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Low Free T4, Normal TSH and Free T3...?
Hi,
I'm a 23 year old male who was diagnosed with Hashimoto's in early 2012 (diagnosis of Celiac's followed in 2013).
I've been feeling really rough for a while now, I've been on 1/2 grain of Armour for almost 2 months. Current symptoms: being exhausted for most of the day (for around 6 - 7 hours after taking the Armour), I tend to feel fairly tired when I wake up especially if I sleep for a normal amount of time (I actually feel less tired when I wake up the less sleep I get), no motivation or pleasure from anything, and other problems associated with depression.
Before that I was on a generic levothyroxine that gave me odd hyper feelings (difficulty regulating body temperature, emotional liability, intense anxiety problems, depression, energy spikes at weird times especially night).
The lack of energy made me suspect something was wrong in the T4 area, lab results confirm that.
Lab Results:
TSH 2.03 (Reference Range: 0.40 - 4.50 mIU/L)
T4, Free 0.8 (R.R.: 0.8 - 1.8 ng/dL)
T3, Free 3.5 (R.R.: 2.3 - 4.2 pg/mL)
If anyone could give me any input as to what I should do or honestly any advice at all I'd be really grateful!
Thank you!
I'm a 23 year old male who was diagnosed with Hashimoto's in early 2012 (diagnosis of Celiac's followed in 2013).
I've been feeling really rough for a while now, I've been on 1/2 grain of Armour for almost 2 months. Current symptoms: being exhausted for most of the day (for around 6 - 7 hours after taking the Armour), I tend to feel fairly tired when I wake up especially if I sleep for a normal amount of time (I actually feel less tired when I wake up the less sleep I get), no motivation or pleasure from anything, and other problems associated with depression.
Before that I was on a generic levothyroxine that gave me odd hyper feelings (difficulty regulating body temperature, emotional liability, intense anxiety problems, depression, energy spikes at weird times especially night).
The lack of energy made me suspect something was wrong in the T4 area, lab results confirm that.
Lab Results:
TSH 2.03 (Reference Range: 0.40 - 4.50 mIU/L)
T4, Free 0.8 (R.R.: 0.8 - 1.8 ng/dL)
T3, Free 3.5 (R.R.: 2.3 - 4.2 pg/mL)
If anyone could give me any input as to what I should do or honestly any advice at all I'd be really grateful!
Thank you!
I would. It's best to keep the FT3 level as even as possible. It's certainly not going to hurt anything, unless of course, you forget to take it. LOL
Ah sorry, one last thing-- would you still recommend taking half in the morning half later in the day?
I totally know what you mean there and I definitely agree with your conclusion for the same reasons. Thank you so much for your help!
Alright, I appreciate that input!
I'd originally been put on .25 mcg of levo but around the time that I was trying to get everything with Celiac's under control that dose seemed to be giving me hyper symptoms (the anxiety, problems regulating emotions, body temp, difficulty sleeping, etc). Which I guess makes sense if part of the cause of the autoimmune attack suddenly isn't there?
So I'd dropped down to 12.5 mcg for a while and seemed okay there but for a bit that even seemed like too much. I was off T4 for a couple of months until I stopped having the hyper symptoms and started up again when hypo symptoms resumed. (I know, probably not the best decision but at the time all I could focus on was how the lack of sleep and intense anxiety attacks that were making hard for me to do my job.)
The last blood work I had was from 6/23/13 when I was still on .25 mcg (I'd lost my insurance mid year hence the lack in bloodwork). But he'd only ordered a TSH w/ reflex to T4 and because the TSH was within range they didn't run the T4.
TSH: 2.97 mIU/L (R.R: 0.40 - 4.50)
I'd originally been put on .25 mcg of levo but around the time that I was trying to get everything with Celiac's under control that dose seemed to be giving me hyper symptoms (the anxiety, problems regulating emotions, body temp, difficulty sleeping, etc). Which I guess makes sense if part of the cause of the autoimmune attack suddenly isn't there?
So I'd dropped down to 12.5 mcg for a while and seemed okay there but for a bit that even seemed like too much. I was off T4 for a couple of months until I stopped having the hyper symptoms and started up again when hypo symptoms resumed. (I know, probably not the best decision but at the time all I could focus on was how the lack of sleep and intense anxiety attacks that were making hard for me to do my job.)
The last blood work I had was from 6/23/13 when I was still on .25 mcg (I'd lost my insurance mid year hence the lack in bloodwork). But he'd only ordered a TSH w/ reflex to T4 and because the TSH was within range they didn't run the T4.
TSH: 2.97 mIU/L (R.R: 0.40 - 4.50)
You could try increasing your Armour a little. Some people find that FT3 has to be well up into the upper third of range. Another alternative would be to add a little synthetic T4 to the Armour you are taking now to raise your FT4 level. This latter alternative would give you a better balance of FT3 relative to FT4.
How much levo had you been on? How long had you been on it? Do you have labs on levo that showed where your FT3 and FT4 were then?
How much levo had you been on? How long had you been on it? Do you have labs on levo that showed where your FT3 and FT4 were then?
I had not taken my meds before the draw. I take them when I wake up every morning but did not take them that day as I knew I was having bloodwork done and wanted to test my current status rather than just the effects of the medication itself. So it would have been at least 24 hours since I'd taken my meds.
Your labs aren't all that unusual for someone on Armour. When you take Armour, you are basically running on T3. Because there's a lot of T3 in Armour, it can be hard to maintain a reasonable level of FT4 without getting FT3 too high.
Your FT4 is right on the floor of the range. However, your FT3 is at 63% of range. The guideline for FT3 is upper half (50+%) to upper third (67+%) of range, so you're pretty close to that. However, with FT4 so low, there is basically nothing there to convert in times of peak demand. Had you taken your meds before the draw?
As I said, when on Armour, you are basically running on your FT3 level. T3 peaks about 3 hours after you take it, and a couple of hours after that, it's gone. So, no matter what you are taking, you're going to have an initial surge in FT3, followed by a crash.
I'll have more to say once I know how long before the draw you'd taken your meds.
Your FT4 is right on the floor of the range. However, your FT3 is at 63% of range. The guideline for FT3 is upper half (50+%) to upper third (67+%) of range, so you're pretty close to that. However, with FT4 so low, there is basically nothing there to convert in times of peak demand. Had you taken your meds before the draw?
As I said, when on Armour, you are basically running on your FT3 level. T3 peaks about 3 hours after you take it, and a couple of hours after that, it's gone. So, no matter what you are taking, you're going to have an initial surge in FT3, followed by a crash.
I'll have more to say once I know how long before the draw you'd taken your meds.
They're my most current labs from being on Armour. I got them done 7/11/14
I don't, I had (probably mistakenly?) thought that was only for doses 1 grain and higher...
I don't, I had (probably mistakenly?) thought that was only for doses 1 grain and higher...
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Poor sleep and anxiety attacks can both be symptoms of hypo as well as hyper. In the initial stages of Hashi's, you can swing back and forth between hypo and hyper. I can only assume that's what your thyroid is doing...producing a bit too much at some times, too little at others.
You know that all this is a bit of an experiment, and we, unfortunately, have to be our own lab rats. You had problems on 12.5 mcg of levo, so that doesn't offer a lot of leeway; however, you have to do something, and I'm also afraid your FT3 level will get too high for you if you increase Armour. I still think adding in a little T4 would be your best bet. It will increase your FT4 more than taking more Armour will, and at the same time, it won't increase your FT3 as much as increasing Armour would. I'd start out very low...ask your doctor about maybe 12.5 every other day.
No easy answers...