Ok guys- in order to get all of the relevant (and probably some irrelevant) info in this post, I feel a long one coming on. I apologize upfront.
I've posted a few questions over the last year or so, but I'll try to consolidate the info. I'm a 34 year old female. I have had Hashimoto's since the birth of my 1st child when I was 23. I was taking Levothyroxine for most of the last 11 years. I increased my levo 25mcgs during every pregnancy, and was not able to go back to the lower dosage post pregnancy (so after first child I was controlled for 2 years on 150, went up to 175 for the second child and for the 3rd child went up to 200). However, in the last year, they have not been able to control the levels (I yo-yo) So i'm going to post my levels for the past year- including medication and dosage (i've changed meds 3 times)
Please note Standard ranges for results below:
TSH: 0.36 - 3.74 m[IU]/L
FT4: 0.76 - 1.46 ng/dL
FT3: 2.3 - 4.2 pg/mL
TT3: 0.60 - 1.81
Test Results and medications below:
*5/12/15*
275 mcgs of Levothyroxine (was MISERABLE on this medication. constantly swollen and tired, regardless of the levels over the last 4 years)
TSH: 4.69 H
TT3: 1.04
FT4: 1.23
*8/03/2015*
175 mcgs of Synthroid + 5 mcg of Cytomel
TSH: 23.05 H
FT4: .86
*9/23/15*
200 mcgs Synthroid + 5 mcg of Cytomel
TSH: 3.61
FT4: 1.09
*11/05/2015*
No dosage change from above: 200 mcgs Synthroid + 5 mcg of Cytomel
TSH: 4.51 H
FT4: 1.05
*1/7/2016*
200 mcgs Tirosint + 5mcg of Cytomel
TSH: .75
FT4: 1.33
*3/31/16*
No change from dosage above 200 mcgs of Tirosint +5mcgs of Cytomel
TSH: .04 L
FT4: 1.58 H
FT3: 4.0
*6/16/16*
188 mcgs of Tirosint + 5 mcgs of Cytomel
TSH: 7.08 H
FT4: .94
*Please note that she does not regularly test my FT3 number and the only time it was tested, I was not told not to take my Cytomel prior to testing. This result may not even be accurate*
Only twice have my numbers been within range, and always on their way to too high or too low- with no med change. Even when in range, I felt exhausted. Starting in December (coinciding with my new med Tirosint), I started to struggle with weight when I had not before, without any changes to my eating habits. Even though I went hyper on Tirosint my symptoms more closely aligned with hypo (weight gain, exhaustion, brain fog, frequently cold, heavy prolonged menstruation. Frankly when I came back hyper in March, I was shocked. My weight struggle and exhaustion had hit a peak at that point. She said she was shocked and expected the exact opposite symptoms
Because my numbers aren't where she wants them again, she wants to go back to 200 mcg of Tirosint (not cheap!) and 5 of Cytomel. However, I just left that dosage in March because it made me hyper.
So what I'm wondering is if one of you whizs can take a look that the numbers/meds above and see a pattern? Should I be looking at something other than the thyroid? (I was tested for celiac and blood test positive for celiac, but there was no damage to the intestines, so absorption should not be affected. I'm working to get my Vitamin D where it should be, too: (Standard Range: 13 - 29 ng/mL My Level: 20 (In March) 50,000 D3 weekly for 2 months. Repeat testing last week, My Level: 29. Repeat previous script and retest)
I know these results are not as helpful because there is no usable FT3 level, but is that number the key? Is there no way to see a pattern or possible other cause without it? I'd like to go in tomorrow with a plan for testing and some idea of what I think might ultimately be causing this fluctuation. Gotta be your own advocate, right?! Any thoughts, or questions, are welcome!
Thanks in advance, and I apologize for the length of the post.