Just happened to think that you might be able to make use of the info in this link when you see the doctor.
http://worldlinkmedical.com/hypothyroid-symptoms-but-normal-tsh-levels-how-to-treat-symptoms-of-low-thyroid-by-optimizing-free-t3-levels/
That small increase of 12 mcg of T4 is not going to do much for you. Your Free T4 is already around the middle of the range. Your problem is that your Free T3 is too low in the range. Clearly your body is not adequately converting T4 to T3. Continuing to increase your T4 med is very unlikely to get your Free T3 high enough to relieve hypo symptoms. You need to add a source of T3, and increase as necessary to relieve hypo symptoms. Hopefully, at your appointment in 6 weeks your doctor will respond correctly to your need for T3. Personally, with your symptoms, I wouldn't leave his office until I got a prescription for some T3 med.
Maybe you should do as a member claimed to have done in similar situation. Threaten to buy a chain and a lock and fasten yourself to the doctor's desk until you get a prescription for T3 med. LOL
Hi & thank you! How can T4 alone hurt the heart? I have looked through that website, STTM, and I will look for the book, too. Thanks for the heads-up.
Based upon my labs from today, what are your thoughts? Is that the right 4:1 ratio? TSH 0.025, range .35-4.0. FT4 1.29, range 0.82-1.77. FT3 2.5, range 2.3-4.3.
Thanks for the information! You've really helped to clear up some questions I had. I am very grateful.
I had some labs run today, and now doctor says I can go from 88 to 100 mcg of Synthroid, but no Cytomel yet. I think that will happen after 6 more weeks, depending on labs. Here were my numbers from today:
TSH 0.025, range .35-4.0. FT4 1.29, range 0.82-1.77. FT3 2.5, range 2.3-4.3.
Any thoughts?
Adding T3 will lower the TSH but as gimel stated that is not the result you are concerned about. It is the ratio of T4 to T3 which is a 4:1 ratio. T4 alone will actual over the long term hurt your heart which is another reason to have T3 in conjunction with T4.
Stop the Thyroid Madness is a book published by a undiagnosed thryoid patient. Wait until the 2014 edition is available if you are going to purchase it. Ignore the derogatory comments about doctors and read about the tests and the impact on symptoms experienced by patients when not dosed or under dosed/overdosed.
I think as serum thyroid levels change and people become hypothyroid, symptoms seem to show up long before the test results become extreme enough for doctors to agree that you are hypo. With Hashi';s, the TSH changes in response to less thyroid hormone being produced as the gland is being attacked and destroyed over an extended period. Within the time frame for this to happen, and given the extremely broad reference range for TSH, een with Hashi's the TSH will remain within the so-called "normal" range for extended periods. How long is that? I don't really know how to even estimate it, and wouldn't know where to look for the info even if it was a vital concern.
For the other major type of hypothyroidism (central), the cause is hypothalamus/pituitary related. In those cases, the TSH is too low within the range to stimulate enough thyroid hormone production. The TSH typically will remain low for an extended period, until the patient's symptoms become so bad that a doctor tests for Free T3 and Free T4 and is knowledgeable enough to understand that the patient really is hypothyroid.
Interpretation of test results
Question:
Could someone please comment on these test results? Ferritin, Serum: 45 -- range 15-150. Iron Bind Cap. (TIBC): 422 -- range 250-450. Iron Saturation: 55% -- range 15-55%. Iron, Serum: 232 H -- range 35-155. UIBC: 190 -- range 150-375. [Lab Tests Online Question referred from: /understanding/analytes/ferritin/tab/faq]
Answer:
Response:
Thank you for contacting the American Society for Clinical Laboratory Science (ASCLS). We are a team of laboratory professionals who volunteer our time and expertise to assist consumers in understanding laboratory tests and results. We try to answer questions within 72 hours, but due to the large volume, we occasionally need more time. An Iron Saturation of 55% is borderline high. All of your other values are normal. You did not give your age or gender which can have a bearing on interpretation of these test results. Also, iron studies should be done on a fasting early morning specimen and you should be off of any iron supplements for at least a week. If you complied with the above, then I would suggest having the tests repeated just to make sure that the saturation level is correct. If it stays the same (i.e. increased or borderline high), depending on your age and gender, you may want to consider some follow-up testing for the condition known as hemochromatosis, or at the very least, repeat the iron studies in six months to see if the % saturation is staying the same or increasing.