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question for Dr. Lupo about test results
Dr. Lupo,
I hope you can help me better understand my lab results. I had a TT in October for papillary carcinoma. This was followed by RAI even though the nodule was small (12mm) and had not spread to the lymph nodes. After RAI, I was put on 125mcg L-thyroxine and up to 75mcg cytomel a day. As I tapered off the cytomel, my hypothyroidism symptoms began to return. Blood work was done (TSH 0.03) and my doctor's PA reduced by L-thyroxine to 116mcg per day and by then I was totally off cytomel anyway. Now, two months later, I have had more blood work done. Here are the results: TSH 0.12, T3 130 (ref 82-179), and fT4 1.95 (ref 0.2-1.9). My concern is that I still have hypothyroidism symptoms: weight gain, constipation (despite being on a full dose of stool softener every day), feeling cold, dry skin (to the point of cracking and bleeding), exhaustion/heavy legs feeling when doing simple things like climbing a flight of stairs, tired/sleeping more than usual, and carpal tunnel returning. Do you have any idea why my numbers look "good", but I still don't feel well? Also, I had high BP before all of this and now I am on lower doses and my BP looks better than it has in years. Honestly, I felt more "normal" when I was on cytomel than I do now. I never felt surges from taking the pills or any heart palpitations. I just want to feel better, but I would like to be better informed before I meet with my endo in 18 days. Can you help me understand? Thanks so much!
Kim
I hope you can help me better understand my lab results. I had a TT in October for papillary carcinoma. This was followed by RAI even though the nodule was small (12mm) and had not spread to the lymph nodes. After RAI, I was put on 125mcg L-thyroxine and up to 75mcg cytomel a day. As I tapered off the cytomel, my hypothyroidism symptoms began to return. Blood work was done (TSH 0.03) and my doctor's PA reduced by L-thyroxine to 116mcg per day and by then I was totally off cytomel anyway. Now, two months later, I have had more blood work done. Here are the results: TSH 0.12, T3 130 (ref 82-179), and fT4 1.95 (ref 0.2-1.9). My concern is that I still have hypothyroidism symptoms: weight gain, constipation (despite being on a full dose of stool softener every day), feeling cold, dry skin (to the point of cracking and bleeding), exhaustion/heavy legs feeling when doing simple things like climbing a flight of stairs, tired/sleeping more than usual, and carpal tunnel returning. Do you have any idea why my numbers look "good", but I still don't feel well? Also, I had high BP before all of this and now I am on lower doses and my BP looks better than it has in years. Honestly, I felt more "normal" when I was on cytomel than I do now. I never felt surges from taking the pills or any heart palpitations. I just want to feel better, but I would like to be better informed before I meet with my endo in 18 days. Can you help me understand? Thanks so much!
Kim
When I saw the doctor's PA at the end of February, I was told flatly "we don't prescribe THAT" in reference to any form of T3. I'll ask, but I'm not optimistic. If she is highly opposed, is there some fact based argument I can make? I know the most recent studies claim to find no improvement with the addition of T3. Thanks so much for your help!
Kim
Kim
MEDICAL PROFESSIONAL
Talk to your doctor about adding back in some cytomel -- this is not an uncommon situation to have okay labs and "hypo" symptoms. With the cancer history would prefer l-t4/cytomel combo over armour.
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