normal free t3 and free t4 but high tsh?

[ASUTodd]

Hi all

MY T4 free is 1.2 and my T3 free is 3.1
my TSH was 9.9

from what I read this is subclinical hypothyroidism
They've got me on 25 mg synthroid and I feel bad, cold, tremors, anxious, stomach issues

What shall I do? some say stop the med or every other day.
ER said to stop the med

[Barb135]

Those "hyper" symptoms can also be present when one is very hypo... what is your current FT3 level, with reference range?  What's the reference range for the FT4?  As noted previously, ranges vary lab to lab and have to come from your own report... It seems on the high side, but not over range according to most ranges we see.

If your FT4 is 1.6, we have to question whether you're converting anything to FT3 or not... You might also want to test Reverse T3 levels to be sure you aren't converting too much to rT3, instead of to the usable FT3.  

I think you've gone very hypo due to lack of conversion to FT3...

[ASUTodd]

Went to 25 mcg for a week and stayed very sick
The endo stopped all synthroid for me 12 days ago and I'm feeling better
Last test 5 days ago showed tsh 12 and Ft4 1.6 which is high
How much longer should I expect these hyper symptoms to last?
What do you guys expect happened here with me?
Again at the onset my problem was just a sore back and feeling a bit cold

[Red_Star]

I meant most OTC thyroid supplements. :)

[Red_Star]

Yes, most thyroid medications in the US have active thyroid hormone. That is good to know if you are suffering hypothyroid symptoms and no doctor will treat you but there is also the possibility of becoming hyperthyroid which is a concern.  In Australia there is only one product I have found with active thyroid hormone from Dr Cabot called Thyroid Hormone Cream.

Excerpt from Medpage - OTC Thyroid 'Boosters' May Harm...

"The $24 billion supplement industry faces little regulation. It's governed by the 1994 Dietary Supplement Health and Education Act (DSHEA), which exempts these pills from FDA quality assurance tests prior to getting on the market."

Excerpt from the article: Popular Over-the-Counter Thyroid Supplements Contain Actual Thyroid Hormone...

"Surprisingly, nine out of ten supplements showed detectable amounts of T3, ranging from 1.3 mcg to 25.4 mcg per tablet.

Taken at the recommended dosage, five of the ten supplements delivered T3 quantities in excess of 10 mcg/day, and four delivered T4 quantities ranging from 8.57 to 91.6 mcg/day.

Among the five thyroid supplements labeled as containing bovine (cow) thyroid tissue, extract or concentrate, one had no level of T3 or T4 detectable; two contained T3 only, and two showed detectable amounts of both T3 and T4.

The researchers concluded that most of the OTC thyroid supplements that were studied contained clinically-significant amounts of T4 and T3, in some cases doses that exceed typical prescribed amounts being used for thyroid hormone replacement treatment."

[matter123]

Yea.. i was assuming the ref ranges were the labcorp ones.. your right it's important to know  this. I take for granted they are the typical ranges

thyrogold DOES work however. it's from cows and it raised my ft4 and ft3 considerably.. their 300mg is equivalent to 3 grains of NDT.

It's primarily used for people who are allergic or prefer not to take  porcine hormone.. i found I didn't feel quite right on Porcine or the Cow.. ..

But it definitely does have the hormone in it.. maybe they aren't allowed to sstate it.. idk

[Barb135]

I'm not sure where you're getting your information... a TSH of 9.9 and you don't know that FT4 of 1.1 and FT3 of 3.1 are "almost ideal", because Todd didn't ever give us the reference ranges used by his lab and since ranges vary lab to lab, we can't go by generic ranges.  Not to mention that we all need different levels of thyroid hormones, so there is no across the board "ideal" level...

Increasing synthroid too fast, as happened in ASUTodd's case is exactly what causes symptoms such as he's had.  

As an OTC product, Thyro-Gold is not allowed to have any measurable thyroid hormones in it... it is merely ground up thyroid gland from cows, with some artificial sweetener and coleus root.  It will do no good for someone who needs thyroid replacement hormones...

[matter123]

btw.. i dont doubt taking the synthroid is making you sick.. your BLOOD levels are almost ideal..

strange issue... i hope u get the answeres

[matter123]

sounds like you may have a syndrome called thyroid resistance..

means your body/organs are not getting the hormone and your pituitary is screaming for more..

your BLOOD levels are pretty close..   perfect ft4 is 1.2 and ft3 is 3.2

u are not far off.. your tsh should not be that high..

have u run Reverse t3?  Dr John Lowe had the same problem.. he's written about it - dont have the links but his wife will talk to you about it - since he passed on..

she sells thyrogold.. which he formulated. her number is on the site,  he couldnt use for his condition btw.. he was on straight t3.

.. you can also find more info here

http://en.wikipedia.org/wiki/Thyroid_hormone_resistance

I would run total blood work, cbc.  heavy metal testing.. and possibly genetics test.. 23andme then import raw data to livewello to see if they show that genetic mutation.. If they dont test for it then u may need to find a genetics specialist..

[Barb135]

I'm sorry, I missed that FT of 3.1... my apology; what's the reference range for that?  

Some of the meds you're looking at are pretty strong stuff... I'm not sure you have generalized anxiety disorder, do you? That's kind of a permanent anxiety... The anxiety caused by hypothyroidism is, typically, temporary and resolves once thyroid hormones are adequate, so I'm not sure you'd  really need anything that "potent" or hard to come down from...

Ahhh... It all becomes clear... a jump from 25 mcg to 75 mcg all at once *was* a huge jump, for some people and was probably what caused your trouble... some doctors just don't know when to leave well enough alone, do they? Many of us have to start low and increase at low increments until we reach our needed dosage.

If you haven't already, the first thing I'd suggest is a different endo; then I'd suggest that you drop back to the 25 mcg and stay there for at least a couple weeks, then try to increase to 50 mcg for a couple of weeks before trying to increase to 75 mcg again... You might be able to make it, but you might have to increase much slower than that by splitting pills or alternating dosages...  I've had to do it, so I can suggest various alternations...

Unfortunately, this approach is going to leave you hypo longer, but your FT levels aren't "horrible" yet so hopefully, you won't be feeling too hypo... just need to get you past the anxiety issue, then you can move forward again.

[ASUTodd]

as posted earlier my free T3 is 3.1
Im looking into a SNRI type of drug which is a primary option for generalized anxiety disorder
•Cymbalta (duloxetine)
•Effexor (venlafaxine)
•Fetzima (levomilnacipran)
•Pristiq (desvenlafaxine)

family doc put me on 25mcg then 3 days later the endo put me on 75mcg
everyone says that was a huge jump

[Barb135]

I posted too soon... I know propanolol is a beta blocker... I was asking if the ER doctor gave you a script so you could continue taking it after you had it via IV and that helped... it doesn't sound like 1 mg/day is enough.  That's a pretty small dose.

Maybe the lorazapram dose is too large if it's making you feel dopy and sleepy... or perhaps it's not the right anxiety med.  I took Buspirone and 15 mg twice/day and it didn't make me feel that way, but it did calm my anxiety a lot.

Have you ever had a Free T3 test?  Have you been tested for Hashimoto's?

[Barb135]

Synthroid is dosed in mcg, rather than mg... your original post says 25 mcg, now you say 75 mcg so I'm confused... were you increased from 25 mcg to 75 mcg?

[ASUTodd]

Propanylol 1mg  1 dose per day is what he prescribed, doesn't seem to be enough
Propanylol is a beta blocker with a tremor reducer
Ive only had two blood test for the free t4 first one was 1.1 without meds
2nd one was 1.2 after a 2.5 weeks of .75mg of synthroid

ER doc gave me a weeks worth prescription of lorazapram it really calms me but makes me feel dopy and sleepy.
yes I do think I have anxiety issues

[Barb135]

Did the doctor give you a script for the propanolol?  If not, he should have... It's not unusual for symptoms like this to appear after we start taking a thyroid replacement hormone, because our body has to get used to having hormones it's been used to getting by without.  If your TSH was 24.5, you'd apparently, been hypo for a while, so it would take some time for your body to readjust to having hormones again.  My initial TSH was 55.5 and I went through the same thing.  My doctor put me on atenolol (beta blocker) to slow down my heart rate and help bring down my blood pressure.

What are the reference ranges for the Free T3 and Free T4?  Reference ranges vary lab to lab and have to come from your own report.  

If you're still having these issues, you should talk to your doctor about starting on a beta blocker until you get used to the med...  I stayed on the atenolol for about 3-4 yrs; I've been off it for about 3 yrs.

Anxiety can cause those same feelings. I had that, too and had to be on a an anti-anxiety med for a couple of years, as well.  None of these things have to be permanent... they just help us get over the rough spots.

Do you know if you have Hashimoto's?

[ASUTodd]

My free t4 was 1.1 before I was on any meds
My TSH was high though 24.5
didn't have any of this sickness before the meds just had a sore back
Went to the ER because I felt I was about to have a heart attack
extreme tremor, tightness in my chest, very high anxiety, heart palpitations.
High blood pressure, cold clammy skin, sweating.
The ER doc put me on propranylol Intravenous and I felt better.
but the symptoms came back the next day
I've been on the med for a month

[Barb135]

What are the reference ranges for the Free T3 and Free T4?  Ranges vary lab to lab and have to come from your own report.  Are those results prior to medication or are they medicated results?  Have you been tested for Hashimoto's.

I know you had another thread going earlier... It's usually best to keep your questions in the same thread, so we don't keep asking you the same questions over and over...

What prompted you to go to the ER?  When did you go? Why are they telling you to stop your med?  If those results are while you're on medication, I don't see any reason to stop them, pending posting the reference ranges for your FT3 and FT4 - they look well below any ranges we're used to seeing.  Your symptoms are consistent with hypothyroidism and as far as I can see, you, most likely need an increase in your med, not a decrease.

How long have you been on the med?