Aa
Still tired and frustrated
So I have been seeing my endo since May 2012. I have Hashimoto. my endo had me on levothyroxine .025 5 days a week and .050 2 days a week. Everything had been going well. Almost all symptoms were relieved until December. I thought that maybe I was feeling exhausted again because of being busy with the holidays but it was actually because the meds had stopped working. My TSH just about tripled in 6 weeks. He switched me to Synthroid and increased my dose to .025 3 days a week and .050 4 days a week. I have been on this dose for 6 weeks now. While I don't have my most recent labs back I can tell you that my symptoms have not approved. I will see my endo next Thursday and get my labs then. I will post them once I have them. My question is...is it normal for meds to just stop working and TSH to triple is 6 weeks? Does anyone have suggestions for combatting the exhaustion?mi am so tired that sometimes I can't even concentrate! It's so frustrating.
I think it's time to unload this guy. My guess is that you aren't going to feel a whole lot better with this change in your meds. Good luck finding a good one...
Yes I am still taking 50x4 and 25x3. He gave me no explanation for lowering the T3 and I have now asked three time for him to test my b12 ever time he says he is going to order it and doesn't! I am so fed up!!!! I am looking for a new endo but there doesn't seem to be many in my area. I found one that I will be calling tomorrow to see if they are taking new clients.
In February I was at a real low with my symptoms to where I was so achy and weak also. Turned out I was low iron, low Ferritin, low hemoglobin, low B12 and low D3. Doc told me to get on those supplements and eat more iron rich foods. He said my thyroid test results were normal, however. But judging by what I'm reading, it doesn't seem completely correct. They were:
T4 FREE CALCULATED - 1.83 (1.43-3.8)
TSH - 2.79 (.40-4.50)
T4 FREE - .9 (.8-1.8)
T3 FREE - 3.2 (2.6-4.2 pg/ml)
Thyroid Peroxidase AB 14 iu/ml (<35)
Anyone's thoughts would be appreciated. But I do have to say that since I have been taking iron with Vitamin C to help absorb it, B12, D3 (and natural progesterone cream between cycles) I am feeling 60% better and functioning better also. I'm curious to see how my thyroid results will be on my follow-up since taking these supplements and natural progesterone. I read that all these things cause thyroid to go down hill. But even though I'm feeling better I still don't have as much umph as I should. Still cold when others aren't - especially feet. Hair still all over bathroom like crazy. Nails aren't as brittle but still ridges. Very oily face but always needing lotion and chap stick for dryness. Still some mental lagging and sleeping ten or twelve hours.
T4 FREE CALCULATED - 1.83 (1.43-3.8)
TSH - 2.79 (.40-4.50)
T4 FREE - .9 (.8-1.8)
T3 FREE - 3.2 (2.6-4.2 pg/ml)
Thyroid Peroxidase AB 14 iu/ml (<35)
Anyone's thoughts would be appreciated. But I do have to say that since I have been taking iron with Vitamin C to help absorb it, B12, D3 (and natural progesterone cream between cycles) I am feeling 60% better and functioning better also. I'm curious to see how my thyroid results will be on my follow-up since taking these supplements and natural progesterone. I read that all these things cause thyroid to go down hill. But even though I'm feeling better I still don't have as much umph as I should. Still cold when others aren't - especially feet. Hair still all over bathroom like crazy. Nails aren't as brittle but still ridges. Very oily face but always needing lotion and chap stick for dryness. Still some mental lagging and sleeping ten or twelve hours.
If your endo decreased either of your meds, then he's looking at TSH and nothing else. In my opinion, he should not have decreased your meds at all.
Your FT4 is on the low side. Are you still taking 50X4 and 25X3?
FT3 is BELOW range, and he lowered your T3 from 10 mcg per day to 5? Did he explain the change in any way?
What about B-12? Has that ever been tested yet?
I think you might consider doctor shopping.
Your FT4 is on the low side. Are you still taking 50X4 and 25X3?
FT3 is BELOW range, and he lowered your T3 from 10 mcg per day to 5? Did he explain the change in any way?
What about B-12? Has that ever been tested yet?
I think you might consider doctor shopping.
Oh I forgot, my endo said my TSH is fine. He did not change my dose of levothyroxine but did decrease my T3 meds from two 5 mcg pills twice a day to one 5 mcg pill twice a day.
Ok new labs are in. Still feeling like crap and SUPER cranky! Legs hurt, arms hurt, feet hurt, just everything hurts! Extreme exhaustion! Any additional suggestions?
TSH 0.14 (0.45 - 4.0)
Free T3 1.93 (2.0- 4.8)
Free T4 1.0 (0.8-1.7)
See above posts for reference to prior labs.
TSH 0.14 (0.45 - 4.0)
Free T3 1.93 (2.0- 4.8)
Free T4 1.0 (0.8-1.7)
See above posts for reference to prior labs.
My vitamin D was low last time so he had me increase my dose from 2,000 to 4,000 daily. I am sure he will be testing it again in June.
As long as you're at it, ask for vitamin D as well. I always ask the phlebotomist what they're testing when I go to have my blood drawn just in case they "forgot" to order something.
No I had asked for those to be tested last time but they "forgot" to order them. They will be tested next time he says.
Don't hesitate to try to see him earlier. If he can't do that, perhaps he'd call in a new script for you in the meantime.
Forgive me if I repeat myself, but have you had vitamin B-12 tested? How about iron/ferritin?
Forgive me if I repeat myself, but have you had vitamin B-12 tested? How about iron/ferritin?
I have not added any new meds nor have I changed how I take my Levo. I am at a complete loss. I really am fed up with the complete and utter exhaustion. Today it felt as though my arms where 100 pounds each every time I moved them. So frustrating! I don't see my endo again until June 18. I'm not sure I'm going to last that long with the symptoms.
The labs seem totally out of whack/balance. Just about the opposite ratio is what is generally needed to feel well.
This is only my opinion. But you are on a roller coaster of hell. Mostly medicine induced.
In my opinion, you are on far too little T4 and on far too much T3. Your body is generally Hypo but you force yourself into short bursts of hyper by the larger doses of short lived T3. You ramp up with the T3 and come crashing down after it is used up.
Your body may be sensing the T3 available and that is what is keeping your T4 levels down as your pituitary is sensing plenty of T3 available.
But since the T3 is so short lived your pituitary can't react that quickly.
In the end I would recommend significantly reducing the T3 dosage and increase the T4 dosage. The actual dosage amounts should be worked out with your Dr.
The general or more common approach to medicating low thyroid is to start with only a T4 medication. And increase dosage slowly. When the FT4 gets to about 50% of the range and your FT3 are still below about 66%, THEN the addition of T3 is added. Again in low dosages and slow increments.
This common process is about exactly the opposite of your history as best I can determine by quickly scanning the long thread history. And the result is a balance of T4 to T3 that is about exactly opposite of what most people seem to feel well at.
This is only my opinion. But you are on a roller coaster of hell. Mostly medicine induced.
In my opinion, you are on far too little T4 and on far too much T3. Your body is generally Hypo but you force yourself into short bursts of hyper by the larger doses of short lived T3. You ramp up with the T3 and come crashing down after it is used up.
Your body may be sensing the T3 available and that is what is keeping your T4 levels down as your pituitary is sensing plenty of T3 available.
But since the T3 is so short lived your pituitary can't react that quickly.
In the end I would recommend significantly reducing the T3 dosage and increase the T4 dosage. The actual dosage amounts should be worked out with your Dr.
The general or more common approach to medicating low thyroid is to start with only a T4 medication. And increase dosage slowly. When the FT4 gets to about 50% of the range and your FT3 are still below about 66%, THEN the addition of T3 is added. Again in low dosages and slow increments.
This common process is about exactly the opposite of your history as best I can determine by quickly scanning the long thread history. And the result is a balance of T4 to T3 that is about exactly opposite of what most people seem to feel well at.
I have to say that I'm at a bit of a loss. With no change in your T4 meds, only adding in the 20 mcg of T3, your FT4 tumbled just a little under half of range. Your FT3 went up a lot, but that's to be expected with the addition of 20 mcg of T3 meds. FT3 is the test that correlates best with symptoms, so you really shouldn't be feeling hypo, except that the balance of FT3 to FT4 has to be right. Yours is way out of balance, with FT4 flat on the bottom of the range and FT3 over the top.
My first question would be about absorption. Is there anything at all different in the way you take your levo? Have you added any other meds or supplements since 2/21 that could be blocking absorption?
My next thought is that your Hashi's is suddenly going like gangbusters, and you are losing thyroid function fast. This frequently happens: the thyroid doesn't decline on a nice, even slope, but dies off in fits and starts. Your levo dose has been pretty low. 200X4 and 25X3 averages out to only 39 mcg per day. That's nowhere near total replacement.
If I were you, I think I'd be asking my doctor to increase T4 meds. You'll probably have to decrease T3 at the same time or you will start feeling hyper since TT3 is already over the top. Given the different characteristics of the two drugs (it takes T4 a while to build in your blood when you increase, but the effect of decreasing T3 is much more immediate), you might want to start the increased T4 a week or so before cutting the T3 down.
My first question would be about absorption. Is there anything at all different in the way you take your levo? Have you added any other meds or supplements since 2/21 that could be blocking absorption?
My next thought is that your Hashi's is suddenly going like gangbusters, and you are losing thyroid function fast. This frequently happens: the thyroid doesn't decline on a nice, even slope, but dies off in fits and starts. Your levo dose has been pretty low. 200X4 and 25X3 averages out to only 39 mcg per day. That's nowhere near total replacement.
If I were you, I think I'd be asking my doctor to increase T4 meds. You'll probably have to decrease T3 at the same time or you will start feeling hyper since TT3 is already over the top. Given the different characteristics of the two drugs (it takes T4 a while to build in your blood when you increase, but the effect of decreasing T3 is much more immediate), you might want to start the increased T4 a week or so before cutting the T3 down.
The only med change on 2/21 was the addition of the T3 medication. Prior to this i was only on the levo. There was no change to my Levo dosage. You are correct about my dosing. Yes I split the 20 mcg of T3 into to doses throughout the day. I am so fustrated with my labs. We have not been able to get my labs stable since December. Prior to December I was pretty stable and symptoms were pretty much gone. They are back and in full force. Since January I have had three episodes of severe vomiting and shakiness the doctors can not figure out what is causing it but I think it is from my hashi's. I think I am getting so exhausted by the end of the week that my body is just shutting down. The doctors don't agree but it is the only thing that I can think of.
Was there a meds change around 2/21 before your TSH went down, your T3 went way up and your FT4 took a tumble?
You take 50 mcg levo 4 days a week, 25 mcg levo 3 days a week and 20 mcg T3 every day, is that correct? What were you on immediately prior to these labs you just posted? Do you split your T3 into more than one partial dose?
You take 50 mcg levo 4 days a week, 25 mcg levo 3 days a week and 20 mcg T3 every day, is that correct? What were you on immediately prior to these labs you just posted? Do you split your T3 into more than one partial dose?
Ok, so I had my follow-up appoinment and got my new test results:
TSH 1.17 (0.45-4.50)
Total T3 207(H) (80-200)
T4 0.8 (0.8 -1.7)
Vitamin D 43(30.1-100.0)
So from February 21 to last week my TSH went down( it was 2.52), my T3 went way up (it was 113) and my T4 went down (it was 1.2). I really wish we could get this figured out. I am SO tired all the time and grumpy. :( He forgot to call in the B12 test so we will do that one in 6 weeks with all the other labs and he said he is not going to test for TPOab as I already have elevated TGab and there is nothing to do about them being elevated. Any suggestions for my next visit? What do you think about Armor? I have read different things about it. Please also note that he was concerned that I might be having hyper symptoms now but I do NOT have hyper symptoms they are still definately hypo symptoms. He did switch my meds around tho. I am now on 50mcg of levothyroxin 4 days a week and 25mcg 3 days a week with 20mcg of the T3 meds and 4000mg of vitamin D. I hope this helps! I am tired of being tired all the time and now my husband is getting grumpy about me falling alseep during the day on the weekends.
TSH 1.17 (0.45-4.50)
Total T3 207(H) (80-200)
T4 0.8 (0.8 -1.7)
Vitamin D 43(30.1-100.0)
So from February 21 to last week my TSH went down( it was 2.52), my T3 went way up (it was 113) and my T4 went down (it was 1.2). I really wish we could get this figured out. I am SO tired all the time and grumpy. :( He forgot to call in the B12 test so we will do that one in 6 weeks with all the other labs and he said he is not going to test for TPOab as I already have elevated TGab and there is nothing to do about them being elevated. Any suggestions for my next visit? What do you think about Armor? I have read different things about it. Please also note that he was concerned that I might be having hyper symptoms now but I do NOT have hyper symptoms they are still definately hypo symptoms. He did switch my meds around tho. I am now on 50mcg of levothyroxin 4 days a week and 25mcg 3 days a week with 20mcg of the T3 meds and 4000mg of vitamin D. I hope this helps! I am tired of being tired all the time and now my husband is getting grumpy about me falling alseep during the day on the weekends.
I increased from 5 to 10 just over a week ago. Thank you I will discuss this with my endo at my appointment. Again I appreciate your help!
So, you've been on T3 for a couple of weeks now, and you just increased from 5 mcg twice a day to 10 mcg twice a day, correct?
If I were you, I'd call or see my doctor and get blood work done. As I said above 20 mcg a day is a hefty dose of T3. I think you've either increased too fast or you simply don't need that much T3. Of course, I'm not a doctor, so you should talk to him about this. Ask him about staying at 5 mcg twice a day (or even going down to 2.5 twice a day if you were alreading having temp problems and sweats on 5 twice a day) until your body adjusts.
If I were you, I'd call or see my doctor and get blood work done. As I said above 20 mcg a day is a hefty dose of T3. I think you've either increased too fast or you simply don't need that much T3. Of course, I'm not a doctor, so you should talk to him about this. Ask him about staying at 5 mcg twice a day (or even going down to 2.5 twice a day if you were alreading having temp problems and sweats on 5 twice a day) until your body adjusts.
I don't understand what you mean when you say I seem to be more hyper sensitive to t4 rather than t3. Additionally, before I even started treatment my endo did adrenal testing which came back within range. Could it be different now? Is that something that could change within less than a years time? I think the sweating may be a side effect of the T3. While i had the sweats before starting treatment they had pretty much gone away once my the was around 1.2 until about December when my TSH just about tripled. We are still working on lowering my TSH again and thus the addition of the T3. I am hoping that once I adjust and get my TSH lowered again the sweats will go away again. My doctor has not armour or anything like that with me. Does it work better? What is the difference? I have an appointment coming up in the beginning of April so maybe I could discuss it with him.
I am wondering more about adrenals (cortisol) related to the night sweats. As we know cortisol fluctuates significantly throughout the day. This could be some reaction to adrenal fatigue and the adrenals trying to get balanced out with the now introduction to new medication and new dosage levels.
These hormone things are complicated. And it is like dropping a stone into the center of a pail of water. The ripples not only go outward in all directions, but they also reflect back from the walls of the pail and keep doing that. But over time the ripples get smaller and smaller and go away.
Are you experiencing the first and thus largest waves of this ripple affecting all the other hormones and adrenals and getting weird reflections back?
Just trying to explain a possibility.
Also worry and stress has a significant factor on the creation of reverse T3 and thus some effect on conversion. So the more you worry the more that could contribute to the conversion issue. On the other hand, that would tend to cause you to be more Hypo then your labs would otherwise indicate, not Hyper like you seem to be experiencing.
It is interesting that you seem more hyper sensitive to T4 rather than the T3. The exact opposite that most people experience. But that is why they call us unique "individuals". Because not everyone reacts the same.
With your sensitivity, I was wondering if any thought has been given to try Armour or another natural dissected thyroid med? I wouldn't necessarily recommend the switch now until you give a little more time to try to sort it out on the track you are on now. But if that doesn't work out, that is another avenue to try.
These hormone things are complicated. And it is like dropping a stone into the center of a pail of water. The ripples not only go outward in all directions, but they also reflect back from the walls of the pail and keep doing that. But over time the ripples get smaller and smaller and go away.
Are you experiencing the first and thus largest waves of this ripple affecting all the other hormones and adrenals and getting weird reflections back?
Just trying to explain a possibility.
Also worry and stress has a significant factor on the creation of reverse T3 and thus some effect on conversion. So the more you worry the more that could contribute to the conversion issue. On the other hand, that would tend to cause you to be more Hypo then your labs would otherwise indicate, not Hyper like you seem to be experiencing.
It is interesting that you seem more hyper sensitive to T4 rather than the T3. The exact opposite that most people experience. But that is why they call us unique "individuals". Because not everyone reacts the same.
With your sensitivity, I was wondering if any thought has been given to try Armour or another natural dissected thyroid med? I wouldn't necessarily recommend the switch now until you give a little more time to try to sort it out on the track you are on now. But if that doesn't work out, that is another avenue to try.
It's probably the T3 doing that. There's an adjustment period when staring it. Please refresh my memory...how much are you taking and do you split your dose?
I started the T3 meds almost two weeks ago and I was wondering if anyone else that is taking T3 meds has heating regulating issues? Prior to being on meds for my thyroid I use to have awful night sweats that seemed to get better once my meds kicked in. However, since I started the T3 not only am I having night sweats again but I am having random hot flashes and sweats throughout the day now. Hot flash and sweats so bad that my clothing is damp. Any suggestions? I also have a call into my doctor but haven't heard anything.
It could be. Last time I was overmedicated, my endo had advised me to take no meds for three days, then go back to my former dose. In that three days, most of the symptoms went away, but it was a couple of weeks before I was back to feeling like I did before the increase.
Don't hesitate to check in with your doctor on this. He might be able to give you something to get you over the rough spots until your thyroid meds get stabilized.
Don't hesitate to check in with your doctor on this. He might be able to give you something to get you over the rough spots until your thyroid meds get stabilized.
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