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T3 levels
I am 42 years old and have been experiencing the hypothyroid symptoms for about 18 months. My mother and two sisters were diagnosed hypothyroid in their 30's. I've had mine checked routinely knowing there might be a high chance I develop it. The docs I had previously seen only drew TSH and I'm always in the "normal" range.
The last 6 months my symptoms have become significantly worse so I went to an endocrinologist. My T4, B12, D, Fe binding percentage were all low. I did have a thyroid ultrasound done in December because it felt enlarged to me. The size was within normal limits but I did have some small cysts. I'm now starting on 88 mcg Synthroid, Vit B12, 5000 IU D3, and selenium. He didn't run a T3 so I am wondering if I should've had it drawn to get a baseline before initiating replacement therapy?? I have the meds and just found this site and thought I'd reach out to get some insight before I begin taking them.
The last 6 months my symptoms have become significantly worse so I went to an endocrinologist. My T4, B12, D, Fe binding percentage were all low. I did have a thyroid ultrasound done in December because it felt enlarged to me. The size was within normal limits but I did have some small cysts. I'm now starting on 88 mcg Synthroid, Vit B12, 5000 IU D3, and selenium. He didn't run a T3 so I am wondering if I should've had it drawn to get a baseline before initiating replacement therapy?? I have the meds and just found this site and thought I'd reach out to get some insight before I begin taking them.
COMMUNITY LEADER
What's the reference range for the T4? Ranges vary lab to lab and have to come from your own report.
Your B-12 is way too low, even if it might be within the reference range, and would be a significant contributor to the mind blowing fatigue, since with B-12 deficiency, no amount of sleep is enough. If left that low for an extended period of time, you can begin to have tingling/numbness/pain in the extremities, since vitamin B-12 affects the nerves. I have permanent nerve damage (peripheral neuropathy) caused by many years of doctors refusing to look for a cause for my constant fatigue and it turned out to be Pernicious Anemia, which is an autoimmune disease, in which one does not absorb vitamin B-12. Now, no matter how high my B-12 level, I live with the pain. Avoid that, at all cost.
You Vitamin D at 17 (X 2 yr) - does that mean it's been the same for the past 2 yrs? Have you supplemented at all? With levels as low as yours, it's not uncommon for doctors to Rx 50,000 IU/week until levels are brought up to the 60-70 level, then drop down to maintenance level of around 2000 IU/day, but you'll have to test regularly to make sure you're maintaining optimal levels... some say you need to be higher than that.
Is the TIBC the only iron related test you had? Typically, the doctor would order a ferritin test prior to ordering the components of an iron panel. If you've had a ferritin test, or other components of an iron panel, please post those results. Ferritin is an iron storage hormone and would tell us whether you have adequate iron stores or not.
Your protein level is on the low side and in view of the fact that your B-12 and D are very low, it could be significant, particularly, if you are supplementing those and your levels continue to stay low. It could indicate an absorption issue; however, it may not be significant, if you don't take in enough of the other components to help with the absorption of protein, such as vitamin B-6 and others.
Your symptoms are consistent with hypothyroidism. Vitamin D and iron are both necessary for the production and metabolism of thyroid hormones.
The difference between the Free Tests and non-Free... Of the Total T4 in your blood, most is bound by protein and can't be utilized, therefore, we test the unbound (FREE) portion... T4 isn't used directly; it's a storage hormone and must be converted to T3 prior to being used... it's the FREE T4 that's converted to T3, so by testing the Free T4, you find how much there is available for conversion.
T3 is the hormone that's used by the individual cells and it works the same way... most of it is bound by protein and can't be used, so we test the FREE T3, which tells us how much is, actually, available for use by the individual cells in the body. Every cell in your body needs Free T3.
It's unusual for a doctor to start someone on a dose, such as your 88 mcg, though some doctors do start out dosing by weight, which often tends to get us into trouble, since many of us find out we don't that high a dose right off the bat. We usually tend to do better starting a much lower dose, as gimel suggested and working up to what we need, since there might be a dose lower than the 88 mcg that will be sufficient for you.
Did you have any thyroid antibody tests done to see if you have Hashimoto's?
Your B-12 is way too low, even if it might be within the reference range, and would be a significant contributor to the mind blowing fatigue, since with B-12 deficiency, no amount of sleep is enough. If left that low for an extended period of time, you can begin to have tingling/numbness/pain in the extremities, since vitamin B-12 affects the nerves. I have permanent nerve damage (peripheral neuropathy) caused by many years of doctors refusing to look for a cause for my constant fatigue and it turned out to be Pernicious Anemia, which is an autoimmune disease, in which one does not absorb vitamin B-12. Now, no matter how high my B-12 level, I live with the pain. Avoid that, at all cost.
You Vitamin D at 17 (X 2 yr) - does that mean it's been the same for the past 2 yrs? Have you supplemented at all? With levels as low as yours, it's not uncommon for doctors to Rx 50,000 IU/week until levels are brought up to the 60-70 level, then drop down to maintenance level of around 2000 IU/day, but you'll have to test regularly to make sure you're maintaining optimal levels... some say you need to be higher than that.
Is the TIBC the only iron related test you had? Typically, the doctor would order a ferritin test prior to ordering the components of an iron panel. If you've had a ferritin test, or other components of an iron panel, please post those results. Ferritin is an iron storage hormone and would tell us whether you have adequate iron stores or not.
Your protein level is on the low side and in view of the fact that your B-12 and D are very low, it could be significant, particularly, if you are supplementing those and your levels continue to stay low. It could indicate an absorption issue; however, it may not be significant, if you don't take in enough of the other components to help with the absorption of protein, such as vitamin B-6 and others.
Your symptoms are consistent with hypothyroidism. Vitamin D and iron are both necessary for the production and metabolism of thyroid hormones.
The difference between the Free Tests and non-Free... Of the Total T4 in your blood, most is bound by protein and can't be utilized, therefore, we test the unbound (FREE) portion... T4 isn't used directly; it's a storage hormone and must be converted to T3 prior to being used... it's the FREE T4 that's converted to T3, so by testing the Free T4, you find how much there is available for conversion.
T3 is the hormone that's used by the individual cells and it works the same way... most of it is bound by protein and can't be used, so we test the FREE T3, which tells us how much is, actually, available for use by the individual cells in the body. Every cell in your body needs Free T3.
It's unusual for a doctor to start someone on a dose, such as your 88 mcg, though some doctors do start out dosing by weight, which often tends to get us into trouble, since many of us find out we don't that high a dose right off the bat. We usually tend to do better starting a much lower dose, as gimel suggested and working up to what we need, since there might be a dose lower than the 88 mcg that will be sufficient for you.
Did you have any thyroid antibody tests done to see if you have Hashimoto's?
T4: 4.8
B-12: 296
D: 17 (x 2 yr)
Iron Binding Capacity: 210 (277-436)
Protein: 6.4 (6.3 - 8.5)
**Not sure if it's relevant other than being odd to me based on my diet being high in protein as "greens" are a bit of an aversion for me lately and I've always tested on the higher side of normal for years.
I cannot answer why I was given the dose of 88 mcg. It was what was ordered. My sister is on 75mcg and she is significantly smaller than I am currently.
Symptoms: FATIGUE, mind blowing fatigue, cold intolerance, loss of hair (generalized), brittle nails, "thin" skin (easily injured), heavy menses, weight gain of close to 20 lbs in 5 months, mental fog ( I have a hard time retrieving info/names/words more), hand weakness and tingling. These are all such a stark contrast to who I am and how I operate. There are days I cannot even get up off the couch to get motivated.
US showed a few cysts not nodules.
What is the difference in Free T tests vs non-free tests?
Thanks for your help.
B-12: 296
D: 17 (x 2 yr)
Iron Binding Capacity: 210 (277-436)
Protein: 6.4 (6.3 - 8.5)
**Not sure if it's relevant other than being odd to me based on my diet being high in protein as "greens" are a bit of an aversion for me lately and I've always tested on the higher side of normal for years.
I cannot answer why I was given the dose of 88 mcg. It was what was ordered. My sister is on 75mcg and she is significantly smaller than I am currently.
Symptoms: FATIGUE, mind blowing fatigue, cold intolerance, loss of hair (generalized), brittle nails, "thin" skin (easily injured), heavy menses, weight gain of close to 20 lbs in 5 months, mental fog ( I have a hard time retrieving info/names/words more), hand weakness and tingling. These are all such a stark contrast to who I am and how I operate. There are days I cannot even get up off the couch to get motivated.
US showed a few cysts not nodules.
What is the difference in Free T tests vs non-free tests?
Thanks for your help.
I think I would want to have a Free T3 and a Free T4 test done just to see how well your body is converting T4 to T3, even before starting on the med. If not tested for ferritin, I would suggest that also.
Please tell us about symptoms you have. Also please post your actual test results and reference ranges so that we can help assess your status.
One thing further is that 88 mcg of T4 is a hefty starting dose, higher than usually recommended, as shown in the following quote.
"The initial dose is 12.5 to 50 mcg orally once a day. The dosage can be increased in 12.5 to 25 mcg/day increments every 2 to 4 weeks. In older patients or in younger patients with a history of cardiovascular disease, the dosage should be increased in 12.5 to 25 mcg increments every 3 to 6 weeks."
Please tell us about symptoms you have. Also please post your actual test results and reference ranges so that we can help assess your status.
One thing further is that 88 mcg of T4 is a hefty starting dose, higher than usually recommended, as shown in the following quote.
"The initial dose is 12.5 to 50 mcg orally once a day. The dosage can be increased in 12.5 to 25 mcg/day increments every 2 to 4 weeks. In older patients or in younger patients with a history of cardiovascular disease, the dosage should be increased in 12.5 to 25 mcg increments every 3 to 6 weeks."
COMMUNITY LEADER
What were your actual TSH, Free T4, B-12, Vitamin D and Iron levels, with reference ranges?
Free T3 should always be done whenever you have a TSH and Free T4, but since you didn't have one, previously, I don't think I'd delay starting medication just to get it. Be sure you have it done every time from now on and be sure it's FREE T3 and FREE T4, not just T3 and T4 because they won't be the same tests.
Why are you starting on 88 mcg Synthroid? How was that dosage arrived at?
Are you sure you have cysts on your thyroid or are they nodules? Nodules are very common. Do you know if you have Hashimoto's?
Free T3 should always be done whenever you have a TSH and Free T4, but since you didn't have one, previously, I don't think I'd delay starting medication just to get it. Be sure you have it done every time from now on and be sure it's FREE T3 and FREE T4, not just T3 and T4 because they won't be the same tests.
Why are you starting on 88 mcg Synthroid? How was that dosage arrived at?
Are you sure you have cysts on your thyroid or are they nodules? Nodules are very common. Do you know if you have Hashimoto's?
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