T3 values

[carla559]

I was taken of levothyroxine by new internist, he was afraid that I would go hyper.
My last studies were.............

TSH 1.28                  0.27-4.20  
T4  Free 1.6               0.9-1.8        
T3 Free 2.1                2.3-4.2
slightly lower
but MD seems
to think that this
is not out of line...........
changed MD's 50 MCGs that he gave me made my hands shake..
another MD noticed and said I was probably being over medicated.......
any ideas - they are close and I sure would not want to go hyperthyroid,
Thanks,
Carla
Derma Mag is okay - but I found it better for the foot soak Tamra...........    

[goolarra]

As you know, I am not a doctor, but I see nothing in your labs that indicates you are on the verge of becomming hyper.  However, hand tremors are a symptom of hyper.  Is there anything else that you can think of that might have caused the tremors?  Your FT3 is too low.  I'd consider cutting back on levo and adding just a very small amount of Cytomel.  With your FT4 so high in the range and your FT3 below range, it would appear that you are not converting T4 to T3.  T4 has to be converted to T3 before your cells can use it.  

What other symptoms do you have (hypo or hyper)?

[carla559]

Hi, I'm still weak can't walk too fast and still have some muscle aches and pains after
about 2 weeks on levo 50mcgs, I started to feel stronger and a little more stamina.
I take ativan for anxiety 3 mgs, and low dose Prozac 8 mgs depression.  Had a very
stressful divorce last year and knocked me down along with a surgery.  Also noticed
my hair starting to come out a little more than normal.  I am told I have Fibromyalgia
mostly muscle aches in lower back, gluts, and calves feel kind of weak. I think maybe
I should go to an endo in my town and get a 2nd opinion.  My neurologist said my #
was not low enough for that kind of muscle ache.  He noticed my shaking in the
hands have had EMG for right hand and arm for tingling can't seem to find anything and
neck xrays done have to wait and get opinions on that.  My muscles twitch like crazy
at times all over.  Right now I have been off of levo for over a week. I did not realize
that there was so much controversy over reading these things........I appreciate
your help  - I don't feel like my usual strong self.  thankis,
Carla   Oh I was given Lyrica to take but reading the side effect for that drug were
outrageous - have you heard anything about that one either?

[goolarra]

Your other symptoms besides the hand tremors sound hypo also.  If you started to feel better after the two weeks on 50 mcg, it probably indicates that it was benefiting you.  Were you only on levo for two weeks altogether?  Do you have the lab results from before you started the levo?

I think going to an endo would be an excellent idea.  I think your neurologist is wrong.  Your numbers are low enough to cause muscle aches, etc.  

If you get your FT3 up, you might be surprised to find out how many of your other ailments are actually thyroid symptoms...anxiety, depression, "fibromyalgia" (I think this is often misdiagnosed when the real culprit is thyroid), etc.  Have you had thyroid antibody tests done?

I'd stay away from Lyrica unless it was absolutely a necessity...but that's me.  I tend to avoid taking everything that I can do without.  The side effects on that one do read like a horror story.  

[Smilerdeb]

I agree with the FT3 being too low.
Maybe you havent given the Levo enough time?
It does take a while for the Levo to absorb into your blood stream then be used by the body as needed.
Usually 4-6 weeks is the usual time.

Also be aware that Doctors are QUICK to diagnose Fibromyalgia.
I was too...only to find out this was incorrect.

[carla559]

Had a change in MD's did not get along with the original, the new one took me off
the levothyroxine - almost tempted to take it again and go to an endocrinologist.
The original value of the T3 was 200 at least the last test it was coming up some.
Probably a mistake - although I like this guy better he just pulled me off of it.
The original MD that gave it to me told me I don't think you really have a thyroid
problem I just want to see if we can get your T4 to trick the T3 into making more
hormone.  50MCGS might have been too much for me I still have the tablets.
I think I need to get a specialist.  This is really frustrating and wrecking my lifestyle
up.

[carla559]

MD did not think it was necessary to do anitbody tests................
it's hard to trust their judgement and you end up feeling lousy.........

[goolarra]

I think you should see an endo.  Your FT3 is so low that I'm sure it's making you feel sick.  It's true, as Smilerdeb said, that you hadn't given the meds very long to work...they do have to build up in your system  

What was the reference range on the T3 you reference above as 200, which I assume is before you were on any meds???  And is it a FT3 or total T3?

[carla559]

That was a FT3 back in beginning of Aug. 09, as of Aug21st, it went up to 2.1
(200) I don't know why the new MD thought that pulling off the meds 8/21 would
accomplish -except that he said it would make me hyper.  reference range 230-420
first test, second test was 2.1 reference range 2.3-4.2  It even said 2.1 L behind it.
He put minor next to it. When I think about he could have cut me back to 25mcgs if
he thought I was getting too much,  I am really concerned and I am going to call
the office tomorrow and tell them.  It's very disappointing in 2009 that they are still
sticking to the same old lines..............

[gakat61]

Just curious -- did the doctor have your Reverse T3 checked as well?

[carla559]

Have no idea..............probably not as far as I know.........please explain this test
to me,
txs,
Carla

[carla559]

With my kind of stats, I wonder what would be the formula to be used.
with a normal TSH and higher T4, a low thyroxine and a bit of cytomel?
Seems like you have to figure it yourself.  I guess there must be a ratio
of these two medications?  Any idea?
txs,
Carla

[gakat61]

It means your T4 isn't converting to T3 like it should, hindering your metabolism.

I just started T3 supplements.

[carla559]

What were your values and what is the name of your T3 supplement?
I would like to relate this to the MD for his FYI
txs,
Carla

[gakat61]

T4 Free            1.4                  0.8 - 1.8
TSH                 0.89                0.40 - 4.50
T3 Free            362                  230-420

T3, Reverse       36 (high)          11-32

All my other tests came back normal, but my doctor gave me the test based upon my symptoms.

I'm taking Liothyronine (generic for cytomel) .......
Thanks,
Kathy

[carla559]

thanks so much for the info - you have been very helpful......went over to my MD's
office this am and made appt with him for next Tues. and wrote him a note about
a supplement for my T3.  I will be calling around for endocrinoligists also. Keep me
posted on your progress please  my goal is to get better and I need all the help I can
get.  The best to you,
Carla

[goolarra]

Usually, T4 is given in a ratio of about four or five to one of T3.  However, that is not a hard and fast rule, and, you're right, everyone has to experiment for herself.

I agree that a reverse T3 test would be a good idea.  Often, if FT4 is high, FT3 is low, and RT3 is high, patients will be put on Cytomel only.  This usually gets the RT3 back into line.  I think this is what your doctor was alluding to when he said he wanted to "see if we can get your T4 to trick the T3 into making more
hormone".  However, he was a bit mixed up in how to go about that...he should have been using T3 meds and not T4.

I think gakat61's idea of RT3 test is excellent.

[gakat61]

I would have them give the test first. Your T3 is definitely low and adding a T3 med will more than likely be beneficial. Yes, you are on the lower end of normal for T4. T3 meds should be considered.

But I would insist that they perform the RT3 before you take any meds.

[carla559]

Appreciate your help will definitely tell him about the RT3 test.  The next step is
getting refferred to an endocrinologist.  The one we have here in Williamsburg is
high but she is supposed to be very good.  I can't imagine why a MD would not take
helpful suggestions, but I will find out.  Thanks for being good moral support I want
us all to feel better,
txs,
Carla

[carla559]

Thanks this is extremely helpful and I appreciate your support - It's difficult and time
consuming to find someone to try and help out in the Medical field.  I'm glad I
discovered this site.  You girls are great!  Thanks for all your help !
Carla

[gakat61]

Keep us informed on how your test turns out. I'll be letting you know how the med helps me out as time goes by.

By the way, I use to live in Hampton ...... took some classes at TNCC, and I took one class at the College of William and Mary. Lots to do there in that area! I do miss it.

Kathy

[carla559]

Well I did it, yesterday I ran around alot in the car and did some errands and I am
paying for it today,  It is amazing one day you can feel ok and the next day ache
and be fatigued.  Wish me luck with my appt . Tuesday and I made another for next
month with an recommended endo in Richmond for a consultation.  I am really
frustrated and want to get some help soon.  thanks for being suppportive,

Carla

[ChitChatNine]

WELCOME!!!

[carla559]

thanks!  Maybe you can tell me a little about yourself.......right now I am
battling the med profession.  

[carla559]

Hey again - I know I ask a lot of questions but you are very nice and informative
about everything.  The endo that was recommended to me supposedly recognizes
subclinical readings I assume this means not "recipe" type text book ones.?
I had to get one in Richmond, VA about 50 miles from me that accepts my medicare ins.
ppo.  This has been tough year and I had no idea this would be so difficult to treat.
I mean my first FT3 came back stated on lab sheet "out of range" 200   230-420 limits
The 2nd one came back FT3 2.1    2.3-4.2 limits stated Low on lab sheet what is wrong
with the MD's?  I am walking around like a zombie sometimes and have the wierdest
aches and pains the come and go with fatigue.  thanks,
Carla