Thyroid Test Results

[sterling5236]

I have been hypothyroidism for approximately 10 years.  I have been on Armour thyroid 60mg during this time. Everything was great until  last summer I have been starting to gain weight approximately 10 lbs. and feeling really tired.  My doctor raised me to 5mg of cytomel but I didnt feel any better and my free t4 came back low (0.48)so he changed me to 90 mg of Armour in June.  I lost 3 lbs but didnt really feel any better still tired.  I just had my blood work done and my TSH came in at .04 (from 0.41)free t3 2.8 (from 3.1 when on armour 60 and 5mg cytomel) and my free t4 is 0.68(from 0.48 when on armour 60 and cytomel 5mg).  
My doctor wants me to continue with the 90mg of armour for 6 days and take one half of the 90mg on one day.  I am afraid of lowering my dose as I am tired all the time with no energy.  I am on a strict diet and exercise approximately 2 to 3 hours a day.  I do weight lifting (body pump), boot camp, spin class , yoga etc (advanced exercises)I write everything I eat down daily and eat very low carborhydrates low fat low sugar diet. I currently weigh 140lbs and I am 5 ft 5 in last summer I weighed 132lbs.   From research I have found that the optimal levels of free  t3 is 3.2 to 3.3 and optimal levels of free t4 is 1.2 to 1.3.  I feel my free t3 and t4 range are not optimal and if i lower my armour I will feel worse and gain more weight.  Please let me know what I should do.    

[goolarra]

I agree with gimel.

I also question your doctor's prescription of Armour and Cytomel together. Armour already has a very heavy T3 component.  Armour contains T4:T3 in a ratio of approximately 4:1.  The healthy human thyroid produces T4:T3 at about 20:1.  So, Armour contains about five times more T3 than our own thyroids would produce (if they could!). Cytomel is a T3-only drug.  To add more T3 to Armour seems quite odd.

I think you need a bit more T4 meds.  Your FT4 is very low in the range (and was below range previously).  T3 is very fast-acting and is neutralized by your system if not used promptly.  With yoiur very low FT4, you barely have enough of the much more stable "storage" form of the thyroid hormones available for conversion to T3 when your body needs it.

Do you split your Armour into more than one dose?  Did you split the Cytomel when you were on that?

"Optimal" levels of F3 and FT4, I believe are very individual.  An FT3 of 3.2 would probably kill me.

[gimel]

Clearly your doctor is one that believes that TSH is a diagnostic, instead of just an indicator.  You are right about raising the frees to alleviate symptoms.  Free T3 correlates best with hypo symptoms. TSH correlates very poorly with hypo symptoms.  So you are going to have to talk with your doctor and give him information along this line, in order to get him to change his approach.  Or, you may have to find a good thyroid doctor that is willing to treat your symptoms by testing and adjusting your free T3 and free T4 levels with meds, as required to alleviate those symptoms.  

Here is a good link about this whole subject area.  A copy for your doctor can't hurt.

http://www.hormonerestoration.com/Thyroid.html