TSH, Free T4, and Total T3 Are All Low, and my hypothyroid symptoms are returning

[Bird_42]

Hello. In early January 2010, I came to this forum and started the following thread:

http://www.medhelp.org/posts/Thyroid-Disorders/Questions-about-Proper-Dosage-of-Thyroid-Medicine/show/1138851

When I originated this thread, I had recently been told that my TSH was 3.461 (normal range = 0.35 - 5.5) and that my free T4 was 1.05 (normal range = 0.71 - 1.81). I was taking 125 mcg of levothyroxine per day. My doctor was suggesting that I go to 137 mcg per day, but I thought that staying at 125 mcg per day might be a better idea. I started the thread to get advice on which dosage to take.

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I just wanted to update you guys on my situation and to get some more advice.

First of all, I decided to stay at 125 mcg per day.

Also, shortly after I was first diagnosed with hypothyroidism in summer 2009, I stopped taking Centrum multivitamin, which I had been taking with my first meal of the day for years. In late December 2009, my doctor told me that it would be OK for me to resume taking Centrum. Of course, to make sure that Centrum did not interfere with my body's absorption of levothyroxine, I would take the Centrum at night with dinner. I would have dinner (with Centrum) at maybe 2 AM or 3 AM, and I would take levothyroxine at about 11:30 AM or 12 PM, an hour or more before my first meal of the day. (I am not a morning person.)

So, from early January 2010 until around February 20, 2010, I took 125 mcg of levothyroxine per day. Also, during part of this time, I took Centrum at night. However, sometimes, I would get chest pains or some other kind of discomfort after taking the Centrum. So, I stopped taking the Centrum, probably in early February 2010.

For the week or two before February 20, 2010, I started feeling soreness in my arms and legs. I also started feeling some overall sluggishness, and I started experiencing some sweating (at various times of the day). My hypothyroid symptoms seemed to be staging a resurgence.

Around February 20, 2010, I took a blood test. I was tested for TSH and free T4, and I was tested for total T3 for the first time. My TSH was 1.919, my free T4 was 1.11, and my total T3 was 1.02 (normal range = 0.67 - 1.99). My doctor left me a message, saying that he feels that my dosage is correct and that he wants to do follow-up blood tests in six months.

Now, my TSH has improved a lot (from 3.461 to 1.919). However, my free T4 has risen only a little (from 1.05 to 1.11), and 1.11 seems to be a low amount anyway. The amount of total T3 (1.02) also seems to be low.

So, should I take 125 mcg of levo for six more months and hope that the free T4 and total T3 levels rise significantly and that the sluggishness and other symptoms are decreased? Or should I ask the doctor for 137 mcg of levo? Should I get T3 therapy (Cytomel)?

Also, I understand that total T3 and free T3 are two different tests. Was I supposed to have the free T3 tested INSTEAD of the total T3?

Furthermore, is it possible that my taking the Centrum caused the amounts of free T4 and total T3 (and the increase in free T4) to be so small? Is it possible that my taking the Centrum caused the resurgence of my symptoms?

Thank you very much for any help that you can give me.

[Barb135]

Fatigued to Fantastic is a book written by Jacob Teitelbaum, who is a famous doctor and it's also a line of vitamins/minerals developed by him... The vitamins/minerals, typically, come in powder form and are mixed with water... They, supposedly, are "pure form" of vitamins/minerals, but if you read on the package they have such ingredients as "cellulose, modified cellulose gum, modified cellulose, stearic acid, magnesium stearate, silicon dioxide, soy lecithin, vegetable glycerin, vegetable juice color, and carnauba wax."

I've never taken them, so I can't vouch for how good they are...

[stella5349]

Oh my Dear Lord!!! - how terrible for that misconduct from the pharamcy... I hope you reported the error.

This is our fight constantly

"He doesn't think that I should have *any* T3 test, free or total. He believes that my T4-to-T3 conversion is fine. Why he assumes this I do not know. If my thyroid can malfunction in producing T4, why can't the T4-to-T3 conversion also be malfunctioning?

This is the most frustrating thing having thyroid tests and almost all go there this fight.

You said is so clear here.

The other common thing moany find is the frustration from our doctors in the beginning. Almost again Always, the first treating doctor decides you are not cooperating and then sends us off to a "specialist". The bad thing with that is most will be sent to someone almost identical in thoughts as the first one and is becoming a big waste of time.

Here is where you own diligentcy needs to be. Start researching all there is - like the labs we talked about. There is alot more things to know too - with thyroid disease. i.e. - kind of doctors that really will help.

I can tell you. I found great success going to Intergrative medicine doctors and now after years - I have the best care I ever had in my life.

It pays to almost interview doctors like they were applying for a job. If they don't openly talk about all forms of treatment. 99% of them are probably  just like the first doctor you had that did nothing too.

[Bird_42]

I spoke to my doctor about two weeks ago.

He doesn't think that I should have *any* T3 test, free or total. He believes that my T4-to-T3 conversion is fine. Why he assumes this I do not know. If my thyroid can malfunction in producing T4, why can't the T4-to-T3 conversion also be malfunctioning?

Also, he believes that Cytomel is antiquated and should not be used.

Furthermore, he believes that I should find a different doctor. He is tired of arguing with me. He believes that I should probably see an endocrinologist. I, too, believe that I should find a new doctor, probably an endocrinologist.

He did, however, give me a prescription for 137 mcg of levothyroxine. On an interesting side note, the pharmacy gave me a bottle labeled 137 mcg, but, when I got home, I found out that the pills inside were 300 mcg pills instead. The label on the pills did not match the label on the instruction sheet, and I called a different pharmacy and was told that the label on the pills corresponds to the 300 mcg levothyroxine.
Thankfully, I discovered the mistake before I took a 300 mcg pill.


Well, for the last 2 weeks, I have been taking the 137 mcg levo. However, my hypothyroidism symptoms seem to be getting worse. Now, when I walk up or down the stairs, my knees hurt.

Also, stella, in your response to my first post, you stated that I should take "pure forms of supplements". Do you mean one pill for vitamin C, a separate pill for vitamin B, etc.? Do you mean that I should avoid all multivitamins and not just Centrum?

Thanks a lot.

[stella5349]

yes you were to have the Free t3 test - the total is your stored hormone that only sticks in the system and does nothing...

Is Cytomel right for you? Not sure - only free T3 testing will determine if you need it.

If you FT3 is low in testing - then yes - you could benefit from adding in this medication.

I have never taken Centrum multi's - but I can say that if you are looking for porper supplementation - you need to look at pure forms of supplements and not filler by products of supplements... Centrum is really not a good daily supply of steady supplementation.

If you like taking a multi I suggest a product made called Fatigue to Fantastic.

[asemides]

I got that Fatigue to Fantastic, what are the benefits of this?