Advice on labs and symptoms

[dani2776]

Ok so here we go again wondering what is wrong.  Here is a list of my labs and symptoms and I really need your advice.

Labs in June
TSH  (0.340-5.600)    Free T4 (0.61-1.12)     Free T3 (210-440)
1.990                       0.92                           353

Labs in July
TSH 5.400    Free T4 0.73    Free T3 305

Labs this morning
TSH 4.150    Free T4 0.92    Free T3 362

In June I was feeling better but still had some anxiety
In July I felt very hypo and can see why with my labs.  My doctor increased meds from 50 to 62.5
Now my worst symptoms are hot flashes, mood swings and VERY bad anxiety.  According to my TSH I am still pretty hypo from but I feel VERY hyper.  I noticed a big increase on my Free T4 and was wondering if I could possibly be having a Hashi attack and that's why I feel hyper and for the increase in my FT4.  Any advice?  I am scared to keep taking my medicine because I feel so hyper.

[dani2776]

Thanks everyone for your opinion.  This whole thyroid disease and everything that goes along with it is very confusing!!!!  I just wish I knew how to distinguish what was what!

[goolarra]

The whole endocrine system is interrelated, and both thyroid and reproductive hormones are part of the endocrine system.  So, yes, one does affect the other.

TSH is not a reliable diagnostic of thyroid disease, and many other factors can affect TSH besides central (secondary) hypothyroidism.  TSH is a pituitary hormone, several steps removed from thyroid hormone levels.  Any disturbance in the thyroid/hypothalamus/pituitary feedback cycle can affect TSH levels.  Some thyroid meds can also make TSH an unreliable tool.  FT3 and FT4 are much more important indicators.

It can be very confusing, especially with Hashi's.  Also, many symptoms can "cross over" and be symptoms of both hypo and hyper.  Anxiety and weight gain are included in those.

You have Hashi's, so that is the cause of your hypothroidism.  I have Hashi's, but I also have a pituitary issue (not secondary hypo).  It's possible to have both.

I agree, however, on the decrease.  I'd cut back to something betwee the 50 (which was too low for you) and the 62.5 (which is too high).  However, I'd give that dose four weeks, retest, reevaluate symptoms and make further decisions based on those.

[euahome]

Then forget about decreasing. You must feel this way because you're still hypo + PMS anxiety. Talk to your doctor about increasing a little. Now you should increase really slowly, like by 6.2 mg for 2 weeks and so on (only doctors don't usually like splitting the pills). Your June labs have been your best so far. You must have had panic attacks because you increased too fast back then. By you're definitely hypo now and should increase a little. If you cut back to 50 you'll only feel worse in the long run.

[dani2776]

So since I have Hashimoto's my thyroid problem is not from the pituitary gland??  I have been on the 62.5 for about 5 weeks.  I was on it before and then he raised me to 75.  I was on 75 when my TSH was1.990 and my FT4 was 0.92 but I was having panic attacks so he cut me back to 50.  

[euahome]

Central hypothyroidism is hypothyroidism caused by pituitary problem (therefore TSH is irrelevant). By you don't have it. I think you should cut back to 56.2  to lessen your symptoms and then in about a week or two increase to 62.5. How long have you been on 62.5?

[Jennifer1987]

I really think you should talk with your doc about cutting back hun!!!!!!!!! Dont do it without his consent, it could only make matters worse....  Wait untill the app. and suggest it to him!!!!!! Its never good to do something with out medical supervisiion....

[dani2776]

What is central hypothyroidism????  So do you think I should cut back to the 50 now?

[euahome]

BTW, being hypo/hyper can REALLY worsen your PMS symptoms.

[euahome]

You should look at your TSH unless you have central hypothyroidism! We need different FT4 and FT3 levels at different times. I think you should cut back a little now and then increase A LITTLE again. Otherwise, you'll be very hypo on that dosage. You can always try and see what works for you but I'm sure about what I'm saying.

[dani2776]

I guess you are right.  I never noticed the similarities in the frees.  My problem though is although I feel hyper I still have some of the hypo symptoms including being tired and gaining weight.  I don't mean just a little weight either, it's bad.  I don't think I will ever unsderstand this thyroid business.  I can never tell what is what with symptoms.  How can you feel hypo and hyper at the same time?  I do have my monthly friend right now and have noticed that I tend to feel hyper around that time of the month.  Is there any coorelation between that??  Oh and I see the doctor on Wednesday so I guess I will see what he says.

[goolarra]

I think you have to stop looking at your TSH.  Your frees in June and now are very similar...FT4 is the same (0.92, which is above midrange), and your FT3 is slightly higher than it was in June (it's right at the bottom of the upper third of the range).  My personal opinion is that you're feeling hyper because you're slightly overmedicated.  

Don't stop taking your medicine.  That would be counterproductive.  Have you asked your doctor about cutting back a little?  

We all have to find our own personal range within the FT3/FT4 population ranges.  We will not all feel comfortable in the entire span of the range.  I think that you're finding that your comfort range is a little lower than your current levels.  Since 50 mcg was a little low for you, and 62.5 is a little high, you most likely want to be somewhere in between.  You can achieve "odd" doses by splitting and/or combining tablets and/or alternating doses from one day to the next.

If I were you, I'd discuss a decrease with my doctor.    

[euahome]

I really do know how you might feel. But this illness is like that, very hard to live with for some and pretty manageable for others. I myself have had for 20 years now and had 2 thyroid surgeries. For about 15 years I felt pretty well. Well I didn't when my ranges were VERY abnormal but otherwise no big deal. But after my 2 surgery (2003) it's been hell. I since learned quite a lot about it and how I personally should go about it. But it's still very hard. The problem in your case and in mine is that the thyroid hormone levels keep fluctuating like crazy and that's why it's hard to find the right dose. Plus our adrenals are weakened by all this suffering therefore sensitivity to the meds. But you will feel better!

[dani2776]

Thank you for your response.  My only question is how am I ever going to get better if I go even slower with my meds?  It has taken me a year and a half to just get to 62.5!! I am so depressed.  The quality of my life is not good and I am missing out on so much with my husband and children.  I am about ready to give up.  

[euahome]

You are very sensitive to the meds increase. That's why you're feeling hyper. Your increases should be even smaller, for example: first from 50 to 56.2 and only then to 62.5 and so on. There are many people who have this problem. I'm one of them.