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Thyroid questions
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Thyroid questions

Okay, so I am back on 137 mcg Levothyroxine now, and already feeling rough, I was very worried about them taking me off my meds, but I was shocked, I was actually feeling human, normal, I couldn't believe how good I felt, no pains and no nervousness. I could even think, go from room to room and remember what I was there for. Anyway, I have some of my numbers, will have the rest on the 7th Feb. My Free T3 is 1.9 pg/ml, normal range ( 2.4-6.8), My T3 total, 0.5 ng/ml, normal range ( 0.8-1.6), My T4 total, 3.2 mcg/dl, normal range 4.5-13.9).
Any advice out there?
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Avatar_m_tn
Posted on the older thread before seeing this one.  Copied and pasted it again here.  

To: Mamaw3
I'd guess that you have been weaning yourself from the med for about 6 weeks, correct?  Assuming that you just recently had these tests done, I'd say that they reflect having only a little of the med left in your system.  Because of that your Free T3 and Free T4 are way below the levels required for symptom relief.  Many members report that symptom relief for them required that Free T3 was adjusted into the upper third of its range and Free T4 adjusted to around the midpoint of its range.

What starting dosage has your doctor prescribed for you to increase those levels to relieve symptoms?  Also, how quickly are you supposed to ramp up the dosage?

What test did the doctor run, that required the reduction of meds?  Has the doctor given you any info from that test?
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Avatar_f_tn
I was told to go right back to the dose I was on before we started this, the 137mcg, the rest of the test results I won't have until Feb. 7th.  
I just can't beleive how good I was feeling, I felt human, normal, no pains in my hips or in my back, hadn't been having panic or anxiety, now here it is, not even one whole week yet back on med's and I have been all gittery, my hips driving me crazy, I know no for sure this all has something to do with my levels or this medication for sure.
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Avatar_m_tn
I am surprised that the doctor told you to start back on 137 instead of a lower starting dose and then gradually build up to whatever level is necessary to relieve your hypo symptoms.  

Rather than letting your doctor continue to adjust your meds by your TSH level, you should insist on being tested for Free T3 and Free T4 every time you go in.  In addition, you should be tested for Vitamin D, B12, RBC magnesium, and a full test panel for iron anemia.  

A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms.  Symptom relief should be all important, not just test results.  You can get some good insight into clinical treatment from this letter written by a good thyroid doctor for patients that he sometimes consults with from a distance.  The letter is sent to the PCP of the patient to help guide treatment.

http://hormonerestoration.com/files/ThyroidPMD.pdf

Since you have been on the 137 mcg dose for about a week I think you should consider getting an appointment for follow up testing in about 3 more weeks.  Then make sure they do all the testing I gave you above and see where you are with that dose.  You should also find out if the doctor will be willing to treat you clinically as described in the letter rather than by TSH levels.

When test results are available, if you will get a copy of the lab report and post test results and their reference ranges, members will be glad to help interpret and advise further.
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Avatar_m_tn
Hi
I would welcome your feedback on these thyroid test results:
Total T3 117ng/dL  & Range is 70 to 204 ng/dL
Total T4 6.45 ul/dl & Range is 5.2 to 12.5 hg/dL
3rd Generation TSH is 10.73 & Range is 0.7 to 6.4.

Taking 125mcg levothroxin daily.

Thanks
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Avatar_m_tn
Total T3 and Total T4 tests are somewhat outdated and not nearly as useful as Free T3 and Free T4.  Only small portions of Total T3 and T4 are not bound to protein molecules.  Only the unbound (free) portions are biologically active.   Free T3 is the most important thyroid hormone test because scientific studies have shown that Free T3 correlated best with hypo symptoms, while Free T4 and TSH did not correlate.

If I assumed that your Free T3 and Free T4 levels would reflect the same position within their ranges as your Total T3 and T4 shown above, then I'd say that you are likely hypothyroid currently, due to inadequate medication.  Your high TSH result is further confirmation of that likelihood.

The reason I say that about FT3 and FT4 is that the so-called "normal" ranges are far too broad.  Results that fall in the lower half of the ranges are frequently associated with being hypothyroid.  Many of our members, myself included, report that symptom relief for them required that Free T3 was adjusted into the upper third of its range and Free T4 adjusted to around the middle of its range.

So it appears that you likely need increased medication.  Also, you need to always be tested for Free T3 and Free T4, not Total T3 and T4, when you go in for testing.  It would also be a good idea to test for Vitamin D and  B12.  I would normally also suggest testing for iron anemia, but I know you have had that done already.  If the doctor resists testing you for FT3 and FT4, then you should insist on it and don't take no for an answer.  

If you are able to get those tests done, then please post results and their reference ranges here and members will be glad to help interpret and advise further.

Another important consideration is whether your doctor is going to be willing to treat you clinically, as described above in the post for Mamaw3.  If not, then you will need to find a good thyroid doctor that will do so.
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Avatar_f_tn
Thank you so much,
I will post all test results as soon as I get them on the 7th.
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