Help with test results please

[mommyjamieof2]

First test
TSH 4.37     0.38-4.70
T4 .86        .59-1.81
T3 1.9         1.8-4.2

This test

TSH .5      Not sure with this lab I don't have the paper yet and missed it over the phone
T4  .76      .58-1.64
T3 3.16      2.5-3.9

I switched doctors hence different lab values

My question is my tsh has dropped so much but my t4 is not moving much and my t3 is up a little so what does this mean?

I was on levo and cytomel and now have switched to armour because I was getting hives.  Am I getting to much medicine, to little?  This was from my OB they don't have much knowledge on thyroid issues and my insurance does not cover a endo so I have to figure this out on my own.  I have not had anti tests done yet.

I am feeling better but not great.

[goolarra]

Don't forget to talk to your doctor before adding Synthroid in.  You should reduce the Armour to compensate for that or you could very well end up overmedicated (hyper)..

In my opinion, you can split anything or combine anything to get the amount of levo (this does NOT apply to any meds with T3 in them, including Armour) you need.  Also, you can alternate days on different doses to achieve the correct dosage, take an extra dose per week, or twice a week, etc.  Since T4 is "stored" until needed, the effect is long term.

[mommyjamieof2]

I will maybe just pay out of pocket for I remember seeing there are coupons my script is for 50 so maybe I can split that??  

I really appreciate your help :)

[goolarra]

You might try a different brand of levo or a brand name versus the generic.  Often it's the fillers in the different preparations that cause problems, like hives.  

It's good you're splitting your dose.

I just think you need to get your FT4 up a bit.  T3 is very fast-acting and neutralized in our bodies quickly if not used.  T4 is relatively stable and floats around until needed, when it is converted to T3.  I think you need more T4 so that it's available when you need it.

Synthroid is fairly cheap.  Also, you can ask your doctor to prescribe two times the dose and split it in half.  This makes it even cheaper since the double dose is only a couple of cents more.  If your doctor orders it as "medically necessary"  would your insurance pay for it?

[mommyjamieof2]

Hmm, only problem is I broke out in a rash/hives I counted 24 mosquito like bumps on my stomach and neck which also have went away since I stopped taking levo they were popping up a few each day until the last couple days it was really bad and I was itching like crazy.

I take the armour twice 7 and again 11 that seems to be the time I crash.

**** I wish I could get synthroid with my insurance.

When I first started taking cytomel it really seemed to helrp the fatigue but it didn't last very long after a couple weeks I felt the same.

Yes I went from 50 to 100

[goolarra]

Okay, so, the switch from levo and Cytomel to Armour was no change in dosage...100 levo plus 25 Cytomel is roughly equivalent to 60 mg Armour.  Did you go from 50 to 100 levo in one jump?  And did you add the Cytomel at the same time?

It looks to me like you are taking too much T3 relative to the T4 you are taking.  Your FT4 has dropped slightly, but your FT3 has risen significantly.  You don't appear to have any issues with conversion.

Did the Cytomel help your fatigue?

My recommendation (not a doctor, just a fellow patient) would be to do one of two things.  1) Add some levo to your Armour and drop the dosage of Armour to compensate. or 2) go back to a combination of levo and Cytomel, but increaase the levo slightly (maybe to 112.5) and drop the Cytomel to 10 mcg (split into two doses).

Are you taking your Armour just once a day, or twice?

[mommyjamieof2]

I called and asked to add cytomel because I was still having alot of fatigue.  they called it in.

[mommyjamieof2]

3 months

Started on 50 went up to 100 added 25 cytomel

switched to armour they gave me 120 to break in half

[goolarra]

So, tell me if this is correct:

1) you had your first test
2) you added 25 Cytomel to your 100 levo without changing the levo
3) you had the second test
4) you switched to 60 mg Armour

How much time was between tests?

[mommyjamieof2]

100 of levo and 25 of cytomel  Then I read that my dose should have been reduced with cytomel..So then I went and did my blood again to see what the heck was happening.
I had not taken any meds 2 days prior to testing because of the hives but I was on this dose but with synthroid and had no problems but had to switch due to insurance.  Not sure if I was going hyper or having an allergic reaction.  Then started on 60 mg  of armour halfed taken in morning and afternoon the next day

Like I said my ob does not know much about it but they are at least trying to help me which is more then I could get otherwise.

[goolarra]

What was your dose of levo and Cytomel?  When did you switch to Armour?  When did you switch meds relative to the two sets of tests above?

Don't worry about the TSH reference range.  FT3 and FT4 are specific to your lab.  However, we tend to use the currently accepted reference range (AACE) of 0.3-3.0 no matter what the lab uses.