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I feel hyper - not sure about results
Hello,
I was diagnosed with Hypothyroidism about 4 years ago and my dose of Levothyroxine has been stable at 150mcg for about a year.
Gradually I have been experiencing symptoms of Hyperthyroidism - trouble breathing, occasional dizziness, weight loss, diahorrea, anxiety, trouble sleeping. I didn't connect the symptoms to my thyroid until about a month ago.
I have now hooked up with an Endocrinologist who took some blood last week. My follow-up consultation is not for another week and I wondered if anyone might be able to pronounce on the significance of a low TSH (0.21 range 0.27-4.2) and a low T3 (1.2 - range 1.3 - 3.1).
Free T3 is in the low end of normal; T4 is right in the middle of acceptable.
I have been in such a state about this, I went a couple of days with no medication, then carried on at 50mcg. The symptoms very definitely started to recede. I then called my GP to discuss the result but she seemed pretty dismissive and said I could cut back my thyroxine to 125.
I'm now taken 100mcg and the symptoms are definitely returning.
If anyone could take the time to offer an opinion, I would be very grateful.
Many thanks
I was diagnosed with Hypothyroidism about 4 years ago and my dose of Levothyroxine has been stable at 150mcg for about a year.
Gradually I have been experiencing symptoms of Hyperthyroidism - trouble breathing, occasional dizziness, weight loss, diahorrea, anxiety, trouble sleeping. I didn't connect the symptoms to my thyroid until about a month ago.
I have now hooked up with an Endocrinologist who took some blood last week. My follow-up consultation is not for another week and I wondered if anyone might be able to pronounce on the significance of a low TSH (0.21 range 0.27-4.2) and a low T3 (1.2 - range 1.3 - 3.1).
Free T3 is in the low end of normal; T4 is right in the middle of acceptable.
I have been in such a state about this, I went a couple of days with no medication, then carried on at 50mcg. The symptoms very definitely started to recede. I then called my GP to discuss the result but she seemed pretty dismissive and said I could cut back my thyroxine to 125.
I'm now taken 100mcg and the symptoms are definitely returning.
If anyone could take the time to offer an opinion, I would be very grateful.
Many thanks
All I can do is offer my sincere thanks to everyone who has showed an interest in my situation. I am delighted to have happened on such a friendly and caring community. As I become more versed in the vagaries of this complex condition, I very much hope to be able to do the same for someone else.
I will post an update after Thursday.
Best regards
I will post an update after Thursday.
Best regards
Oh, I forgot to mention, I never had any symptoms whatsoever (apart from two dry patches of skin on my legs) prior to being diagnosed. I think I was probably hypo for several years before I saw the Dr if the dry patches are indicative.
I guess the menopause has possibly screwed things up. Ironically, I originally made the appointment to see the specialist for advice about menopause symptoms (she is an expert in bio-identical hormones as well), but by the time the appointment came around (she has a long waiting list) the thyroid issue had taken over.
I guess the menopause has possibly screwed things up. Ironically, I originally made the appointment to see the specialist for advice about menopause symptoms (she is an expert in bio-identical hormones as well), but by the time the appointment came around (she has a long waiting list) the thyroid issue had taken over.
Thank you goolarra for your informative reply.
Without wishing to put too fine a point on it, the diarrhoea has been with me almost constantly for about 8 months and I do have a fairly dramatic weight loss. Maybe there's something else going on there. I do take magnesium which could, I guess, be responsible, but I have taken it for many many years without any problem.
What puzzles me a bit is the symptoms I describe above definitely subsided earlier this week when I took three days off of the Levo. Probably a silly thing to do but I was feeling so wretched and getting seriously worried about my health. I started back again at 50mcg then 100mcg and the symptoms have returned. However the two patches of dry skin on my legs that were ever present before I was originally diagnosed with thyroid problems are also starting to return. I am so confused.
My blood pressure has always has very low although this past week I've taken three readings and they have all been normal. Another sleepless night last night with heart pounding furiously again as well. I've also noticed a strange burning sensation in my feet at night recently. I do, btw, have bags of energy - I walk about 8 miles a day and I'm on the go pretty much all the time.
I don't have any other lab tests unfortunately. My own GP is fairly uncommunicative about these things. I chugged along happily on the levo for about 3 years so didn't feel the need to see an expert. The Endocrinologist I have just been to see is, I believe, widely respected, but unfortunately has been away and my next appointment is not until Thursday. I sincerely hope that her observations will be similar to what I have read here, but I will take these comments along all the same.
Once again, my sincere thanks for all the help people have given. I hope I'll be in a position to give some back one day.
Without wishing to put too fine a point on it, the diarrhoea has been with me almost constantly for about 8 months and I do have a fairly dramatic weight loss. Maybe there's something else going on there. I do take magnesium which could, I guess, be responsible, but I have taken it for many many years without any problem.
What puzzles me a bit is the symptoms I describe above definitely subsided earlier this week when I took three days off of the Levo. Probably a silly thing to do but I was feeling so wretched and getting seriously worried about my health. I started back again at 50mcg then 100mcg and the symptoms have returned. However the two patches of dry skin on my legs that were ever present before I was originally diagnosed with thyroid problems are also starting to return. I am so confused.
My blood pressure has always has very low although this past week I've taken three readings and they have all been normal. Another sleepless night last night with heart pounding furiously again as well. I've also noticed a strange burning sensation in my feet at night recently. I do, btw, have bags of energy - I walk about 8 miles a day and I'm on the go pretty much all the time.
I don't have any other lab tests unfortunately. My own GP is fairly uncommunicative about these things. I chugged along happily on the levo for about 3 years so didn't feel the need to see an expert. The Endocrinologist I have just been to see is, I believe, widely respected, but unfortunately has been away and my next appointment is not until Thursday. I sincerely hope that her observations will be similar to what I have read here, but I will take these comments along all the same.
Once again, my sincere thanks for all the help people have given. I hope I'll be in a position to give some back one day.
I agree with Moose that you are not converting well (and this is also why your results are upside-down). With your FT4 just short of midrange, we'd expect your FT3 to be well into the upper half of the range if you were converting properly.
You probably want to look into reducing your levo a bit and adding a direct source of T3 to your meds. T3 is very fast-acting and neutralized by your body very quickly if not used promptly. If you add T3 meds, ask about splitting the dose into two during the day for more stability.
You said, "The symptoms I'm referring to are the hyper (diarrhoea, fullness in throat, difficulty catching my breath, anxiety, trouble sleeping)." I agree again with Moose...these can all be hypo symptoms as well. Diarrhea is unusual, but we are all different. Do you know what your blood pressure and heart rate are doing?
FT3 is the test that correlates best with symptoms, followed distantly by FT4, and TSH doesn't correlate at all.
Do you have any more test history to post? It's often useful to see if there is a "trend" developing. It can sometimes supply more information than snapshot numbers.
You probably want to look into reducing your levo a bit and adding a direct source of T3 to your meds. T3 is very fast-acting and neutralized by your body very quickly if not used promptly. If you add T3 meds, ask about splitting the dose into two during the day for more stability.
You said, "The symptoms I'm referring to are the hyper (diarrhoea, fullness in throat, difficulty catching my breath, anxiety, trouble sleeping)." I agree again with Moose...these can all be hypo symptoms as well. Diarrhea is unusual, but we are all different. Do you know what your blood pressure and heart rate are doing?
FT3 is the test that correlates best with symptoms, followed distantly by FT4, and TSH doesn't correlate at all.
Do you have any more test history to post? It's often useful to see if there is a "trend" developing. It can sometimes supply more information than snapshot numbers.
Good grief, it's not straightforward is it? Than you for your help. I will get my pituitary checked.
Thank you LazyMoose - the immunology test was Thyroglobulin Antibody (negative and Thyroid Microsomal Ab (positive).
I didn't lose or gain weight after I was initially diagnosed. The weight loss started about the same time as my dose went up to 150mcg. The (hyper?) symptoms have been gradually getting worse during this year.
Don't know if it's relevant but I was taken into hospital last winter for suspected pericarditis. I'd had a full heart MOT two years ago when I hit 50 and was given the thumbs up. However when I mentioned the pericarditis to my consultant he said it was probably myocarditis although he seemed a bit puzzled by it.
I didn't lose or gain weight after I was initially diagnosed. The weight loss started about the same time as my dose went up to 150mcg. The (hyper?) symptoms have been gradually getting worse during this year.
Don't know if it's relevant but I was taken into hospital last winter for suspected pericarditis. I'd had a full heart MOT two years ago when I hit 50 and was given the thumbs up. However when I mentioned the pericarditis to my consultant he said it was probably myocarditis although he seemed a bit puzzled by it.
"The symptoms I'm referring to are the hyper (diarrhoea, fullness in throat, difficulty catching my breath, anxiety, trouble sleeping) "
- I and many here have had all those symptoms and were hypo. Hyper and hypo can have the same symptoms. I do not totaly agree that you are hyper. Anxiety and insomnia is VERY common when hypo. People are confused by this.
I have felt hyper but was accualy hypo. This is not juged by TSH. Its judged by the free hormones. TSH is not really a hormone your cells use up , it a signal. And a messed up pituitatry can create a messed up TSH signal. But some just have to ignore the TSH #'s. You cant ignore the Free #'s.
Getting checked for nodules is also important, many have them, and its generaly no big deal.
At one point I had a TSH in the 50's. Guess what , I only could not sleep only 3 hrs a night. And I was 'wired from anxiety'; all day long. It can be the opposite of what one thinks. I started calming as Frees went up and TSH went down. My BP even goes UP when hypo because the heart is working harder.
"Any idea why my results seem to be upside down? ' Yes, Pituitary - this is why I stated to get a Pituitary test. You might have a pituitary issue, best to rule it out.
- I and many here have had all those symptoms and were hypo. Hyper and hypo can have the same symptoms. I do not totaly agree that you are hyper. Anxiety and insomnia is VERY common when hypo. People are confused by this.
I have felt hyper but was accualy hypo. This is not juged by TSH. Its judged by the free hormones. TSH is not really a hormone your cells use up , it a signal. And a messed up pituitatry can create a messed up TSH signal. But some just have to ignore the TSH #'s. You cant ignore the Free #'s.
Getting checked for nodules is also important, many have them, and its generaly no big deal.
At one point I had a TSH in the 50's. Guess what , I only could not sleep only 3 hrs a night. And I was 'wired from anxiety'; all day long. It can be the opposite of what one thinks. I started calming as Frees went up and TSH went down. My BP even goes UP when hypo because the heart is working harder.
"Any idea why my results seem to be upside down? ' Yes, Pituitary - this is why I stated to get a Pituitary test. You might have a pituitary issue, best to rule it out.
Many thanks for taking the time to reply.
The symptoms I'm referring to are the hyper (diarrhoea, fullness in throat, difficulty catching my breath, anxiety, trouble sleeping)
I cut my Levo down from 150mcg to 125mcg about 6 weeks before the lab work.
Any idea why my results seem to be upside down?
The symptoms I'm referring to are the hyper (diarrhoea, fullness in throat, difficulty catching my breath, anxiety, trouble sleeping)
I cut my Levo down from 150mcg to 125mcg about 6 weeks before the lab work.
Any idea why my results seem to be upside down?
"Free T3 is 3.7 (range 3.1-6.8)."
- BINGO, that is low and is guaranteed to have heath effects.
"Free T4 is 16.7 (range 12 - 22)"
- Mid range is good for FT4.
Your body is NOT converting 4 to 3 like it should. Think of Free T4 as your local gas station and Free T3 as the gas in your car. Dosent matter how much gas the station has if the pump can only fill your tank with 'fumes'.
Added T4 hormone might get you more T3, but you will most likely need to add a t3 med. Many docs dont understand this, find one that does.
***Still you need the Pituitary checked, it would be more common to have a high TSH with that low Free t3 you have. ***
1)"The blood test shows positive Thyroid Antibodies' which test did you get, several out there.
2) Thyroid and weight. Its rare but some lose weight with low thyroid. - they get weak. I think this is more common in those that were more physically active and in shape before Dx'd.
3)"frequent sweating" is also very common to hypo thyroid. The hypothyroid men here can prove this. So in your case it might or might not be female hormones but for shur its not only from Hyper.
"would anyone advise me to cut out the Levo until then?" - I wouldnt, it will mess up the thyroid blood test, and he will draw blood at the first exam.
- BINGO, that is low and is guaranteed to have heath effects.
"Free T4 is 16.7 (range 12 - 22)"
- Mid range is good for FT4.
Your body is NOT converting 4 to 3 like it should. Think of Free T4 as your local gas station and Free T3 as the gas in your car. Dosent matter how much gas the station has if the pump can only fill your tank with 'fumes'.
Added T4 hormone might get you more T3, but you will most likely need to add a t3 med. Many docs dont understand this, find one that does.
***Still you need the Pituitary checked, it would be more common to have a high TSH with that low Free t3 you have. ***
1)"The blood test shows positive Thyroid Antibodies' which test did you get, several out there.
2) Thyroid and weight. Its rare but some lose weight with low thyroid. - they get weak. I think this is more common in those that were more physically active and in shape before Dx'd.
3)"frequent sweating" is also very common to hypo thyroid. The hypothyroid men here can prove this. So in your case it might or might not be female hormones but for shur its not only from Hyper.
"would anyone advise me to cut out the Levo until then?" - I wouldnt, it will mess up the thyroid blood test, and he will draw blood at the first exam.
You are correct that the positive result for antibodies (TPOab) indicates that you have Hashi's.
In your initial question, you say, "I'm now taken 100mcg and the symptoms are definitely returning." Are you referring to hyper symptoms or hypo symptoms?
Menopause is very relevant. Unfortunately, many of the symptoms can be the same, confusing the issues even further. Also, the hormonal changes in the rest of the endocrine system can alter thyroid meds requirements since the whole endocrine system is interrelated. Also, as was pointed out above, many symptoms "cross over" and can be symptoms of both hypo and hyper.
Your FT4 is just below the middle of the range, which is good. However, FT3 is low, way down at 16% of range, and the recommendation for FT3 is upper half to upper third. It looks like you are not converting T4 to T3 well at all. Also, your labs are a bit "upside down" as FT3 should be higher in its range than FT4 is in its. LazyMoose asks a relevant question - what dose were you taking before these labs, and had that changed at all in the six weeks prior to the labs?
No, don't cut out the levo until your appointment. Thyroid meds changes have to be made in very small increments. A very small change in dose can have a huge effect on symptoms, especially if you are close to your optimal dose. Stopping and starting or any drastic change will make it even more difficult to pinpoint what is happening.
In your initial question, you say, "I'm now taken 100mcg and the symptoms are definitely returning." Are you referring to hyper symptoms or hypo symptoms?
Menopause is very relevant. Unfortunately, many of the symptoms can be the same, confusing the issues even further. Also, the hormonal changes in the rest of the endocrine system can alter thyroid meds requirements since the whole endocrine system is interrelated. Also, as was pointed out above, many symptoms "cross over" and can be symptoms of both hypo and hyper.
Your FT4 is just below the middle of the range, which is good. However, FT3 is low, way down at 16% of range, and the recommendation for FT3 is upper half to upper third. It looks like you are not converting T4 to T3 well at all. Also, your labs are a bit "upside down" as FT3 should be higher in its range than FT4 is in its. LazyMoose asks a relevant question - what dose were you taking before these labs, and had that changed at all in the six weeks prior to the labs?
No, don't cut out the levo until your appointment. Thyroid meds changes have to be made in very small increments. A very small change in dose can have a huge effect on symptoms, especially if you are close to your optimal dose. Stopping and starting or any drastic change will make it even more difficult to pinpoint what is happening.
Hello
No, the T3 is 1.2 (range 1.3 -3.1) and the Free T3 is 3.7 (range 3.1-6.8).
Total T4 is 91 (range 59-154) Free T4 is 16.7 (range 12 - 22). I have spent quite a long time Googling low TSH with low T3 and found very little about. Finally I found this forum.
When I got this lab work done, I had reduced from 150mcg to 125mcg about 6 weeks before as I had been having problems sleeping. At this stage I did not connect the seemingly disparate collection of other vague symptoms I was having. I've lost 20lbs in just over a year and while I thought something must be up, I had made changes to my diet and exercise regime and was pleased to lose it so I didn't question it too much. The diarrhoea has been going on for about 6 months and the breathing difficulties and sort of fullness in the bottom of the neck has been getting progressively worse over the past three months, hence the visit to the Endocrinologist.
The blood test shows positive Thyroid Antibodies - am I right in thinking this means Hashi's?
Not sure if it's relevant, but I'm also going through the menopause - I put the frequent sweating down to that but I read that it can also be a symptom of hyperthyroidism.
My follow-up consultation with the Endocrinologist is next Thursday; would anyone advise me to cut out the Levo until then?
Many thanks
Many thanks for your help.
No, the T3 is 1.2 (range 1.3 -3.1) and the Free T3 is 3.7 (range 3.1-6.8).
Total T4 is 91 (range 59-154) Free T4 is 16.7 (range 12 - 22). I have spent quite a long time Googling low TSH with low T3 and found very little about. Finally I found this forum.
When I got this lab work done, I had reduced from 150mcg to 125mcg about 6 weeks before as I had been having problems sleeping. At this stage I did not connect the seemingly disparate collection of other vague symptoms I was having. I've lost 20lbs in just over a year and while I thought something must be up, I had made changes to my diet and exercise regime and was pleased to lose it so I didn't question it too much. The diarrhoea has been going on for about 6 months and the breathing difficulties and sort of fullness in the bottom of the neck has been getting progressively worse over the past three months, hence the visit to the Endocrinologist.
The blood test shows positive Thyroid Antibodies - am I right in thinking this means Hashi's?
Not sure if it's relevant, but I'm also going through the menopause - I put the frequent sweating down to that but I read that it can also be a symptom of hyperthyroidism.
My follow-up consultation with the Endocrinologist is next Thursday; would anyone advise me to cut out the Levo until then?
Many thanks
Many thanks for your help.
a low T3 (1.2 - range 1.3 - 3.1)
Please clarify.
1)Is the above Free T3 ? If so, its obviously low and you may have a conversion problem converting T4 to T3, if your FT4 is in mid-range.
Please for clarify reasons post Free T4 and Free T4.
It is unusual to have such a low TSH also with a LOW T3 with most people. But some peoples TSH does not correlate well with their Free t3 , t4 levels.
2)When did you get this lab test, was this before you switched doses?
In these cases its best to get the pituitary checked, 1st step is the prolactin test.
3)And do you know if you have Hashimoto and thyroid nodules - and how long?
Some hypo symptoms are very similar to hyper. Anxiety, no sleep, and especially loss of deep breathing or ability to 'catch breath'.
This is why its best to keep all your lab records and note symptoms or lack of for future comparison.
5)So what did your past lab tests look like.? When the doc says your good, always get a copy of the report. Lab ranges are very wide. Bottom of range is not good.
Please clarify.
1)Is the above Free T3 ? If so, its obviously low and you may have a conversion problem converting T4 to T3, if your FT4 is in mid-range.
Please for clarify reasons post Free T4 and Free T4.
It is unusual to have such a low TSH also with a LOW T3 with most people. But some peoples TSH does not correlate well with their Free t3 , t4 levels.
2)When did you get this lab test, was this before you switched doses?
In these cases its best to get the pituitary checked, 1st step is the prolactin test.
3)And do you know if you have Hashimoto and thyroid nodules - and how long?
Some hypo symptoms are very similar to hyper. Anxiety, no sleep, and especially loss of deep breathing or ability to 'catch breath'.
This is why its best to keep all your lab records and note symptoms or lack of for future comparison.
5)So what did your past lab tests look like.? When the doc says your good, always get a copy of the report. Lab ranges are very wide. Bottom of range is not good.
I've been reading up on this as much as time will allow. My immediate reaction was to stop taking the levo, then I read on another forum that you shouldn't just stop. The anxiety and breathing difficulties etc certainly seem to be connected to the levo.
The antibodies test has come back positive (Thyroglobulin Antibody negative). I'm assuming this means I have Hashi's.
Thank you very much for your help. I've got a lot of learning to do by the looks of it.
The antibodies test has come back positive (Thyroglobulin Antibody negative). I'm assuming this means I have Hashi's.
Thank you very much for your help. I've got a lot of learning to do by the looks of it.
Try and contact members Gimel, and Goolara, who are very familiar with hypo numbers, interpretation, and hypothyroid. I am hyper going into Hashi's, and not as much help.
You do seem to be swinging a bit toward hyper, but the symptoms can also be related to other issues, including Thyroiditis or a severly infected gland. Has your blood work been done to look at white blood cell count?
Best
You do seem to be swinging a bit toward hyper, but the symptoms can also be related to other issues, including Thyroiditis or a severly infected gland. Has your blood work been done to look at white blood cell count?
Best
You may have hashimotos(thyroiditis) it's basically swinging back and forth to hyper until the antibodies completly destroy your thyroid rendering you permantley hypo. You need to get tested for the antibodies. I hope your not still taking the Levo with numbers like that!
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You're right about the magnesium...that could be contributing. Is it possible that now that your thyroid levels are more properly adjusted, you don't need it any more?
If your BP is usually low (consistent with hypo), and it's been normal lately, then it's, in effect, "high" for you. That supports being hyper or overmedicated. So does the excess (?) energy.
It's interesting that you had no symptoms before being diagnosed, except for the dry patches on your legs. When it comes to symptom interpretation, it can be very helpful to know just how you, personally, felt when hypo. For example, fatigue is an almost universal complaint for us. Once our meds are adjusted, many of us panic when we feel fatigued (even if there's a good reason for the fatigue). I'm no exception...I always have to ask, "Why am I tired?" However, I was hypo (very), and I didn't really suffer from fatigue. I was almost narcoleptic. I didn't lack energy as long as I kept moving, but riding in the car or sitting in front of my computer ar sitting anywhere for more than a few minutes, I was asleep. So, now I know that being a little tired is not indicative of hypo for me. If I'm not nodding off uncontrollably, then it's probably not related.
It's also interesting that when you took the three days off, your symptoms subsided. That's not a totally foolish thing to do. When I was overmedicated, my endo had me stop all meds for three days, then resume at my previous dose. The three days alleviated the symptoms considerably, although it took a couple of weeks for them to go away completely (but, wow, did I have clean windows by then!).
Although we say that midrange is the rule of thumb on FT4, it doesn't work for everyone. I, for one, am quite happy in the lower ends of the free ranges, and my FT4 has never even gotten close to midrange. This is complicated by a pituitary issue that keeps my TSH permanently around 20 (no, I didn't forget the decimal point!). In my case, TSH has to be thrown out, and we have to go by the frees.
FT3 and FT4 levels both have to be right for you to feel your best. My guess is that your current FT4 may be a little high for you. At the same time, your FT3 is definitely low. This can cause a confusion of symptoms. It's also possible that you have a pituitary issue, which would be worrth exploring, as Moose suggested, but my guess is that it's the imbalance in your FT3/FT4 levels that is causing your symptoms. Add menopause to that, and oh, boy, are we having fun now, or what?! Hormones going crazy in every direction.
I'll be interested to see what your doctor has to say. Please let us know how it goes.
In the meantime, if I were you, I'd go with my instincts. If possible, it's best to stay on a relatively stable dose...stopping meds and then restarting can further confuse an already confusing situation. However, that should not prevent you from stopping or cutting back for a few days (75, maybe?) if you really feel the need. Only you know what your body is telling you.
I hope you feel better as Thursday approaches...