Aa
TSH out of control
I am a 33yo female, TT done in 2012 with positive lymph involvement. I had follow up RAI, but I have had consistent positive thyroglobulin testing the last couple years it has been on a slow sliding scale of 0.7-2.1 (I have not received the most recent results yet).
My question is my TSH seems to have went off track and I am not sure why, they still want me suppressed due to having ThyCa, I take 300mcg of brand Synthroid a day. My last two TSH results (6 months apart) were .02, and .01. (They want me .01-.05). My most recent result is 5.86 :O ! My current endo who I have only had one visit with as I was recently referred there from my last one for additional radiation etc is not a supporter of T3 at all, which I am on, (25mcg a day). I have suffered from zombism (extreme fatigue with no strength since my thyroidectomy....but of course none of the Numerous endo's I have seen think that has anything to do with the TT or my thyca.....it just started on the exact day they sliced my neck open...) anyway, since he doesn't support my t3, he didn't order a t3free. But here are the current results that I have...
TSH 5.86 range 0.40-4.20
T4 Free 0.84 range 0.70-1.48
T3 116 range 58-159
My last t3free ordered by my pcp was dated 10/15/15 resulted = 3.80 range 1.71-3.71.
My question is my TSH seems to have went off track and I am not sure why, they still want me suppressed due to having ThyCa, I take 300mcg of brand Synthroid a day. My last two TSH results (6 months apart) were .02, and .01. (They want me .01-.05). My most recent result is 5.86 :O ! My current endo who I have only had one visit with as I was recently referred there from my last one for additional radiation etc is not a supporter of T3 at all, which I am on, (25mcg a day). I have suffered from zombism (extreme fatigue with no strength since my thyroidectomy....but of course none of the Numerous endo's I have seen think that has anything to do with the TT or my thyca.....it just started on the exact day they sliced my neck open...) anyway, since he doesn't support my t3, he didn't order a t3free. But here are the current results that I have...
TSH 5.86 range 0.40-4.20
T4 Free 0.84 range 0.70-1.48
T3 116 range 58-159
My last t3free ordered by my pcp was dated 10/15/15 resulted = 3.80 range 1.71-3.71.
Without knowing your Free T3 it is difficult to assess how much your fatigue is due to thyroid. I strongly recommend that you ask the doctor to test for both Free T3 and Reverse T3. Those will give a better idea of tissue thyroid levels, which can be different from serum thyroid levels. Also, B12 and ferritin can have a big impact on fatigue, so I also recommend getting those tested and then supplement as needed to optimize. B12 should be in the upper end of if range and ferritin should be at least 70. Cortisol levels also affect how thyroid hormone is metabolized, so I suggest a morning serum cortisol test as well.
Since you are taking a large dose of T4 yet it is in the low end of the range, I also suggest that you should test for estradiol and progesterone. The ratio of P to E is important in determining the level of Thyroxine Binding Globulin (TBG). Estrogen dominance and high levels of TBG can cause excessive binding of thyroid hormone, resulting in lower levels of the Free T4 and Free T3 than would be expected with high doses of thyroid med.
Sorry to suggest all these tests, but that is what you doctor should be doing to find out what is causing your symptoms. If you can get the tests done, then please pot results and their reference ranges and we will be glad to help interpret and advise further.
Since you are taking a large dose of T4 yet it is in the low end of the range, I also suggest that you should test for estradiol and progesterone. The ratio of P to E is important in determining the level of Thyroxine Binding Globulin (TBG). Estrogen dominance and high levels of TBG can cause excessive binding of thyroid hormone, resulting in lower levels of the Free T4 and Free T3 than would be expected with high doses of thyroid med.
Sorry to suggest all these tests, but that is what you doctor should be doing to find out what is causing your symptoms. If you can get the tests done, then please pot results and their reference ranges and we will be glad to help interpret and advise further.
I don't think I have ever been tested for ferritin
1.37 was my free t4 on 10/15/15
My last vit d was 1/23/14 and resulted 30 ref range 30-80 (I also take 5000 iu per day)
I could not find a test at all for b12 or ferritin...sorry :/ , I don't think I've ever been tested.
1.37 was my free t4 on 10/15/15
My last vit d was 1/23/14 and resulted 30 ref range 30-80 (I also take 5000 iu per day)
I could not find a test at all for b12 or ferritin...sorry :/ , I don't think I've ever been tested.
Your Free T4 is far from optimal, even with the large dose of T4 med. For many people it works best when at the middle of the range, at minimum. The doctor should be testing you for Free T3, not Total T3. You should make sure they always test for both Free T4 and Free T3 each time you go in.
Before further discussion, what was your Free T4 on 10/15? Have you been tested for Vitamin D, B12 and ferritin?
Before further discussion, what was your Free T4 on 10/15? Have you been tested for Vitamin D, B12 and ferritin?
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