Lab work, currently on Euthyrox

[tgab]

Hi all,

My mother is 68 years old. 40 years ago she underwent Radioactive Iodine
treatment for hyperthyroidism. Her thyroid gland was completely destroyed. She
had been taking Natural Desiccated Thyroid until three years ago her doctor
switched her to Euthyrox (synthetic T4). Eight months ago, she started feeling
weak, couldn't get out of the bed, and started experiencing high blood pressure.
We have been trying to adjust the dose with no improvement. She is currently
taking 87 ug per day. She tried different doses 75, 87 and 100 ug with not clear
indication of improvement.

The lab work below are from a period of taking 87 ug (11/15 - 12/19), 75 ug/day (10/3 - 11/15) and about
87 ug before 10/3:

Oct. 12 lab:
FT3: 2.83 pg/ml (reference: 1.88-4.10)
FT4: 1.22 ng/dl (reference: 0.81-1.89)
T3: 0.77 ng/ml (reference: 0.66-1.92)
T4: 9.2 ug/dl (reference: 4.30-12.50)
TSH: 0.404 uIU/ml (reference: 0.38-4.34)
TgAb: 548.8 IU/ml (reference: <115)
TPOAb: 30.26 IU/ml (reference: < 34)

Nov. 05 lab:
FT3: 2.75 pg/ml (reference: 1.88-4.10)
FT4: 1.05 ng/dl (reference: 0.81-1.89)
TSH: 0.394 uIU/ml (reference: 0.38-4.34)

Dec. 19 lab:
FT3: 2.68 pg/ml (reference: 1.88-4.10)
FT4: 0.91 ng/dl (reference: 0.81-1.89)
T3: 0.98 ng/ml (reference: 0.66-1.92)
T4: 7.81 ug/dl (reference: 4.30-12.50)
TSH: 0.369 uIU/ml (reference: 0.38-4.34)

We are still trying to figure out what causes her fatigue and discomfort especially in the morning right after she take the Euthyrox.

[FTB4]

I should mention that most thyroid sufferers feel best when the Free T4 is 50% in iys range and Free T3 at 66% of its range, and the TSH supressed below 1.0 So since TSH is not important, You would want her medication increased to bring up those percentages, but it should be done in small steps, large dosage bumps do not help. Best to try and get her back on the Armour, The T3 will really help since it is the actual hormone the body functions on. FTB4

[FTB4]

She is very low in the ranges, Her Free T3 based on 12/19  is only 36% in its range.  The T4 is 10% in its range. I do not know why she would feel worse after taking medication, unless it is just the time of day and not the fact that she takes her meds at that time. I don't understand why the MD would change her medication if she was feeling fine, the difference is that desiccated thyroid is Part T4 and Part T3, which is the best medication to be on if you do not have a functioning thyroid, this is due to the T3 portion being the active hormone while the T4 is being converted, I would think the sudden drop in the T3 alone would have fatigued her. I guess the MD does not beleive in the old saying "If it aint broke, don't fix it"  He should have just left things the way they were. However, if he will not reconsider placing her back on Desiccated, then maybe another MD would be best. Best Regards  FTB4