Thyroid question

[godiva121]

I went for blood test, my free t3 and free t4 were normal, my tsh was at 4.90 range 0.5 - 5.5.  When I take my t3, I get shortness of breath, does this mean I should not take any?

[gimel]

Please post your thyroid related test results and reference ranges shown on the lab report.  What other symptoms, if any, do you have?  

[godiva121]

my results:
Free T4 14.8, range 12.0 - 22.0 pmol/L
TSH 4.90, range 0.35 - 5.00 m?I?U/L
Free T3   5.1 range 2.6 - 5.7 pmol/L
TIBC 42, RANGE 45 - 77 UMOL/l
UIBC 16, range 20 - 66 umol/L
% Saturation 0.63, range 0.20 - 0.50
Serum Iron 26.4, range 6.0 - 27.0 umol/L

[godiva121]

My main symptoms are fatigue.  @ the moment I am taking 2.5 mcg twice daily.........do you think it is an okay dosing?
I left a message for my doctor, he has not called me back yet.

[gimel]

I should have asked previously if you are also taking T4 meds.  If so, what is the daily dose?  Also, are those lab results from before starting on the T3 med or after?  If the test results are after starting on the T3. did you take your T3 med the morning before the blood draw for tests?

[godiva121]

no I am not taking t4.  those lab results were when I was not taking t3 t4 for a month.

thank you for your help.......you are so much faster than my doctor.

I do not know if it is because I did not sleep well but, I have heart palpitation this morning.

[gimel]

Since those labs were when you were not taking any thyroid med, and your the main symptom you mentioned was fatigue, I am a bit unclear as to why the doctor placed you on T3 med when your Free T3 was 80 % up in the range. Your Free T4 was lower than optimal, and your TSH was on the high end, which I think indicates the need for more tests to evaluate for Hashi's.  Two tests would be required, TPO ab and TG ab.  What did the doctor say about all that?

One thing I do see is that your iron tests show some anomalies.  The TIBC, UIBC, and % saturation were outside the ranges, and your serum iron level was at the very high end of its range.  If you have a look at the table in this link, I think it suggests iron overload, which can cause fatigue.  That little bit of info is even more than I understand about the subject, so I suggest you should discuss with the doctor.

http://labtestsonline.org/understanding/analytes/ferritin/tab/test

[godiva121]

I forgot to mentioned to you that my TPO ab and tg ab is normal  47.3 ug/l range 1.6 - 50.0 ug/L
tgb ab 0.9, range less 4.9 kIU/L........he said they all normal.

yes I have an excess of copper that translate in toxicity of iron..........I was told to take multivitamin without copper..........started 2 days ago.

to tell you the truth, you are so knowledgable......your info. are so useful........I questioned if my dr knows all these information, he is certainly not letting me know about it.

when I take my t3, I am able to get up during the night and go to the washroom by myself.........other wise I have to wake up my husband and ask him to come with me....my balance is off and I cannot walk.
I know that t3 is probably not for me, I have high pulse during  the day..........do you have a suggestion?  thank you so much.
the toxic level of iron it is me that did search, my doctor kept telling me....take more you are low.
thank you for the chart.

[gimel]

Those lab results for Free T3 and Free T4, when you were not taking thyroid med, looks like your body was trying to raise tissue thyroid levels, even though the serum level was adequate.  That makes me wonder if you could have a problem with excessive Reverse T3 levels or your cortisol level.  Low/high cortisol can sometimes cause "pooling of T3 in the blood" because it is not getting into cells.  This would be consistent with the seeming benefit when you take the T3 med.  So, I suggest that you should test for Reverse T3, and also get a diurnal saliva cortisol panel of 4 tests done.  

The saliva cortisol level varies over 24 hours, so 4 tests are done at various times.  Doctors are usually resistant to doing this, they only want to run one test of serum cortisol.  That is not sufficient.  If you cannot get the doctor to do the saliva test, then for about $135 you could also order a ZRT test kit on line and send it in for analysis.  You should be able to get the doctor to test for Reverse T3, along with Free T3 at the same time, so that a ratio of Free T3 to Reverse T3 can  be calculated.  .  

[godiva121]

i will go for reverse t3 test along with t3, do I have to stop t3 for a while before going for these test?
I did the saliva cortisol...I will post my results.

..I know that the private lab I go to, they don't do RT3, I am in montreal, do you happen to know a lab that can do this test?  ...if not in your area, don't worry.

I cannot thank you enough for all your help.  I actually learned many things.""...will try to find saliva/cortisol

I can tell you, that as soon as I started to take t4, t3 or SYnthroid, my feet became red...maybe it is something else....I also have Lyme disease.

Do you think that 2.5MCG twice daily of t3 is sufficient or I should up my dose?

[gimel]

Yes, it is best to delay any T3 med until after the blood draw for tests.  I don't know what companies provide lab test services in Canada.  You might look on line for them.  You mentioned T3 testing.  Make sure it is Free T3, not Total T3. I would not raise the T3 med right now because your Free T3 level is near the upper limit.  Wait until we know more from the RT3 and Free T3 results.  And I am interested in the saliva cortisol results.  

[godiva121]

hi,
I went for blood test........free t3, rt3...

results for saliva hormones test:
Estradiol 4.5, range 1.0 - 9.0 pg/ml
Progesterone 140, range 50 - 250 pg/ml
Testosterone 61, range 15 - 45 pg/ml
DHEAS 3.8, range 1.2 - 8.0 ng/ml
Cortisol AM 9.0, range 2.0 - 11 ng/ml  ( sampled within 1 hour of waking)
Cortisol Noon 3.8, range 1.0 - 7.0 ng/mL
Cortisol HS 0.72, 0.20 - 1.3 ng/ml ( sampled taken after 9pm and before 1 AM)

[godiva121]

results for saliva hormones test:
Estradiol 4.5, range 1.0 - 9.0 pg/ml
Progesterone 140, range 50 - 250 pg/ml
Testosterone 61, range 15 - 45 pg/ml
DHEAS 3.8, range 1.2 - 8.0 ng/ml
Cortisol AM 9.0, range 2.0 - 11 ng/ml  ( sampled within 1 hour of waking)
Cortisol Noon 3.8, range 1.0 - 7.0 ng/mL
Cortisol HS 0.72, 0.20 - 1.3 ng/ml ( sampled taken after 9pm and before 1 AM)
.

what do you suggest I do?

[godiva121]

I also forgot to mentioned to you that my ankles are swollen, and a part of my feet..............does this mean the dosage is too low, too high or I should take t4 along with the t3?  I would really appreciate your advice.

[gimel]

Those last tests appear to be normal.  Since you mention Lyme Disease, obviously that can be causing symptoms like fatigue.  The iron overload problem needs to be addressed, I think, before anything else.  You do have some symptoms of being hypothyroid, even though your Free T3 is fairly high in the range.  That is likely due to the high iron level.  I see no value to taking  thyroid med at this time.  More important to reduce the iron level and that should improve the transport of T3 into cells, and improve your hypo symptoms.  You can monitor your iron level by just testing ferritin.  

What is your doctor doing for your Lyme Disease?

[godiva121]

I was taking t3 medication, although that gets my feet...especially the left one all swollen, should I switch to t3&t4 instead?   I am just a little worry because this seems to give me insomnia
Do you have suggestions for t3?

[godiva121]

Sorry...so you don't think I should take thyroid medication?
I do not take iron and copper at the moment

My Lyme Dr gave me an herb mixture that I took for 2years...stopped it did nothing

My tsh is at 4.90 it is almost at the range, shouldn't I take some to lower the number?

[gimel]

Not saying that you won't need thyroid med in the future, even the near future, but at this point I think you need to get your iron issue resolved.  When did you stop iron and copper?  I think It takes a while, say several weeks, for iron to dissipate down to your normal level.  So when you have given it some time, I would go back and request to be tested for ferritin.  No need to test all the others also.  When your ferritin returns to within the range, you should see some benefit to you tissue thyroid levels,  how you are feeling, and whether you need thyroid meds.  Also, you should get new tests for Free T4 and Free T3 at that time.  We haven't mentioned Vitamin D and B12.  They are important also.  D needs to be about 55-60 and B12 needs to be in the high end of the range.  

Since you may also still be affected by the Lyme Disease, I also suggest that you go to the Forum for Lyme Disease and see what suggestions they have for you.  

[godiva121]

thank you for your suggestions.  unfortunately, I do not know how long the copper issue will take.  for the moment I am taking t3 twice per day and Zinc to sleep as Zinc gets rid of the excess copper and iron...........I am so exhausted I I do not take t3.............so in order to function during the day, I have to take thyroid medication.  
I will go on the lyme community, as I would like to solve my thyroid issue first..........my ankle gets swollen in the morning after taking the t3, after it resolves after my 2nd dosing.
I went for blood test as per your suggestions a few days back for t3, t4 and rt3............I hope you still want to see those results?

[gimel]

Yes definitely want to see those test results.

[godiva121]

lab results

TSH 5.02, reference 0.27 - 4.2 miU/L
Free T4 13.9, reference 12-22 pmol/L
Free T3 5.2, reference 3.1 - 6.8 pmol/L
Reverse T3 0.026, reference 0.012 - 0.038

[gimel]

   We don't hear from many members with iron overload problems.   From your labs you clearly have a problem with that.  You can read bout hemochromatosis in this link.  Following the link are some of the common symptoms.  In doing some reading I also found evidence of adverse affects on thyroid function due to iron overload.  

http://labtestsonline.org/understanding/conditions/hemochrom


    Fatigue, weakness
    Abdominal pain
    Joint pain
    Increased blood glucose levels and diabetes
    Liver dysfunction and/or abnormal liver blood tests
    Decreased sex drive, impotence in men
    Lack of menstruation in women
    Hypothyroidism
    Changes in skin color, turning grey or bronze

To me, all this points to iron overload as your primary problem that needs to be addressed before assuming there is an underlying thyroid problem.  Also, if there has been confirmation of the Lyme Disease you mentioned, then that also needs to be addressed by your doctor.