Thyroid

[Suzicueb]

57 yrs old.  Been on Synthroid for years.  Last lab work showed the following:


                                     Range
TSH 1.73.                     O.450-4.50
T4 ( thyroxine) 12.4.      4.5- 12.0
T3 uptake  22                 24- 39%
Free Thyroxine. 2.7.       1.2- 4.9
Triiodothyronine. 130.     71- 180

I have been having increase heart rate, nervousness, increased blood pressure, and since February tinnitus.  My nephrologist did this routine blood test and suggested I contact my gp. When I did she wasn't concerned at all .  I told her I was.  She couldnt decide if I needed increase or decrease and went w increase of Synthroid.  To say the least, I am concerned about her decision.  Please help.  What are your thoughts?  

[flyingfool]

You mean you will take the increased dosage of 88 mcg right?

I agree with barb, it is most likely low Free T3.

I would strongly recommend that you demand that the FREE T3 be tested along with the Free T4.  And don't waste your time or money on the uptake and total tests as barb stated they are of very little if any value.

Also if possible you  might want to get in a couple weeks sooner if you want.  As stated it takes up to 6 weeks for the new T4 dosage to stabilize.  So waiting to 8 weeks may not be necessary, but I would not recommend going in prior to 6 weeks either.

I too have always had background ringing of my ears.  All my life even as a kid.  But I also seem to have very subtle low thyroid symptoms too for all my life. But all my thyroid tests come back "normal" so no one does anything.  I think IF I am hypo (low) thyroid, it is very mild.  So I can live with it. But it sure would be nice to have a little more energy and not be cold and constipated all the time with high cholesterol.

[Suzicueb]

Thank you. I hope to be retested in a month by an endocronologist so maybe she will do the most current blood work.  I guess in the mean time, I will continue taking 75 mg of Synthroid.  

[Barb135]

Yes, your Total T4 is high, but the majority of that is bound by protein and is unusable.  That's why it's considered obsolete and we use the Free T4 result instead, because the Free T4 is the portion that's "Free" (unbound by protein) and is available for conversion to Free T3.

Your Free T4 is only at 40% of the range; rule of thumb is for it to be at about 50% of its range.  You have a ways to go yet.

Yes, hypothyroidism can contribute to tinnitus; however, I'm not a good source of information on that, because I've had tinnitus most of my life and I've only been diagnosed with thyroid condition for 7 yrs. There are many causes for it.  Nothing seems to make it go away; sounds like I have crickets chirping in my head most of the time; other times, it's a high pitched squeal.

[Suzicueb]

I don't know if you mistyped or looked at my levels incorrectly, my T4 is high not low.....your thoughts?  

[Barb135]

It takes between 4-6 weeks for a dosage change to reach full potential, then it can often take a few more weeks for the body to "get well".  Many people don't realize that hypothyroidism is an illness and we have to get well from it, just as we do from the flu or a cold or any other illness.   The body heals the most important things first, like heart rate, body temperature, etc, so things like tinnitus, hair loss, etc might be last on the list of things to get better.  It's even possible that they won't get better until after the next dosage increase.

[Suzicueb]

I was on 75 mg increased to 88 mg.  I am scheduled to go back in 8 wks.  I understand that your thyroid plays a part in causing tinnitus.  I have a severe case of tinnitus; therefore, I certainly don't want to go in the wrong direction along w the other symptoms I am having.   How long after the increase of meds will it take to get to feeling better?

[Barb135]

Unfortunately, your nephrologist ordered, mostly, outdated tests, so it is hard to decide what to do.  Total T4 (Thyroxine), T3 uptake and Triiodothyronine are all outdated.  Free Thyroxine (Free T4) and Free T3 are much more useful.

Your Free T4 is only at about 40% of its range; rule of thumb is for it to be mid range. It's too bad there isn't a Free T3, since that's the hormone that's actually used by the individual cells.  Free T4 is a storage hormone and has to be converted to FT3 prior to being used by the cells.

What dosage of Synthroid were you on?  How much of an increase were you given?  When are you scheduled for further testing?  You should retest after 5-6 weeks and make sure you request the Free T3 and Free T4 tests.

Because of your low FT4, I would probably have increased, as well.