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Should my med be adjusted?
I recently switched from levothyroxine to levoxyl. Given my last labs i thought my doctor would possibly lower my T4 med to 75mcg then add cytomel but he said would leave me on the 88mcg and add 5 mcg of cytomel since my ft4 was fine, all we needed was my ft3 to go up a little. Ive been feeling great...symptom free.
The last couple days my hair has been falling out so not sure if its due to switching from levothyroxine to levoxyl. Another thing is that for the first time in a couple years my temp was back up at 97.8* it had been hovering around 96.2 for a long time. I did a good 42 minute workout that morning and started the paleo diet. By the time i went to bed last night my legs were obviously aching but i let it go. Around 2am this morning my heart rate had gone up from 72 to 84, it only lasted for a short time. Is this bad? Can pain increase your heart rate? Was left wondering if i should ask for the 75/10 combo instead of the 88/5 im on now. Reason why i panicked about my heart rate was that I've read that a heart rate above 80 is bad. So not sure if its just my body getting used to the new meds as my heart rate jumping up to 84 is okay.
Here are my labs:
Dec 2014 (88 mcg Levothyroxine)
TSH 0.090 (.36-3.74)
FT3 3.2 (2.18-3.98)
FT4 1.3 (.76-1.46)
Total T3 83 (70-190)
Oct 2014 (88 mcg Levothyroxine)
TSH 0.010 (.36-3.74)
FT3 3.6 (2.18-3.98)
FT4 1.2 (.76-1.46)
The last couple days my hair has been falling out so not sure if its due to switching from levothyroxine to levoxyl. Another thing is that for the first time in a couple years my temp was back up at 97.8* it had been hovering around 96.2 for a long time. I did a good 42 minute workout that morning and started the paleo diet. By the time i went to bed last night my legs were obviously aching but i let it go. Around 2am this morning my heart rate had gone up from 72 to 84, it only lasted for a short time. Is this bad? Can pain increase your heart rate? Was left wondering if i should ask for the 75/10 combo instead of the 88/5 im on now. Reason why i panicked about my heart rate was that I've read that a heart rate above 80 is bad. So not sure if its just my body getting used to the new meds as my heart rate jumping up to 84 is okay.
Here are my labs:
Dec 2014 (88 mcg Levothyroxine)
TSH 0.090 (.36-3.74)
FT3 3.2 (2.18-3.98)
FT4 1.3 (.76-1.46)
Total T3 83 (70-190)
Oct 2014 (88 mcg Levothyroxine)
TSH 0.010 (.36-3.74)
FT3 3.6 (2.18-3.98)
FT4 1.2 (.76-1.46)
Best Answer
Thank you! The ranges are exactly what my labs indicated. The december labs were with levothyroxine only. Haven't had labs done with my Levoxyl/cytomel yet.
A factor that i didnt know till recently was that i was diagnosed a few years ago with Bradycardia. I had gone to see a doctor 6 yrs ago wondering if there was a change hypothyroidism was causing bradycardia, she agreed and had labs drawn. Labs all came back within range and she said my bradycardia was mostlikely normal for me so no worries. Haha! I pretty much forgot about this because i figured its not a big deal. BUT recently did my research and it all came back full curcle. Connection is that when my heart rate dips into the 60s my symptoms return. Meaning, if im seriously fatigued, freezing, and brainfog I can bet you my heart rate is low, sure enough it has fallen into the 60s. Good thing now is that the cytomel has corrected this.
I rejected the increase in my T4 med cause i believe its good where its at, i just need a small bump in T3...for now as you said. Haha!
Another awesome thing is that my basal temp is now at 98* (was 96 for YEARS) things are finally looking up. :)
A factor that i didnt know till recently was that i was diagnosed a few years ago with Bradycardia. I had gone to see a doctor 6 yrs ago wondering if there was a change hypothyroidism was causing bradycardia, she agreed and had labs drawn. Labs all came back within range and she said my bradycardia was mostlikely normal for me so no worries. Haha! I pretty much forgot about this because i figured its not a big deal. BUT recently did my research and it all came back full curcle. Connection is that when my heart rate dips into the 60s my symptoms return. Meaning, if im seriously fatigued, freezing, and brainfog I can bet you my heart rate is low, sure enough it has fallen into the 60s. Good thing now is that the cytomel has corrected this.
I rejected the increase in my T4 med cause i believe its good where its at, i just need a small bump in T3...for now as you said. Haha!
Another awesome thing is that my basal temp is now at 98* (was 96 for YEARS) things are finally looking up. :)
There are a few sites that say a pulse of 80 bpm is not healthy which i dont understand. When my pulse was in the 60s i was told (as the sites say as well) that thats a sign of an athletic heart...hows that if i dont exercise (except for yesterday which doesnt really count)?
My experience with my body has been that when symptoms return (hashimotos) it also means my heart rate has dropped alittle. When I'm feeling well its going at a rate which for me is 72-80. For some reason 84 felt much more like my heart was racing or pounding harder....if that makes sense? Since going on levothyroxine palpitations have pretty much disappears except for once or twice (before switching meds) that i felt a single thump out of no where but still no where near what i experienced prior to going on thyroid meds.
My experience with my body has been that when symptoms return (hashimotos) it also means my heart rate has dropped alittle. When I'm feeling well its going at a rate which for me is 72-80. For some reason 84 felt much more like my heart was racing or pounding harder....if that makes sense? Since going on levothyroxine palpitations have pretty much disappears except for once or twice (before switching meds) that i felt a single thump out of no where but still no where near what i experienced prior to going on thyroid meds.
I had to switch to levoxyl cause synthroid and levothyroxine have gluten and lactose, which i had no clue till a couple weeks prior to the switch. Spent lots of money on OTC meds for stomach issues that were easily resolved by just switching meds. Haha!
Now that I'm on levoxyl, it definately works better then levothyroxine to keep my symptoms away. That said, when i switched i avoided the cytomel to get used to the levoxyl just so if i felt anything i knew what was to blame. In that time i noticed the brain fog creeping in and another 1-2 symptoms that it was clear I had to start adding cytomel. I've been on the combo for a week now so it may have been something i did, as you said cause im totally fine now.
My husband is more worried about me now having a heart rate near 80 cause his co-workers told him that's very high and I was at risk for a heart attack. So telling him my heart rate was 84 last night might have led to an ER visit. Haha!
Prior to hypothyroidism unwelcomed visit 2 yrs ago my pulse was 80 bpm. When hypo creeped in is when my pulse dropped to 50 and sometimes 40. When starting the meds it came up to 62, 68, and seldomly 72. Well 72 bpm if I was walking.
I check my pulse just now (cuff and stethoscope) and its 110/80 i just ate 30 minutes ago so not sure if it was too soon to check it.
Now that I'm on levoxyl, it definately works better then levothyroxine to keep my symptoms away. That said, when i switched i avoided the cytomel to get used to the levoxyl just so if i felt anything i knew what was to blame. In that time i noticed the brain fog creeping in and another 1-2 symptoms that it was clear I had to start adding cytomel. I've been on the combo for a week now so it may have been something i did, as you said cause im totally fine now.
My husband is more worried about me now having a heart rate near 80 cause his co-workers told him that's very high and I was at risk for a heart attack. So telling him my heart rate was 84 last night might have led to an ER visit. Haha!
Prior to hypothyroidism unwelcomed visit 2 yrs ago my pulse was 80 bpm. When hypo creeped in is when my pulse dropped to 50 and sometimes 40. When starting the meds it came up to 62, 68, and seldomly 72. Well 72 bpm if I was walking.
I check my pulse just now (cuff and stethoscope) and its 110/80 i just ate 30 minutes ago so not sure if it was too soon to check it.
It is hard to determine what is going on since you have taken 3 or 4 changes almost all at the exact same time:
1) Change in brand of T4
2) Added Cytomel
3) Added a new diet
4) Added workout
So you have no idea which one of those or any particular combination is causing the change.
My concern is that there was a change at all when you are reporting that you were feeling excellent. So why add the cytomel? (by the numbers I don't disagree, but symptoms and how you feel trump the numbers on theblood lab in my opinion.).
As I see it you can pretty easily go back to a single change (the brand of T4) by simply go back to your normal diet and excercise and stop the Cytomel. That is up to you. Then you might be able to determine that it was the brand name change of T4 and the fillers which are giving you the issues.
Another option is to continue and wait this out for a while. As it is not uncommon for symptoms to worsen when starting a new medications/dosage.
But the fact that you felt well to me would tend my to lean towards going bak to the what you were doing before. I might even ask the pharmacy to see if you can go back to the old brand name that was apparently working for you.
Just my 2 cents.
1) Change in brand of T4
2) Added Cytomel
3) Added a new diet
4) Added workout
So you have no idea which one of those or any particular combination is causing the change.
My concern is that there was a change at all when you are reporting that you were feeling excellent. So why add the cytomel? (by the numbers I don't disagree, but symptoms and how you feel trump the numbers on theblood lab in my opinion.).
As I see it you can pretty easily go back to a single change (the brand of T4) by simply go back to your normal diet and excercise and stop the Cytomel. That is up to you. Then you might be able to determine that it was the brand name change of T4 and the fillers which are giving you the issues.
Another option is to continue and wait this out for a while. As it is not uncommon for symptoms to worsen when starting a new medications/dosage.
But the fact that you felt well to me would tend my to lean towards going bak to the what you were doing before. I might even ask the pharmacy to see if you can go back to the old brand name that was apparently working for you.
Just my 2 cents.
Maybe you are getting heart palpitations, which is expected in a suppressed TSH.
You can always ask your doctor to lower your dose. My TSH is undetectable. Doesn't even register to be tested. But my dr. is fine with it as long as I don't show any symptoms or complain. I do at times get the heart palpitations, but nothing scary.
My heart rate has also been above 80 when resting...usually runs 85-90 which is normal for me.
You can always request a dosage adjustment if you are getting symptoms.
You can always ask your doctor to lower your dose. My TSH is undetectable. Doesn't even register to be tested. But my dr. is fine with it as long as I don't show any symptoms or complain. I do at times get the heart palpitations, but nothing scary.
My heart rate has also been above 80 when resting...usually runs 85-90 which is normal for me.
You can always request a dosage adjustment if you are getting symptoms.
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When I excersive I believe my heart rate and it is supposed to be for a 48 year old man to be about 160. Again that is during a full hard work out and NOT a resting heart rate. After swimming regularly for 4 years my resting rate is mid 70's to nearing 80. Granted a man has a heart rate that is normally higher than women.
It is good to know that you seem to be feeling well. And it seems pretty clear that you have determined that you in fact need the cytomel in order to feel better.
If you read her long you know that the rule of thumb or target where most people feel well you have to have BOTH of the following.
1) FT4 to be 50% or a bit more of the range. Your December test result is 62.9% so that would seem plenty. But I'd also like to note that the reference range you list for FT4 is extremely small. So you might want to double check that range.
and
2) FT3 to be in the UPPER half to UPPER 1/3 of the range. So between 50% and 67% of the range. Many or most need it closer to 67%. Your december test result is that your FT3 to be 56.6% of the range. So that would indicate that it is OK but if you are still symptomatic that there is room for some further increase.
So it really comes down to how you feel overall from a symptoms perspective. If you feel fine, then you may be optimized at least for the moment. If you are still showing symptoms of Hypo, than your latest results would indicate that a small bump in cytomel is something you would want to discuss with your Dr. for consideration.