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484699 tn?1208719497

T3/T/4 difference between someone hypo and a cancer survior

Hi, I bought the book Living Well with Hypothyroidism, I flipped straight to the Thyroid cancer section. I have always been confused when my doctor tells me I am on the highest dose for my body, but after reading this book I now understand.  
150 mg is my dose which is usually designed for someone who weighs 190-225 but because I am a thyroid cancer survior I am on that dose to keep the cancer from reoccuring. I'm 5 4" and weigh 180 lb. I gained 20lbs since my surgey 4 years ago.  
I now reconize why there are times that I have symptoms of hyper vs hypo  due to the high dose. This apparently is normal and the Endocrinology doctors frown on T3 because T3 can cause the THS levels to read inaccurate in order for them to monitor the cancer reoccurance.  
The ups and downs of the whole mess makes me crazy and now I feel like because I am a Thyroid cancer survior I am different then a hypo patient and from what i'm reading there dosent seem to be a silver lining for me.
I'm hoping someone here can help me with what I'm reading is the truth. I was getting geared up to push my doctor into putting me on a T3/T4 medication to make me feel better but am I setting myself up for a reoccurance of the cancer? Thanks Patty
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484699 tn?1208719497
Thanks for your help. I'm scheduled April 28th for my 4 year check, a couple of shots an ultrasound of my neck and when the results come back ok, I will push forward with getting my dose under control for me.
I have to say I am so excited with this forum I feel I have learned so much in such a short time online. Yes lots of different opinions and tricks to help you out, but how great to know I can type a few words and get so much help.
The most important part of this experience is actually begining to understand why I feel the way I do and there is other people out there to help.
FYI my mother, and both her sisters have had Total Thyroidectomy's and have had zero hypo/hyper symtoms. Because they are my support system and they dont go thru this up and down stuff, I thought it was me and my crazy work schedule, social life ect...   but now I realize they couldnt relate to me.
The difference I think from my family and me is they were lucky no cancer all 3 were  removed due to goiter growth so they are on much lower doses plus theyre a bit older and not looking for the engery to go mountain biking after work lol.
As of yesterday I cut out the wheat, sugar and lowered my intake of caffeine added a couple of table spoon of apple cider vinager to help my bloat. and yes ACV worked so well. Again thanks for you help.
Helpful - 0
213044 tn?1236527460
This is a stab in the dark, because I don't know your lab range limits on the T4, so take it with a grain of sand.

I have my latest lab sheet here in front of me.
My Free T4 was 1.38, range is 0.58-1.64.
My TSH was 0.92.

Assuming your lab is using a similar range, which is a good guess, your Free T4 is looking very good. Your TSH is quite low, which puzzles me. I know it needs to be low for cancer suppression, and 0.05 is not EXTREMELY low, but it seems it should be higher by looking at your T4.

Free T3 tests ar run less frequently for a couple of reasons. They usually mirror the Free T4, they are a bit more expensive, and very few labs process the test, so they are always sent out. That means they come back several days later than the TSH and Free T4, which is just a pain.

I would ask your doctor to run a Free T3 test, just to see if perhaps you would benefit from additional T3. You may find your T3 is already high, which might explain the low TSH.

It may also explain your feeling of being hyper by times.

I would be happier if I could post a reply without so many ifs, maybes, and possiblies, but thyroid disease seems to be full of them.

Ask for copies of a few of your tests. I get a copy of every test if I can. It helps to see what the ranges are, and where your score sits within the range. Thyroid test ranges are wide, but the target within the range is small. Some doctors fail to realize this.

Ideally, your T4 and your T3 should both be about two thirds up the scale from low to high.

The test scores of mine that I posted are ideal for many people, although in truth we are all a little different and have different needs. Maybe 1.4 is a bit too much T4 for your system. I hope you get it figured out.
Helpful - 0
484699 tn?1208719497
You are somewhat correct in reading my posts. I feel like I am smack in the middle between hypo & hyper. For example it's 12:37 and I feel like closing my eyes I would normally have a cup of coffee to pep me up but I am trying to kick the caffeine because I am so sensitive to caffeine, I feel like i'm going to jump out of my skin after I drink it. If I dont add something to my body i'm too tired to do anything after work i.e. ride my bike, workout.
I called my doctor and found that my TSH level is 0.05 and my T4 is 1.4 they show no record of my T3 level being done. Thanks Patty
Helpful - 0
213044 tn?1236527460
You know you are converting T4 to t3 successfully if your Free T4 and Free T3 tests are in line with each other, and hopefully in the correct range. If your T4 is high, and your T3 is low, then you may have a conversion problem.

You realize that both hormones need to be in the correct range.
If you are converting T4 to T3 properly, and you are on the right dose of replacement hormone, you don't need T3 added to it. If your T4 is in the proper range, taking additional T3 can make you ill. Unless you have a conversion problem.

Your original post hints that you feel you are on too high a dose of medication. Do you know what your TSH is? Most doctors try to hold it low for cancer supression. Do you know what your Free T4 and Free T3 are? Are they at the high end of normal?

Some people get along fine with a TSH of 0.5 or 0.2, but many can't feel well unless they are above 1.0. Some look at it as a quality of life issue and try to stay between 1.0 and 1.5, because feeling healthy is worth the risk they are taking by not staying below 1.0. That's a personal choice you have to make.

Some people need Armour or Cytomel+Levoxyl.
Most people do not.  
Helpful - 0
484699 tn?1208719497
Do you know of another reliable source? & How do I know if I am converting T4 to T3?
The other question I have is why does everyone seem to say once they add T3 they feel better.  
Helpful - 0
213044 tn?1236527460
Unless you have trouble converting T4 to T3, you do not need Cytomel. You need the proper dose of a NAME BRAND T4 drug.

The only difference between a cancer survivor and any other Hypothyroid person as far as their med dosage is concerned, is that a cancer survivor should try to keep their TSH below 1.0.

Your complaint seems to be that you sometimes feel hyper, and need a smaller dose of meds. T3 added to your meds is not going to change that.

It's all about hormone levels. What your T4 and T3 levels are. The TSH just happens to be a mirror, convenient for the doctor.

Mary Shomon is not a reliable source of information.
Took me three tries to say that politely.
Helpful - 0
484699 tn?1208719497
Did you have a total?
Helpful - 0
484699 tn?1208719497
Hi, The book is written by Mary F Shomon.
My doctor gave me cytomel 2 years ago with my Levoxyl but the dose of the cytomel was small and didnt change anything so I sat back and thought oh well this is how life will be. Alot has changed over the last couple of years so I hope that doctors are more responsive to how we feel. I'm afraid of pushing to feel better and risk the cancer recurring.
Helpful - 0
479481 tn?1219708409
Hi patty315,
I was diagnosed with Thyroid Cancer 17 yrs ago and had it removed.  I'm 5'3" and weight 15 lbs more than you do.  A yr ago my Dr  added the T3 (Cytomel) to help me with my sluggish.  Of course that didn't work for me.  I'm on 112mcg of Synthroid and I have asked my Dr about raising it.  He told me that if I have it too high, I could have a stroke or a heart attack.  So I'd stayed at that level, have for the past 10 yrs.  This is the first I heard of keeping a dose at a certain level to prevent cancer from returning.  I need to buy that book.  I've come to learn that Dr's don't always tell you everything.  I have a body scan every yr to make sure I am cancer free. But I have learned that the best information is just doing research yourself and asking a lot of questions and of course getting second opinions.  The cytomel did not work for me, but I have known it has for others.  Good Luck!
Helpful - 0
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