Thyroid Disorders Community
help with my stats - going to endo tomorrow
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This patient support community is for discussions relating to thyroid issues, goiter, Graves disease, Hashimoto's Thyroiditis, Human Growth Hormone (HGH), hyperthyroid, hypothyroid, metabolism, parathyroid, pituitary gland, thyroiditis, and thyroid Stimulating Hormone (TSH).

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help with my stats - going to endo tomorrow

I am going to endo tomorrow.  I got the results of my tests.  They are as follows T4 1.24  range 0.82-1.77,  TSH 2.470 uIU/mL range 0,450-4.500, Vit. D  19.4  range 30.0-100.0, T3  118 ng/dL range 71-180.       My TSH has changed from Sept 28 2011, 1.540 uIU/mL same range.  I know these are all normal range except for the Vit D.  I still don't feel good.  I still have foggy brain, confusion at times.  I can feel pretty good and boom my mind just feels disconnected and not functioning good.  I have to push through this and concentrate.  I have hashimoto and RAI and my thyroid still produces at times.  I know I don't have a good understanding of all this even though I have had it for a long time.  I am just now beginning to get a handle on the fact that the way I feel and have felt has been caused from my thyroid condition.  I don't understand how I can still feel bad when my numbers are within the norm.  I also have been gluten free for about 3 months and that has definitely made me feel better.  I am so fed up with not feeling normal (what is that).  I was surprised to see my numbers still be within the normal range.  Does you tsh fluctuate within the normal range.  My endo raised my Synthroid from 37.5 everyday to 37.5 for 4 days and 75 for 3 days.  That did bring me back down to the 1.540 from the 4.5 range.  It had been going up and up until she changed it.  Now it has again started going up.  I also get extreme pain about 15 minutes after I take my synthroid in the am on an empty stomach.  It doesn't last to long.  I don't remember exactly how long but I would say 10-15 minutes or so.  Does it make a difference that she didn't test free T3?  I was thinking that maybe I should try the new thyroid pill Tirosint as maybe the fillers in the synthroid I could be allergic to.  I am very sensitive to all medication.  I couldn't take the generic synthroid and felt so much better when I changed to the synthroid.  I didn't notice the pain as I was having so many other symtoms (symptoms).  I am finally getting to where I can see the different things wrong and now want to try to treak things so I can feel even better.  I know I am better so I think what I have done up to now is good but where to go from here so I can feel better with a clearer mind and no headaches.  I hadnt had a headache in 30 years and all of the sudden I am having them every day.  Not bad ones, just slightly there.  I also am currently having high blood pressure.  Could I be reacting to the synthroid.  I just don't know and there are other symptoms that I am haven't that I can't think of right now.   I am tired, not sleeping right, memory problems, weight loss and then weight gain.  None of this is severe.  I even had an anxiety which I haven't had in a long time.  What I am trying to say is that I feel now is the time to start addressing the way I feel.  I have read so many saying that it doesn't matter the numbers but it is how you feel.  What do you think.?   Am I crazy or not.  I am so tired of not finding answers.  I do agree with some that I read that it is a trial and error and a process.  As I read some of the symptoms I know I have them at times.  My big question is when my thyroid is producing hormone and I am taking hormone, could this be causing the ups and downs that I feel. I am trying not to be discouraged as it is good that my numbers are in supposedly normal range but it still doesn't mean that I feel ok.  Please let me know your experience with this.    
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Avatar_m_tn
Lots of questions, so I'll try to answer some of the most important for now.  

Yes, it definitely makes a difference that you have not been tested for Free T3.  FT3 largely regulates metabolism and many other body functions.  Scientific studies have shown that Free T3 correlated best with hypo symptoms, while Free T4 and TSH did not correlate.  Doctors often assume that if they know the level of Free T4, then they don't need to tst for Free T3.  This is false, because many patients taking thyroid meds find that their body does not adequately convert the T4 med to T3.  Without testing of Free t3 level (not Total T3), you don't have all the info needed to adequately treat a hypo patient.

I had a TSH of about .05 for well over 25 years while taking a full daily replacement dose of T4 med, of 200 mcg.  During this time I never had hyper symptoms.  In fact I had lingering hypo symptoms.  After learning about the importance of free T3 here on the Forum, mine was tested and confirmed as low in its range, which is consistent with having hypo symptoms.  My doctor revised my meds from T4 to a desiccated T4/T3 type.  After some tweaking, my Free T3 is now 3.9, and I feel best ever.  

So the first thing you need to do is to request testing for Free T3, along with the Free T4.   Also it would be a good idea to find out if your doctor is willing to treat you  clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  Symptom relief should be all important, not just test results.  I would also add to the list of tests you need, Vitamin B12, and a full test panel for iron anemia.  Another question for your doctor is to find out if he is willing to prescribe meds with T3 in them.


When test results are available, please get a copy and post results and reference ranges shown on the lab report and members will be glad to interpret and advise further.
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Avatar_m_tn
Lots of questions, so I'll try to answer some of the most important for now.  

Yes, it definitely makes a difference that you have not been tested for Free T3.  FT3 largely regulates metabolism and many other body functions.  Scientific studies have shown that Free T3 correlated best with hypo symptoms, while Free T4 and TSH did not correlate.  Doctors often assume that if they know the level of Free T4, then they don't need to tst for Free T3.  This is false, because many patients taking thyroid meds find that their body does not adequately convert the T4 med to T3.  Without testing of Free t3 level (not Total T3), you don't have all the info needed to adequately treat a hypo patient.

I had a TSH of about .05 for well over 25 years while taking a full daily replacement dose of T4 med, of 200 mcg.  During this time I never had hyper symptoms.  In fact I had lingering hypo symptoms.  After learning about the importance of free T3 here on the Forum, mine was tested and confirmed as low in its range, which is consistent with having hypo symptoms.  My doctor revised my meds from T4 to a desiccated T4/T3 type.  After some tweaking, my Free T3 is now 3.9, and I feel best ever.  

So the first thing you need to do is to request testing for Free T3, along with the Free T4.   Also it would be a good idea to find out if your doctor is willing to treat you  clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  Symptom relief should be all important, not just test results.  I would also add to the list of tests you need, Vitamin B12, and a full test panel for iron anemia.  Another question for your doctor is to find out if he is willing to prescribe meds with T3 in them.


When test results are available, please get a copy and post results and reference ranges shown on the lab report and members will be glad to interpret and advise further.
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200220_tn?1361955154
Thank you for answering so quickly.  Here it is 3:00 am and I am up.  I am upset as not knowing what to do.  I am going to pursue my thought that the way I feel is because of my thyroid.  I was disappointed that she didn't test my free T3.  Would the results be different than the just plain T3.  I will ask her today also for the Vit B12 and iron anemia.  I am going to copy this email and take it with me.  I desperately need some hope to know there is answers for me that eventually will help with the way I feel.  I make it but I want to feel a lot better than I feel and confident that I will continue to feel better.  Thank you again.  I have always been very obedient to the doctors but I now feel I must take some charge here and do something.  
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200220_tn?1361955154
I went to my endo today.  I cried through most of the appointment.  I told her my list of symptoms and that even thought my tests were normal range except for Vit.D, I didn't feel good at all.  She was very nice and explained that she didn't treat the T3 because at this time she didn't find in her practice that it needed according to her research to be treated.  She was open however to changing this if she finds it to be different.  I took several of the letters from this forum with me and mentioned some of the results.  I asked her about the Tirosint and although she at the present doesn't have anybody on it, she was willing to change me to it.  I start on Monday with 50mcg everyday.  I am hoping that the pain I had after taking the synthroid  will stop as this is a gel cap.  It is not expensive.  My insurance doesn't cover it but it is only 30.00 for 4 week supply.  I pay that with insurance with my synthroid.  I was quite upset as she didn't give me too many answers but was willing to listen and comment on what I had to say.  She said that maybe I could find an endo that would treat the T3 but I had a time finding her and I am not ready to move on with another doctor.  I feel I am on the right track and will continue to try to find what to do with each of the symptoms that I have.  The main one right now is the pain in my stomach and esophogus.  I have been diagnosed with severe gastritis and told to take a Prilosec 2 times a day forever.  I am not doing that but need to find out what to do.  The gluten free has made me feel better mentally, but I still have the pain when I eat.  I don't have the bloating anymore so that is a relief.  I will look at other forums to see what others say about this.  She also told me for the B12 test and the iron to see my family doctor.  I guess I am encouraged that at least she listened.  I told her that I don't have a lot of faith in doctors as no one has really made me feel totally better.  It has been a little at a time and I guess that is progress.  
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