach was based on going gluten free, on the unproven basis that gluten causes the autoimmune system to produce thyroid antibodies. It was never specified as to how that related to there being two different thyroid antibodies. TPO ab and TG ab. The proposed treatment also included special supplements that were only obtained through the author of the book. It was very easy to get the impression that the main object of the whole thing was money for the practitioners, most of whom seemed to be chiropractors, rather than medical doctors.
Sorry, but unless some conclusive scientific data are presented, count me as continuing to be skeptical.
Hi Sissaphus,
Just saw your post. If you are interested in an alternative point of view, here is one: some people experience big thyroid improvements by changing their diet. I had Hashimoto's (hypothyroidism) for years and came out clear. The interesting thing about thyroid problems is this: they are mostly caused by an autoimmune disorder; your own immune system starts destroying your thyroid. I know, it sounds weird and unlikely and probably your doc didn't tell you this. Google it and you see what you find :-)
Yes, TSH, Free T3, Total T3, Free T4 are important but you also need to measure your anti-thyroid antibodies (TPO and TGB) to see how severe is the inflammation of your immune system. This is the core root of your problem. Hashimoto's is an autoimmune disorder. I know, docs don't tell you that...
Many people who change their diets experience an improved immune system and then the thyroid gets better. This is what I experienced and my life changed.
Message me if you want to know more.
Magdalena.
Just saw your post. If you are interested in an alternative point of view, here is one: some people experience big thyroid improvements by changing their diet. I had Hashimoto's (hypothyroidism) for years and came out clear. The interesting thing about thyroid problems is this: they are mostly caused by an autoimmune disorder; your own immune system starts destroying your thyroid. I know, it sounds weird and unlikely and probably your doc didn't tell you this. Google it and you see what you find :-)
Yes, TSH, Free T3, Total T3, Free T4 are important but you also need to measure your anti-thyroid antibodies (TPO and TGB) to see how severe is the inflammation of your immune system. This is the core root of your problem. Hashimoto's is an autoimmune disorder. I know, docs don't tell you that...
Many people who change their diets experience an improved immune system and then the thyroid gets better. This is what I experienced and my life changed.
Message me if you want to know more.
Magdalena.
Yes, have been on Cytomel 10 for a little over four weeks. Started on 2.5 and increased to 10 over a six or seven week period.
What I meant about hyper symptoms is that I had hair loss, muscle weakness and exercise intolerance before Cytomel, but since being on Cytomel I think my hair loss and muscle weekness have improved, but not intolerance to exercise. That hasn't improved. I think these are all hypo symptoms too. So I don't have any symptoms that are unique to hyper.
I really hope he'll leave my treatment alone for now and give it more time. Before this bad news I was hoping he'd increase my Cytomel by 5mcg because I'm badly constipated, have brain fog and 20lbs recent weight gain.
If he doesn't leave it alone. I'm going to ignore him, but I really don't want to resort to that since I'll only have a few months supply and do see a value in testing too. It was disappointing to hear "if you have any symptoms they are not due to hypothyroid at this point"
What I meant about hyper symptoms is that I had hair loss, muscle weakness and exercise intolerance before Cytomel, but since being on Cytomel I think my hair loss and muscle weekness have improved, but not intolerance to exercise. That hasn't improved. I think these are all hypo symptoms too. So I don't have any symptoms that are unique to hyper.
I really hope he'll leave my treatment alone for now and give it more time. Before this bad news I was hoping he'd increase my Cytomel by 5mcg because I'm badly constipated, have brain fog and 20lbs recent weight gain.
If he doesn't leave it alone. I'm going to ignore him, but I really don't want to resort to that since I'll only have a few months supply and do see a value in testing too. It was disappointing to hear "if you have any symptoms they are not due to hypothyroid at this point"
Your post say you've been on cytomel 10 for only 4 weeks?
If that is true, and your body seems to like this brand of T3 (if there was intolerance you would know by now), in more time, symptoms should still decrease.
Adding T3 shocks your body for a while at first. In my opinion for those that need T3, it seems to take on a physical healing process, that takes time, depending on how long you were hypo. Increasing tolerance to exercise is a prime example, this takes months - even a year or more if you have problem areas - muscles, tendons ect..
If you are not experiencing any negative symptoms to this dose (hyper), and feel less hypo than before, well, then your on the right track.
If that is true, and your body seems to like this brand of T3 (if there was intolerance you would know by now), in more time, symptoms should still decrease.
Adding T3 shocks your body for a while at first. In my opinion for those that need T3, it seems to take on a physical healing process, that takes time, depending on how long you were hypo. Increasing tolerance to exercise is a prime example, this takes months - even a year or more if you have problem areas - muscles, tendons ect..
If you are not experiencing any negative symptoms to this dose (hyper), and feel less hypo than before, well, then your on the right track.
Thanks LazyMoose,
I'll follow your plan. The only hyperthyroid symptoms I have/had are hair loss, intolerance to exercise and muscle weakness. These except intolerance to exercise are pre the addition of Cytomel.
So, you think I'll get better on the same dose and my FT3 will continue increasing?
Thanks again
I'll follow your plan. The only hyperthyroid symptoms I have/had are hair loss, intolerance to exercise and muscle weakness. These except intolerance to exercise are pre the addition of Cytomel.
So, you think I'll get better on the same dose and my FT3 will continue increasing?
Thanks again
Yes, seems like all docs I have met would decrease your med per the TSH.
Your situation is similar to what mine was yesterday, however, it looks like you have only been on this combo of med for a short time period? You need to get across to the Dr what hypo symptoms have decreased. And make sure he understands if you lack hyper symptoms, you are not hyper. Look at my opening line to my Dr visit in my post and tailor it to your situation.
If you truly have only been on this combo of meds for a short time and seen some improvement, chances are it will get better in more time on the same dose.
Your situation is similar to what mine was yesterday, however, it looks like you have only been on this combo of med for a short time period? You need to get across to the Dr what hypo symptoms have decreased. And make sure he understands if you lack hyper symptoms, you are not hyper. Look at my opening line to my Dr visit in my post and tailor it to your situation.
If you truly have only been on this combo of meds for a short time and seen some improvement, chances are it will get better in more time on the same dose.
Should he be lowering my T4 and increasing T3? I think he might be willing to do that if I approach him from that angle. My T4 has only been in mid range when I have been on 112 mcg T4 medication, but 112 mcg also supresses my TSH. My FT3 has never been any where near the top 1/3 of the range and has sometimes not even been in range. It's been too low.
I am quite sad and stressed.
I am quite sad and stressed.
Thank you for your reply. I was hoping you'd see this.
That's right. He's going on TSH. I'm so sad. I thought I was going to tell him about my continues symptoms and that he'd help me. He said my symptoms aren't due to my thyroid at this point. I'm sad I'm actually crying.
I think he would be very good about accepting research. I was just looking at LazyMoose's post for tips on how to handle this. I found two studies that Gimel posted and was going to bring "The Thyroid Solution" by Ridha Arem with me.
It was a beautiful day and my apartment was 77 degrees and I was cold. I don't have a bowel movement for days at a time and when I do it's difficult. I have gained almost 20 lbs in a few months. I still have so many hypo symptoms, but things - mostly energy and depression recently improved. I believe because my FT3 levels have improved.
Pleas if you have any research you can post or email me, I'll be happy to have them.
I did resist and he's willing to let me stay on my current dose until I see him this coming Monday, but I only have two more refills on Cytomel. My T3 isn't even where it should be yet. I thought he was going to reduce my T4 meds and increase T3 or something. I was afraid this would happen and sad that it has.
That's right. He's going on TSH. I'm so sad. I thought I was going to tell him about my continues symptoms and that he'd help me. He said my symptoms aren't due to my thyroid at this point. I'm sad I'm actually crying.
I think he would be very good about accepting research. I was just looking at LazyMoose's post for tips on how to handle this. I found two studies that Gimel posted and was going to bring "The Thyroid Solution" by Ridha Arem with me.
It was a beautiful day and my apartment was 77 degrees and I was cold. I don't have a bowel movement for days at a time and when I do it's difficult. I have gained almost 20 lbs in a few months. I still have so many hypo symptoms, but things - mostly energy and depression recently improved. I believe because my FT3 levels have improved.
Pleas if you have any research you can post or email me, I'll be happy to have them.
I did resist and he's willing to let me stay on my current dose until I see him this coming Monday, but I only have two more refills on Cytomel. My T3 isn't even where it should be yet. I thought he was going to reduce my T4 meds and increase T3 or something. I was afraid this would happen and sad that it has.
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I'm going to go out on a limb here and guess that your doctor is reacting to the low TSH. Your FT4 is not even mid range, nor is your FT3 anywhere near the upper 1/3 of its range.
It's very common for those of us on medication (particularly T3 med) to have suppressed TSH -- mine routinely runs at < 0.01, but as long as my FT's are good, my endo doesn't even look at that.
I don't know how your doctor is about accepting research, but you might point this out to him.
If I had levels like yours, and still had hypo symptoms, I'd resist any decision to decrease either med.