Aa
Need help with labs and what to do about meds:
Hey all.
Just wanted to update because I'm STILL having issues with medicine and feel so fatigue after al this time following my thyroidectomy.
I've been on Tirosint since swapping from NDT. I started at 125, then 137, then 163 (by alternating meds) and adding in 5 mcg of Cytomel. My FT3 will not jump at all while my FT4 tends to be pretty high. After being moved from 190 + 5, my doc had me lower it again to 175 T4 with the 5 T3.
What I find on T4 alone is that everytime it raises, I don't feel better. I think that maybe I'm converting but at such a small, if not minute amount. Cytomel does a bit for me but sometimes with side effects. However, by the evening I feel like a runoff of T4, if that makes sense. This was even prior to my initial experience with Cytomel, but my heart beats harder, not faster, as if it's realizing it's hypo, my hair is STILL falling out like a damn sweater that wheneer I see the strands I have a near panic attack because I'm just awaiting on the worse, I've gained a few pounds and I'm extremely fatigued and lethargic and it's been almost two years of this sh*t that I really don't know how much longer I can take. I used to be SOOO active but now I don't sleep more than a few hours, it takes me forever to get motivated, my body is so physically drained, and I'm depressed.
I think about returning to Levoxyl or even trying Synthroid again... I am so sad that I feel at a loss of what to do... maybe either trying a much higher dose of T4 solo (my TSH even on 163 was just at 1.2, so it was barely budging) or just add in all the Cytomel but even when I was on 25mcg with 150 T4 this time last year, I didn't feel all that well.... just anxious and hot.
Please offer any insight... again, past my wit's end. Like, past, past it.
I'll include most recent labs in hopes that anyone can suggest anything.
And I'm aware of the STTM protocol and my iron is good and B12, etc.
(ranges in parenthesis)
TSH: .04 (.4 - 4.5)
FT4: 1.6 (0.8 - 1.7)
FT3: 2.82 ( 2.0 - 4.4)
RT3: 17.5 ( 9.2 - 24.1)
Total T3: 94 (71-180)
Just wanted to update because I'm STILL having issues with medicine and feel so fatigue after al this time following my thyroidectomy.
I've been on Tirosint since swapping from NDT. I started at 125, then 137, then 163 (by alternating meds) and adding in 5 mcg of Cytomel. My FT3 will not jump at all while my FT4 tends to be pretty high. After being moved from 190 + 5, my doc had me lower it again to 175 T4 with the 5 T3.
What I find on T4 alone is that everytime it raises, I don't feel better. I think that maybe I'm converting but at such a small, if not minute amount. Cytomel does a bit for me but sometimes with side effects. However, by the evening I feel like a runoff of T4, if that makes sense. This was even prior to my initial experience with Cytomel, but my heart beats harder, not faster, as if it's realizing it's hypo, my hair is STILL falling out like a damn sweater that wheneer I see the strands I have a near panic attack because I'm just awaiting on the worse, I've gained a few pounds and I'm extremely fatigued and lethargic and it's been almost two years of this sh*t that I really don't know how much longer I can take. I used to be SOOO active but now I don't sleep more than a few hours, it takes me forever to get motivated, my body is so physically drained, and I'm depressed.
I think about returning to Levoxyl or even trying Synthroid again... I am so sad that I feel at a loss of what to do... maybe either trying a much higher dose of T4 solo (my TSH even on 163 was just at 1.2, so it was barely budging) or just add in all the Cytomel but even when I was on 25mcg with 150 T4 this time last year, I didn't feel all that well.... just anxious and hot.
Please offer any insight... again, past my wit's end. Like, past, past it.
I'll include most recent labs in hopes that anyone can suggest anything.
And I'm aware of the STTM protocol and my iron is good and B12, etc.
(ranges in parenthesis)
TSH: .04 (.4 - 4.5)
FT4: 1.6 (0.8 - 1.7)
FT3: 2.82 ( 2.0 - 4.4)
RT3: 17.5 ( 9.2 - 24.1)
Total T3: 94 (71-180)
If your Vitamin D was 55, there is no need to take more.
With your Free T4 at 89 % of its range and your Free T3 only at 34% of its range, it is clear that your body is not adequately converting the T4 to T3. I think you need to reduce your T4 med and add some T3 enough to raise your Free T3 into the upper third of its range, or as needed to relieve hypo symptoms. Free T3 is used by all cells of the body and it correlates best with hypothyroid symptoms. So you need to discuss with your doctor that you need some T3 med and a reduction in your T4 med.
Since your iron was at top of range, I suggest that at next opportunity you should also ask to be tested for ferritin and a full iron test panel (serum iron, TIBC, and % saturation).
With your Free T4 at 89 % of its range and your Free T3 only at 34% of its range, it is clear that your body is not adequately converting the T4 to T3. I think you need to reduce your T4 med and add some T3 enough to raise your Free T3 into the upper third of its range, or as needed to relieve hypo symptoms. Free T3 is used by all cells of the body and it correlates best with hypothyroid symptoms. So you need to discuss with your doctor that you need some T3 med and a reduction in your T4 med.
Since your iron was at top of range, I suggest that at next opportunity you should also ask to be tested for ferritin and a full iron test panel (serum iron, TIBC, and % saturation).
Hey! thank you for the response...
I don't know what my iron was off hand, but I know it was really high considering, almost at top of the range. My vitamin-D was 55 (range of 30-80) as of a month ago and I've since started taking two thousand more units daily since then... and B12? I was actually advised to stop taking it for 30 days because it was high and I also had an injection of it...
Any suggestions on amount I should be taking for meds? When on T4 alone it always felt like 137 and less was too little and once I go to 163 I become more lethargic... I don't know if I'm some freak that needs to just have an astronomical amount of T4 but for being a 35 year old woman, I am at a loss of what to do. Since 33, I've felt like I've lost two otherwise solid years and am so tired... just since starting levothyroxine, I can't stay asleep and wake up exhausted until I take my medicine again. Night is only when I feel alive but then it's a vicious cycle, and one I'm not too sure of how much longer I can take...
I don't know what my iron was off hand, but I know it was really high considering, almost at top of the range. My vitamin-D was 55 (range of 30-80) as of a month ago and I've since started taking two thousand more units daily since then... and B12? I was actually advised to stop taking it for 30 days because it was high and I also had an injection of it...
Any suggestions on amount I should be taking for meds? When on T4 alone it always felt like 137 and less was too little and once I go to 163 I become more lethargic... I don't know if I'm some freak that needs to just have an astronomical amount of T4 but for being a 35 year old woman, I am at a loss of what to do. Since 33, I've felt like I've lost two otherwise solid years and am so tired... just since starting levothyroxine, I can't stay asleep and wake up exhausted until I take my medicine again. Night is only when I feel alive but then it's a vicious cycle, and one I'm not too sure of how much longer I can take...
From your symptoms and those test results I'd say that your Free T4 is higher than needed, and your Free T3 is much too low, being only at 34% of the range. We generally recommend Free T4 at the middle of its range combined with Free T3 in the upper part of its range, adjusted upward as needed to relieve symptoms.
Since you mention hair loss, what iron test was done and what was the actual result? Also, have you been tested for Vitamin D? What was your actual B12 level?
Since you mention hair loss, what iron test was done and what was the actual result? Also, have you been tested for Vitamin D? What was your actual B12 level?
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