I am hypothyroid, 25 weeks pregnant and having lots of symptoms, advice please.

[jenb2018]

Hi There,

Can someone please give me some advice.  I am currently 25 weeks pregnant and feeling really symptomatic.  My reverse T3 was tested in January and was 24 with a range of 8-25.

My current TSH is 1.01 range .32 -4
T3 is 3.9 range is 3.1 to 6.2
T4 is 13 range is 9-19.

I just switched to 100 of Synthroid and 5 of Cytomel.  Previously I was only taking 125 of Synthroid.

Is this the best course of action to take right now?  I had to beg my dr for Cytomel.
Thanks

[gimel]

You have many symptoms that occur more frequently with hypothyroidism.  Next step is to confirm with biochemical tests, which were done.  TSH is meaningless when taking thyroid med.   As concluded in a recent, very excellent scientific study,  "Hypothyroid
symptom relief was associated with both a T4 dose giving TSH-suppression below the lower reference limit and FT3 elevated further into the upper half of its reference range. "  Your Free T4 is adequate.  The problem is your relatively low Free T3, made worse by  your Reverse T3 being high in its range.  

So you are going to have to convince your doctor that you need further increase in your T3 med, in order to get your Free T3 into the upper third of its range.  By the way, when you switched, your  equivalent dosage actually was reduced from 125 mcg of T4 to 115 mcg of T4 (100 + 3 times 5 = 115).  Even the ATA/AACE Guidelines say that T3 is 3 times as potent as T4.   In addition you need to supplement Vitamin D, B12 and ferritin to optimize.  D should be at least 50 ng/mL, B12 should be in the upper part of its range, and ferritin should be at least 100.  All three are very important for a hypothyroid patient.  Also low levels of these 3 can cause increased levels of Reverse T3.  You can read about that in Rec. 11 on page 13 of the following link.  I also recommend reading at least the first two pages of the paper, and more, if you want to get into the discussion and scientific evidence for all that is recommended.

https://tinyurl.com/y8k2zswb

Also, I am sending a PM with some info.  To access, click on your name and then from your personal page, click on messages.

[gimel]

In trying to assess a person's thyroid status, most important  is an evaluation for symptoms that occur more frequently with hypothyroidism.   So please tell us about the symptoms you have.   Are those test results from before or after the switch in med dosages?

[jenb2018]

Those are from before the switch.  

My current symptoms are;
Less energy
Easy fatigue
Nodding off easily
Difficulty getting through work day
Exhaustion on every dimension - physical, mental, emotional
More fatigued as the day goes on
Hyper sensitive towards others
Crying easier
Anxiety
Lack of motivation
Moody
Poor levels of Iron, B12 and Vitamin D
Cracking heels
Dry skin
Inability to concentrate
Inability to read long periods of time
Inability to retain
Forgetfulness
Foggy thinking aka Brain Fog
Memory issues
Low libido
Constipation