Question about Labs and Concerning Heart Symptoms - Newbie ❤️

[Dunamis444]

Hello,

I am a woman, age 48.  I have been reading the forum for about a year and a half, when my symptoms started interfering with my ability to do my daily ‘tasks’, and live my life normally.

I was diagnosed with hypothyroidism back in 1999, by an endocrinologist who was pretty progressive back then.  He did the full thyroid panel, as I recall, and put me on Synthroid.  The Synthroid made me feel anxious, and I did not continue for very long.  After a few months, I stopped seeing the doctor.  I’ve been having, what I now know to be thyroid symptoms, for years, but just started getting help from a doctor about 1.5 years ago.  

In June, I started working with a thyroid specialist, and he put me on 90 mg of Armour.  
Since then, he supplemented the Armour with Liothyronine.
I was to start with 5 mcg - 2x/day, and increase to 10 mcg - 2x/day, until I was at 60 mcg total per day.
The Liothyronine seems to be helping, but I was an anxious mess at 20 mcg/day, so I started tapering myself off after talking with doctor and getting another consultation with a nurse practitioner about other health stuff.  Just seeing me she thought that I was hyperthyroid.  When I taper down, I have to do it really slowly, 2.5 mcg/week of Liothyronine.  I can reduce my Armour at about 15 mg/week. If I don’t do this, I will wake up in the middle of the night feeling like I cannot breathe, it feels like the air is restricted to my brain.

Please see below for my most recent lab work. I will be going this week to get additional lab work and Will update this post when I do so.

My most recent lab results, with ranges - 8/31/21:
(When I had this blood work done, I was taking 90 mg of Armour, and 10 mcg Liothyronine.  
After these tests, my thyroid doc added the additional T3 (Liothyronine, as stated above. -
His explanation about the higher T3 test, is that my thyroid surges at times.
I do not take any thyroid meds in the morning, prior to bloodwork, and always have my blood drawn by 9 am.)

TSH          0.01 L  (0.40-4.50)
T4, FREE  0.8     (0.8 - 1.8)
T3, FREE  4.7     (2.3 - 4.2)
T3, TOTAL  173   (76-181)
T3 REVERSE 8   (8-25)
Thyroid peroxidase antibodies 1

Other related tests:
Iodine, serum/Plasma    43L    (52-109)
Aldosterone, LC/MS       8
DHEA SULFATE            39      (19-231)

Since the above labwork, I did increase my Liothyronine, per my Dr.s instructions, above.  I started to have symptoms such as racing thoughts, extreme anxiety and excite ability, and I was having a hard time getting to sleep at night.  It felt as though I could jump out of my own skin, and I could not relax.  So, I started tapering down, as above, and am now at 90 mg Armour and 10 mcg Liothyronine per day.

My current symptoms:  My heart is racing walking up stairs, and from small tasks...  I get winded and out of breath easily, and I do not have much stamina.  I feel as though I have to catch my breath periodically throughout the day.  Brain fog and memory problems, waking up some nights at 3 am and not being able to get back to sleep.  (Sleep was not an issue for me prior to thyroid treatment.)  l have symptoms of numbness in both legs, and pain on the left side of my body (from my head to toes) that gets worse when I forget to take my thyroid and take it late.  I also feel this left side pain in my thyroid area most of the time, and it gets worse when I take a dose late, or when. I was tapering down too quickly.

Previous Labwork - I will update this posting with all previous lab results, from July 2021 when I find it. My email is not loading properly.
From memory, my B-12 was low, and Dr. is having me supplement with 5k mcg/day.
Vitamin D was also low, and he has me supplementing 10,000 IU/day.
My total iron was 142?  I am not supplementing because I am sensitive to the ones I have tried, suggestions appreciated.

I also had an ultrasound, and will get these official results, if needed.
The doctor told me, from my ultrasound, that I have a goiter and inflammation in my thyroid.

Thank you so much for reading!!  I sincerely appreciate your input and time.  

[Barb135]

Why is your doctor increasing Liothyronine (T3) when your level was already over range?  

With an FT4 at the bottom of the range, you should be increasing T4 dosage, not T3.   When one is on Armour (or other desiccated hormones, it’s common to need additional T4, not additional T3.  It seems they’re dosing you backwards.  

[flyingfool]

You and your drs have you on a roller coaster of hell.

My opinion. You did not take your armor or  the T3 and your free T3 is OVER the top of the range!  With both of the Armoir and the T3 your blood levels of free T3 have to be WAY higher!

Your symptoms are mostly of being hyper. Because you in my opinion are WAY over medicated!

My opinion. But I think they addd the wrong medication to your base level of Armor.

Your free T4 level is rock bottom. This is very common for someone on Armor alone. And what probably should have been added was synthroid or levvo that is a T4 medication. NOT la T3 med.

Typically to feel well most people need to have BOTH of the following.

1). Free T4 to be 50% to 66% of the range.

AND

2) Free T3 to be at least 50% of the range.

Free T3 levels correspond best to symptoms generally.

You do not say when you take your meds. But any T3 med which includes Armour which is high in T3 should not be taken after abiut 2PM as it can mess with sleep.

T4 is a storage hormone. It takes about 6 WEEKS to stabilize in the blood.

T3 is immediately usable and it leaks in blood abiut 4 HOURS after taking it. And most of it is gone by 8 hours.

So to help level out the T3 is usually is taken in 2 doses. Half in the morning and the other half about 4 to 6 hours later. That way the second dose is ramping up in the blood as the first dose is fading away.

Just my opinions for you to consider.