Still completely heat intolerant after Tapazole made me hypothyroid?

[youngandold]

Hi everyone

I was diagnosed "mild" T3 hyperthyroidism
I was prescribed Tapazole 20 mg/day.
Recent tests shows now I'm HYPOthyroid from the Tapazole. So the endo will likely reduce the dose on the next appointment.

Why I'm still completely heat intolerant?
Could it be something else beside hyperthyroidism? Maybe a Pheochromocytoma? Besides heat intolerance I still have some high blood pressure and tachycardia although not as bad as before Tapazole treatment.

Blood tests

2/10/2015
TSH   2.67uIU/ml (0.27-4.20) --- NORMAL
Free T3   5.09 pg/ml (2.0-4.4) --- HIGH
Free T4   1.25 ng/dl (0.93-1.7) --- NORMAL
Negative antinuclear antibodies.

Began 20mg/day Tapazole treatment on 2/28/2015

4/9/2015
TSH   5.09 uIU/ml (0.27-4.20) --- HIGH
Free T3   4.75 pg/ml (2.0-4.4) --- A BIT HIGH
Free T4   0.93 ng/dl (0.93-1.7) --- BORDERLINE LOW

Endo kept me on 20 mg Tapazole

5/13/2015
TSH   86.99 uIU/ml (0.27-4.20) --- VERY HIGH
Free T3   2.32 pg/ml (2.0-4.4) --- LOW NORMAL
Free T4   0.28 ng/dl (0.93-1.7) --- LOW

Thanks a lot for your help.

[gimel]

Clearly now your Free T4 and Free T3 are too low.  So seems to me it would be a good idea to get off the Tapazole, and find out about your ferritin level to see if that could have been causing pooling of T3 in your blood.  If that was the case, the diagnosis of mild T3 hyperthyroidism, which I have never heard of before with serum levels like yours, and symptoms that can be either hyper or hypo,was not correct.  Ferritin for women needs to be at least 60.  If ferritin testing shows okay, then you should get a diurnal saliva cortisol test (4 tests over 24 hours).  That will show if your cortisol is too high or too low, each of which can also cause pooling of T3.  

What problems were caused by the oral iron supplements?

[youngandold]

Because of my symptoms.

Lifelong thin build despite good appetite.
Lifelong heavy sweating even during not too hot weather to the point of drenching clothes.
Recent (3 years) Nasty high blood pressure only properly controlled by Atenolol or Propranolol.
Fine hand tremor.
Recent easily irritated and itchy eyes.
A bit of a staring look. So I've been told.

So the endo decided I had too many hyperthyroid and virtually no hypothyroid symptoms so he decided to give Tapazole a try.

It worked a bit.
Now my blood pressure is almost completely controlled by milder BP meds like Enalapril and Lisinopril. As compared to Atenolol up to 200 mg/day when BP was worse.
After 3 or 4 years of insanely high BP and sweating, now sometimes I feel fine after waking up only to feel hot again in the afternoon.

I'm trying to determine what else triggers that heat intolerance.
I've switched from Enalapril to the previously prescribed Lisinopril.
I even stopped taking vitamins or supplements.

Thank you for your advice on Ferritin.
Actually I was diagnosed anemia and low Iron before the 'T3 hyperthyroidism'.
I was injected IV iron as I couldn't take oral Iron supplements.

Now that you mention it I will get checked for Iron again.
No follow up blood tests were made to see if Iron was properly replenished, fell short or if it was even excessive (iron overload).

Thank you so very much for your reply.

[gimel]

I have a hard time understanding why you would have been diagnosed as having "mild" T3 hyperthyroidism, from those lab results, including a negative ANA result.  What symptoms were you having at that time?

Also, interestingly, heat intolerance is not limited to hyperthyroidism.  Note this section of a very long list of hypothyroid symptoms.

Body Temperature:

    Cold extremities
    Cold sweats
    Night sweats
    Heat intolerance
    Cold intolerance
    Internal shivering
    Hypothermia
    Cold hands
    Clammy palms
    Cold feet
    Excessive perspiration
    Little perspiration
    Low basal body temperature (below 97.8 degrees Fahrenheit)

Also, this section from same source.

Heart:

    High blood pressure
    Low blood pressure
    Slow/weak pulse (under 60 bpm)
    Fast pulse (over 90 bpm at rest)
    Arrhythmia (irregular heartbeat)
    Skipped beats
    Heart flutters
    Heart palpitations
    Chest pain
    High cholesterol
    High triglycerides
    High LDL (“bad”) cholesterol
    Mitral Valve Prolapse
    Atherosclerosis
    Coronary Artery Disease
    Elevated C-Reactive Protein
    Fibrillations
    Plaque buildup
    Fluid retention
    Poor circulation
    Enlarged heart
    Congestive Heart Failure
    Stroke
    Heart Attack
  
To me, having the high Free T3 result, with normal TSH and Free T4, does not indicate hyperthyroidism as much as the possibility of T3 pooling in your blood, rather than being transported into the cells.  This is reported to be caused by low or high cortisol, or low ferritin.  Have you had a ferritin test?  I didn't ask about cortisol because serum cortisol tests are not very revealing anyway.