Aa
basal temps
I am currently on Synthroid .125mcg and Cytomel 25 in the am and 5 in the afternoon. 7 weeks after starting cytomel my FT3 went from 3.00 to 3.03 with the range of 2.77-5.27, so we added the additional 5.
Saw the doctor yesterday and I'm to check my temps in the am and call him Friday as I am due for a new Rx. When I asked if he was going to redraw the FT3 and told me no. He's not gonna chase the labs, gonna go by symptoms!! If the temps are low, we are making a change. I'm pretty sure Armour, as he mentioned it last time.
Well the last 2 days, my temps were 96.5 and 96.2 (both axillary). Wow! I did check mine oral this morning and it was 97.4 so I think the thermometer is accurate, that's pretty much the expected difference in temps.
Well after that, I started checking my 15yo daughters temp first thing in the morning and that really freaked me out.
Yesterday 93.4, repeated 93.2., repeated today, 94.6 axillary, checked oral and got 96.6. Had her labs done last week and guess what NORMAL.
TSH 1.53 Range is 0.34-4.82
FT4 1.20 range is 0.93-1.60
Her pediatrician didn't think the FT 3 was necessary. However, she is exhausted all the time. When I work her up this morning she was sleeping in a hooded sweat shirt and flannel pants, her normal sleep attire these days. She has gained weight, despiting being a cheerleader and playing basketball. And she just seems overall "blah".
I think I'll be taking my daughter and her labs to a big girl doctor now and see what mine thinks of her temps.
Any suggestions for her temps? Those just seem much lower to me than hypothyroid would lead to.
Thank you in advance and so sorry for the long post!!
Saw the doctor yesterday and I'm to check my temps in the am and call him Friday as I am due for a new Rx. When I asked if he was going to redraw the FT3 and told me no. He's not gonna chase the labs, gonna go by symptoms!! If the temps are low, we are making a change. I'm pretty sure Armour, as he mentioned it last time.
Well the last 2 days, my temps were 96.5 and 96.2 (both axillary). Wow! I did check mine oral this morning and it was 97.4 so I think the thermometer is accurate, that's pretty much the expected difference in temps.
Well after that, I started checking my 15yo daughters temp first thing in the morning and that really freaked me out.
Yesterday 93.4, repeated 93.2., repeated today, 94.6 axillary, checked oral and got 96.6. Had her labs done last week and guess what NORMAL.
TSH 1.53 Range is 0.34-4.82
FT4 1.20 range is 0.93-1.60
Her pediatrician didn't think the FT 3 was necessary. However, she is exhausted all the time. When I work her up this morning she was sleeping in a hooded sweat shirt and flannel pants, her normal sleep attire these days. She has gained weight, despiting being a cheerleader and playing basketball. And she just seems overall "blah".
I think I'll be taking my daughter and her labs to a big girl doctor now and see what mine thinks of her temps.
Any suggestions for her temps? Those just seem much lower to me than hypothyroid would lead to.
Thank you in advance and so sorry for the long post!!
Sorry about that. I have used it before and no one questioned it. I guess you are the first to really want to read it. LOL
Try it this way and then click on the full text version on the right side.
http://www.clinchem.org/cgi/content/abstract/51/8/1480
Try it this way and then click on the full text version on the right side.
http://www.clinchem.org/cgi/content/abstract/51/8/1480
The link did not work for me. I got an error message. It appears to be an email address not a web page.
I don't think there should be any significant concern for a pituitary issue because of the low TSH when taking larger doses of thyroid meds. I say this for two primary reasons. First many members report that their TSH is suppressed below the reference range when taking such doses. My TSH has been about .05 for over 25 years because of that. Second, TSH is affected by so many variables, that studies have shown that a TSH test cannot really distinguish among hyper, euthyroid, and hypo. If you are interested, have a look through this link to confirm.
http://sz0102.ev.mail.comcast.net/service/home/~/KratzschNewRefRange.pdf?auth=co&loc=en_US&id=135360&part=2&disp=a
I have also seen somewhere an explanation of why doses of T4 will suppress TSH more than you would think. I'll have to see if I can find it again.
http://sz0102.ev.mail.comcast.net/service/home/~/KratzschNewRefRange.pdf?auth=co&loc=en_US&id=135360&part=2&disp=a
I have also seen somewhere an explanation of why doses of T4 will suppress TSH more than you would think. I'll have to see if I can find it again.
Also. TSH is a pituitary gland product. So not having a Thyroid has nothing to do with what the pituitary gland excretes. The pituitary doesn't even "know" if there is, or is not a Thyroid present. You report that your TSH is for all intents and purposes zero.
Would that not indicate a potential pituitary issue. Since you seem to be still hypo but the pituitary is not sensing that. With or without a Thyroid, your Pituitary should be measuring your thyroid levels and if the pituitary senses that you are low, it would kick out TSH so as to tell the thyroid gland to produce more thyroid hormone. Like I said, the pituitary doesn't know if the thyroid gland is there or not. It is just sending it a message. Kind of like a person who did not know their friend moved would continue to send a letter in the mail to the old address but no one is home. Yet you keep trying.
Would that not indicate a potential pituitary issue. Since you seem to be still hypo but the pituitary is not sensing that. With or without a Thyroid, your Pituitary should be measuring your thyroid levels and if the pituitary senses that you are low, it would kick out TSH so as to tell the thyroid gland to produce more thyroid hormone. Like I said, the pituitary doesn't know if the thyroid gland is there or not. It is just sending it a message. Kind of like a person who did not know their friend moved would continue to send a letter in the mail to the old address but no one is home. Yet you keep trying.
Good point, again! Guess I'll see what the doctor says tomorrow when I call. I'll keep you posted.
That recommended dose of 1.7 mcg/kg/day comes from people who only recommend using a T4 med. They typically don't recognize the problem of T4 to T3 conversion and the need for T3 meds. Since T3 is the active thyroid hormone and T4 the "storage" hormone that has to be converted to T3, I think I'd increase the Cytomel, not the Synthroid. JMHO
Thanks for the quote, I think I'll print those off for future reference.
So basically, you're telling me not to get all caught up in the dosing either? ;) It remains all about symptom improvement. Maybe I need an increase in Synthroid as opposed to Cytomel? If the recommended dose is 1.7mcg/kg/day, my 125mcg maybe a little low. Obviously without a thyroid, my TSH of 0.01 is irrelevant.
Oh what a tangled web we weave, just trying to stay warm, awake and aware. What a beating!!
So basically, you're telling me not to get all caught up in the dosing either? ;) It remains all about symptom improvement. Maybe I need an increase in Synthroid as opposed to Cytomel? If the recommended dose is 1.7mcg/kg/day, my 125mcg maybe a little low. Obviously without a thyroid, my TSH of 0.01 is irrelevant.
Oh what a tangled web we weave, just trying to stay warm, awake and aware. What a beating!!
Well, you've accomplished a couple of important steps. First is finding a doctor that is willing to treat you clinically. Second is that you understand about what is most important and you can help guide the doctor in that direction. Now I think it is only a matter of getting your meds adjusted adequately and finding your own "sweet spot" for FT3 and FT4, at which you feel good.
You may be glad to know about one of our members with very bad symptoms and very low FT3 and FT4 results, even though she was taking heavy doses of thyroid meds. This is a copy of my post to her.
___________________________
Well, I searched for possible reasons for the low FT4 and FT3 until I ran out of patience. In desperation to try to find something useful, I finally decided to try a long shot. I found an email address for a doctor that is a highly regarded thyroid doctor and sent an email explaining your situation and pleading for any direction that he could provide. To my amazement I got a pretty fast response quoted below.
"A person on levothyroxine should have a free T4 in the upper third of the reference range. (see p. 36, NACB: Laboratory Support for the Diagnosis and Monitoring of Thyroid Disease) For many persons it even needs to be above the FT4 ref. range. They need high FT4 levels to drive sufficient FT3 production.
I don't know what lab's ranges are involved, but LabCorp's range for FT4 is 0.82-1.77ng/dl, and for free T3 are 2.0-4.4 pg/ml. If her lab's ranges are similar, perhaps you have misstated her FT4 and it should be 0.6ng/dL. If her lab's ranges are similar to LabCorps, then she is being undertreated. She needs to be given enough levothyroxine to raise her FT4 to at least 1.5ng/dL. This should raise her FT3 to at least 3pg/ml.
The dose is irrelevant. Maybe she absorbs oral T4 poorly or she metabolizes it rapidly. It doesn't matter. She needs to be given whatever amount of oral levothyroxine it takes to 1.) eliminate signs and symptoms of hypothyroidism and probably 2.) to restore her FT4 and FT3 levels to around the numbers I've mentioned--or to a similar level within the laboratory's reference range. This amount of levothyroxine will no doubt normalize her TSH. The doctor should have no problem with prescribing enough levothyroxine to at least "normalize" her TSH." However the NACB guidelines are also clear on the TSH goal of levothyroxine therapy--the patient usually needs to be given enough levothyroxine to lower the TSH into the lower part of the range (from 0.5 to 2.0 miU/L).
___________________________
And then another quote from the same doctor.
"T4-only therapy (Synthroid, Levoxyl), to merely “normalize” the TSH is typically inadequate as the H-P axis is often under-active to begin with, is more sensitive to T4, and is over-suppressed by the once-daily oral thyroid hormone peaks. TSH-normalizing T4 therapy often leaves both FT4 and FT3 levels relatively low, and the patient symptomatic. Recognizing this, NACB guidelines call for dosing T4 to keep the TSH near the bottom of its RR (<1) and the FT4 in the upper third of its RR; but even this may not be sufficient. The ultimate criterion for dose adjustment must always be the clinical response. I have prescribed natural dessicated thyroid for your patient (Armour or Nature-Throid). These contain T4 and T3 (40mcg and 9mcg respectively per 60mg). They are more effective than T4 therapy for most patients. Since they provide more
T3 than the thyroid gland produces, the well-replaced patient’s free T4 will be around the middle of its range or lower, and the FT3 will be high-“normal” or slightly high before the AM dose.
Excessive thyroid dosing causes many negative symptoms, and overdosed patients do not feel well. I suggest lowering the dose in any patient who has developed insomnia, shakiness, irritability, palpitations, overheating, excessive sweating, etc. The most serious problem that can occur is atrial fibrillation. It can occur in susceptible patients with any increase in their thyroid levels, and is more likely with higher doses. It should not recur if the dose is kept lower than their threshold. Thyroid hormone does not cause bone loss, it simply increases metabolic rate and therefore the rate of the current bone formation or loss. Most older people are losing bone due to their combined sex steroid, DHEA, Vitamin D, and growth hormone deficiencies. The solution is not life-long hypothyroidism or bisphosphonates; one should correct the hormone deficiencies."
You may be glad to know about one of our members with very bad symptoms and very low FT3 and FT4 results, even though she was taking heavy doses of thyroid meds. This is a copy of my post to her.
___________________________
Well, I searched for possible reasons for the low FT4 and FT3 until I ran out of patience. In desperation to try to find something useful, I finally decided to try a long shot. I found an email address for a doctor that is a highly regarded thyroid doctor and sent an email explaining your situation and pleading for any direction that he could provide. To my amazement I got a pretty fast response quoted below.
"A person on levothyroxine should have a free T4 in the upper third of the reference range. (see p. 36, NACB: Laboratory Support for the Diagnosis and Monitoring of Thyroid Disease) For many persons it even needs to be above the FT4 ref. range. They need high FT4 levels to drive sufficient FT3 production.
I don't know what lab's ranges are involved, but LabCorp's range for FT4 is 0.82-1.77ng/dl, and for free T3 are 2.0-4.4 pg/ml. If her lab's ranges are similar, perhaps you have misstated her FT4 and it should be 0.6ng/dL. If her lab's ranges are similar to LabCorps, then she is being undertreated. She needs to be given enough levothyroxine to raise her FT4 to at least 1.5ng/dL. This should raise her FT3 to at least 3pg/ml.
The dose is irrelevant. Maybe she absorbs oral T4 poorly or she metabolizes it rapidly. It doesn't matter. She needs to be given whatever amount of oral levothyroxine it takes to 1.) eliminate signs and symptoms of hypothyroidism and probably 2.) to restore her FT4 and FT3 levels to around the numbers I've mentioned--or to a similar level within the laboratory's reference range. This amount of levothyroxine will no doubt normalize her TSH. The doctor should have no problem with prescribing enough levothyroxine to at least "normalize" her TSH." However the NACB guidelines are also clear on the TSH goal of levothyroxine therapy--the patient usually needs to be given enough levothyroxine to lower the TSH into the lower part of the range (from 0.5 to 2.0 miU/L).
___________________________
And then another quote from the same doctor.
"T4-only therapy (Synthroid, Levoxyl), to merely “normalize” the TSH is typically inadequate as the H-P axis is often under-active to begin with, is more sensitive to T4, and is over-suppressed by the once-daily oral thyroid hormone peaks. TSH-normalizing T4 therapy often leaves both FT4 and FT3 levels relatively low, and the patient symptomatic. Recognizing this, NACB guidelines call for dosing T4 to keep the TSH near the bottom of its RR (<1) and the FT4 in the upper third of its RR; but even this may not be sufficient. The ultimate criterion for dose adjustment must always be the clinical response. I have prescribed natural dessicated thyroid for your patient (Armour or Nature-Throid). These contain T4 and T3 (40mcg and 9mcg respectively per 60mg). They are more effective than T4 therapy for most patients. Since they provide more
T3 than the thyroid gland produces, the well-replaced patient’s free T4 will be around the middle of its range or lower, and the FT3 will be high-“normal” or slightly high before the AM dose.
Excessive thyroid dosing causes many negative symptoms, and overdosed patients do not feel well. I suggest lowering the dose in any patient who has developed insomnia, shakiness, irritability, palpitations, overheating, excessive sweating, etc. The most serious problem that can occur is atrial fibrillation. It can occur in susceptible patients with any increase in their thyroid levels, and is more likely with higher doses. It should not recur if the dose is kept lower than their threshold. Thyroid hormone does not cause bone loss, it simply increases metabolic rate and therefore the rate of the current bone formation or loss. Most older people are losing bone due to their combined sex steroid, DHEA, Vitamin D, and growth hormone deficiencies. The solution is not life-long hypothyroidism or bisphosphonates; one should correct the hormone deficiencies."
I understand about not knowing prior too and there is probably something to that.
Prior to October, I had never taken cytomel. At that time the FT3 was 3.00. That was the very first time anyone ever checked my FT3. It has always just been the TSH and FT4.
We added 25 of Cytomel, rechecked the labs in early December and the FT3 was 3.03. So at that time, we added the additional 5 of Cytomel. I have not had the FT3 redrawan since adding the other 5. I saw the doctor early this week when I took my son for a flu shot and he asked how I was feeling. When I told him not really any different, that's when he said monitor the temps and call him Friday. Because my temps have been so low, I assume he will do something different, but not really sure what, if at all.
I have read on here that's a pretty high dose of Cytomel compared to what others are taking. I guess I'm feeling desperate to feel better and was hoping that by this time, things would have improved. Do I have an unrealistic expectation for how long this wil take?
I'm just so over all this.
Prior to October, I had never taken cytomel. At that time the FT3 was 3.00. That was the very first time anyone ever checked my FT3. It has always just been the TSH and FT4.
We added 25 of Cytomel, rechecked the labs in early December and the FT3 was 3.03. So at that time, we added the additional 5 of Cytomel. I have not had the FT3 redrawan since adding the other 5. I saw the doctor early this week when I took my son for a flu shot and he asked how I was feeling. When I told him not really any different, that's when he said monitor the temps and call him Friday. Because my temps have been so low, I assume he will do something different, but not really sure what, if at all.
I have read on here that's a pretty high dose of Cytomel compared to what others are taking. I guess I'm feeling desperate to feel better and was hoping that by this time, things would have improved. Do I have an unrealistic expectation for how long this wil take?
I'm just so over all this.
My biased opinion is that the improvement patients sometimes identify when switching to Armour is only due to having been previously too low in FT3, due to poor conversion of T4 to T3 when taking their T4 med. Many times they never even know what their FT3 levels were before or after, but they notice the improvement in symptoms and attribute it only to the Armour. Adding in Cytomel could have accomplished the same FT3 effect.
Understand I'm not advocating Synthroid/Cytomel over Armour or other T4/T3 meds. I just believe it is the levels of FT3, and somewhat FT4, not the type of medication.
In view of that my hesitation to going to Armour is only a reluctance to throw in another variable and have to take time to monitor and adjust for that.
You said that the second FT3 test was taken about 18 hours after your T3 meds. How about the first test? What was the time interval between your T3 meds and the blood draw for that test?
Understand I'm not advocating Synthroid/Cytomel over Armour or other T4/T3 meds. I just believe it is the levels of FT3, and somewhat FT4, not the type of medication.
In view of that my hesitation to going to Armour is only a reluctance to throw in another variable and have to take time to monitor and adjust for that.
You said that the second FT3 test was taken about 18 hours after your T3 meds. How about the first test? What was the time interval between your T3 meds and the blood draw for that test?
I didn't take the Cytomel the morning of my last FT3, actually, it had been greater than 18 hours since the last dose. I actually have seen no imrovement in how I feel. I think the reason for switching to Armour has to do with so many reports of the dessicated thyroid working better for some than traditional synthroid. Because he has been studying a book given to him by a patient, "Hypothyroidism Type II, it has opened his eyes to treating patients and being more open to other options in treatment.
It has been 3 months since adding the Cytomel and I feel nothing different and my FT3 only increased by 0.03. If I figured the midpoint of the range correctly, my FT3 should be at least 4.02. The range is 2.77-5.27. So with a 3.03, I'm definately below the midpoint.
Would 3 months not be enough time to begin to see improvement? I am actually now at 30mcg of Cytomel with really not much effect or change in labs.
We are hoping that the change in meds may be what I need to get that FT3 higher in the range. I would not do Armour and Cytomel, just the Armour, monitor how I feel with the labs and go from there.
Am I off base? I really value your opinion. I've read so much all over the boards about how many feel better on desicated, I thought maybe that would help.
Again, Thank you so much!
It has been 3 months since adding the Cytomel and I feel nothing different and my FT3 only increased by 0.03. If I figured the midpoint of the range correctly, my FT3 should be at least 4.02. The range is 2.77-5.27. So with a 3.03, I'm definately below the midpoint.
Would 3 months not be enough time to begin to see improvement? I am actually now at 30mcg of Cytomel with really not much effect or change in labs.
We are hoping that the change in meds may be what I need to get that FT3 higher in the range. I would not do Armour and Cytomel, just the Armour, monitor how I feel with the labs and go from there.
Am I off base? I really value your opinion. I've read so much all over the boards about how many feel better on desicated, I thought maybe that would help.
Again, Thank you so much!
No good explanation for why the FT3 did not go up more. Of course test variability is always a possibility. Also, do you take the Cytomel before or after the blood draw for tests? It makes a difference in test results.
Of much more importance is how you are feeling (symptoms). One thing to keep in mind with that is that symptoms often lag behind changes in blood levels of thyroid hormones. So it is important that med changes are made somewhat slowly, giving time for the full effect.
One other thing that came to mind is that I am not aware of any beneficial effect of Armour over equivalent amounts of Synthroid and Cytomel. So, why bring that variable into play by switching to Armour? I think I would just increase the Cytomel and move FT3 higher into the range. Many of our members report that symptom relief for them required that FT3 was adjusted into the upper part of its range and FT4 adjusted to at least midpoint of its range.
Of much more importance is how you are feeling (symptoms). One thing to keep in mind with that is that symptoms often lag behind changes in blood levels of thyroid hormones. So it is important that med changes are made somewhat slowly, giving time for the full effect.
One other thing that came to mind is that I am not aware of any beneficial effect of Armour over equivalent amounts of Synthroid and Cytomel. So, why bring that variable into play by switching to Armour? I think I would just increase the Cytomel and move FT3 higher into the range. Many of our members report that symptom relief for them required that FT3 was adjusted into the upper part of its range and FT4 adjusted to at least midpoint of its range.
I totally agree about the difficulty with getting labs done.
My FP has sort of had an epiphany after reading a new book. When he first did my blood work in December, I told the nurse what I wanted drawn and she replied "he does all of those now". I had no trouble with the getting the FT3 and FT4. I think at this point its time to switch to an adult doctor now anyways, so I will make her an appointment for next week.
I hear ya on the whole teenager behavior or thyroid issue. My family has extensive hx with thyroid issues as well.
I figure that will give me at least 10 days of temps to show him. I checked her HR this morning and it was 62. I started a chart to track her axillary and oral temps as well as heart rate. So I'll have some good data to show him. I do respect him, as he has always been willing to work with me and hear me out. Guess we'll see what happens.
What happens next with your daughter?
Good luck!
My FP has sort of had an epiphany after reading a new book. When he first did my blood work in December, I told the nurse what I wanted drawn and she replied "he does all of those now". I had no trouble with the getting the FT3 and FT4. I think at this point its time to switch to an adult doctor now anyways, so I will make her an appointment for next week.
I hear ya on the whole teenager behavior or thyroid issue. My family has extensive hx with thyroid issues as well.
I figure that will give me at least 10 days of temps to show him. I checked her HR this morning and it was 62. I started a chart to track her axillary and oral temps as well as heart rate. So I'll have some good data to show him. I do respect him, as he has always been willing to work with me and hear me out. Guess we'll see what happens.
What happens next with your daughter?
Good luck!
The book by Dr. Barnes is old but he really stressed thyroid function by basil body temp.
I really believe this is indicative but really again gets you only close to the best dosage.
In his book he said that under arm temp taken first thing in AM with a mercury thermometer for 15 min. And the temp if your thyroid is normal should be If I remember right was 97.8 to 98.2 degrees. Thus under arm should be about half to one degree below the "normal" 98.6 taken orally. Again I think of this basil body temp range similar to TSH or T3 &T4 reference ranges. Just because you are within range does not mean you have found the sweet spot for level of medication dosage. Most find that they need to be in the upper 1/3 of the T3 & T4 ranges to feel the best. Not merely somewhere within the range. This would make sense since the reference range is I think the range where 95% of the people fall. However when you consider that potentially 30% of those tested are Hypo it would mean that the optimum curve would have to shift higher into the range.
I know my wife who is also Hypo still can't get her basil under arm temp up to 97.0 Most are in the mid to upper 96 range. Still at least a half degree low or more. Dr. is going to raise for the 3rd time this year her Levo dosage another 12 mcg. She started this year at I think 60 mcg. She will now be going to 112 mcg.
Your daughter has something going on. And it only makes sense that the body's furnace is not working. I think of the Thyroid as the thermostat. The pituitary is the signal from the thermostat. That is TSH tells the Thermostat (thyroid) to click "on" to produce heat. If either the signal or the thermostat are broken, then the furnace doesn't turn on. If the furnace is not burning fuel. The body will gain weight.
We also had my 16 year old daughter tested for low thyroid since it runs in the family. And she is cold and tired and grumpy all the time. Which may just be a normal teenager behavior, or the family thyroid curse is in full swing. We DIRECTLY demanded Free T3 and Free T4 tests be done. However last night we just got the results back. They ONLY tested TSH (which was perfect) and therefore they said that the running of T3 & T4 was not warranted unless she had other conditions which she doesn't have.
I'm so pissed my head would explode. Why the hell the Dr. won't run the tests the patient DEMANDS is totally beyond me. They act like the test are paid for directly out of the Dr's. pocket! They have absolutely nothing to lose by running the tests. It doesn't cost them a freaking dime. me and my insurance company maybe. But not them. And it should not even remotely be considered "unusual" or outside the norm to ask for FT3 &FT4 labs for a person known to be Hypo like my wife.
I really believe this is indicative but really again gets you only close to the best dosage.
In his book he said that under arm temp taken first thing in AM with a mercury thermometer for 15 min. And the temp if your thyroid is normal should be If I remember right was 97.8 to 98.2 degrees. Thus under arm should be about half to one degree below the "normal" 98.6 taken orally. Again I think of this basil body temp range similar to TSH or T3 &T4 reference ranges. Just because you are within range does not mean you have found the sweet spot for level of medication dosage. Most find that they need to be in the upper 1/3 of the T3 & T4 ranges to feel the best. Not merely somewhere within the range. This would make sense since the reference range is I think the range where 95% of the people fall. However when you consider that potentially 30% of those tested are Hypo it would mean that the optimum curve would have to shift higher into the range.
I know my wife who is also Hypo still can't get her basil under arm temp up to 97.0 Most are in the mid to upper 96 range. Still at least a half degree low or more. Dr. is going to raise for the 3rd time this year her Levo dosage another 12 mcg. She started this year at I think 60 mcg. She will now be going to 112 mcg.
Your daughter has something going on. And it only makes sense that the body's furnace is not working. I think of the Thyroid as the thermostat. The pituitary is the signal from the thermostat. That is TSH tells the Thermostat (thyroid) to click "on" to produce heat. If either the signal or the thermostat are broken, then the furnace doesn't turn on. If the furnace is not burning fuel. The body will gain weight.
We also had my 16 year old daughter tested for low thyroid since it runs in the family. And she is cold and tired and grumpy all the time. Which may just be a normal teenager behavior, or the family thyroid curse is in full swing. We DIRECTLY demanded Free T3 and Free T4 tests be done. However last night we just got the results back. They ONLY tested TSH (which was perfect) and therefore they said that the running of T3 & T4 was not warranted unless she had other conditions which she doesn't have.
I'm so pissed my head would explode. Why the hell the Dr. won't run the tests the patient DEMANDS is totally beyond me. They act like the test are paid for directly out of the Dr's. pocket! They have absolutely nothing to lose by running the tests. It doesn't cost them a freaking dime. me and my insurance company maybe. But not them. And it should not even remotely be considered "unusual" or outside the norm to ask for FT3 &FT4 labs for a person known to be Hypo like my wife.
Totally agree! We went through many of the symptoms and my list is pretty extensive. I had my thyroid removed 2 years ago for an obstructive goiter. Both my FT4 and FT3 were in the lower 1/3 of the the range and the addition of ctyomel orignially only increased my FT3 by 0.03. I really believe he is trying to find a balance between symptoms and labs, when before his theory was pretty much to follow the lab results.
I think the plan will be to switch to Armour, since I feel no real improvement with the addition of Cytomel and the lab shows it really didn't seem to make an impact.
My thought is that I ask for an Armour dose equivalent to what I'm taking now between Synthroid and Cytomel. Then recheck the labs in 4-6 weeks to see if they correlate with how I feel.
Do you think that would be a reasonable approach?
I just can't figure out why the heck my FT3 didn't really budge at all? And adding the 5mcg in the afternoon hasn't seemed to help either.
My hope is to find a place where I feel better and see what the lab is at that time. Then I will know what lab values are OPTIMAL for me.
Am I on the right track?
I think the plan will be to switch to Armour, since I feel no real improvement with the addition of Cytomel and the lab shows it really didn't seem to make an impact.
My thought is that I ask for an Armour dose equivalent to what I'm taking now between Synthroid and Cytomel. Then recheck the labs in 4-6 weeks to see if they correlate with how I feel.
Do you think that would be a reasonable approach?
I just can't figure out why the heck my FT3 didn't really budge at all? And adding the 5mcg in the afternoon hasn't seemed to help either.
My hope is to find a place where I feel better and see what the lab is at that time. Then I will know what lab values are OPTIMAL for me.
Am I on the right track?
You mentioned that your doctor is going to go by symptoms, rather than by blood tests. I think that in general that is the best approach; however, I think I would also want to test for the biologically active thyroid hormones, FT3 and FT4, in order to track changes. I would also be reluctant to be medicated based only on basal temperature. It is a good indicator, but I would also want to rely on other symptoms as well, since temperature can be affected by variables other than just thyroid, such as adrenal effects.
So while on the subject of symptoms, how about using the extensive checklist in this link and identifying what symptoms you and your daughter have.
http://thyroid.about.com/cs/basics_starthere/a/hypochecklist.htm
So while on the subject of symptoms, how about using the extensive checklist in this link and identifying what symptoms you and your daughter have.
http://thyroid.about.com/cs/basics_starthere/a/hypochecklist.htm
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