NEED YOUR ADVICE PLEASE!!!

[froggy0936]

FINALLY spoke to Endo and told him all of my troubling symptoms. Anxiety, brain fog, trouble concentating, etc etc.

Have been on 125mcg Synthroid since TT Dec 09. FT4 high, FT3 low. Added 2.5 Cytomel, had chest pain and stopped it. Very med sensitive! He explained to me that people with Thyroid issues can have symptoms of anxiety,  etc etc. He said he wants to lower my dose back to 112mcg and then to add the 2.5 Cytomel..even if I break that small bit in half and take it twice a day. Also, that it will be ANOTHER adjusment period. That, I know..but I'm hoping it's not so bad as to where I miss work. I NEED to work. I'm single and have no one to depend on.

The thing that struck me funny with him is that I was practically reciting advice from this forum...of course, he thought it was me doing my research..which I'm trying, but you guys know best for the time being! Anyway, I was suggesting this and that and he was just going along with my/your ideas! First he said to cut my 2.5 Cytomel in half and then when I suggested lowering my dose (because Ive heard on here that you should do that)..he agreed!

What do you guys think?? And I'm supposed to see my new Endo next week! Which I am keeping because what could it hurt...so...what can i expect and do you agree???

Thanks a bunch!

Lynda  

[stella5349]

I like it and now seeing the actual percentages - conversion could certainly play a big role in this.

In the low 56% of T3 hormone adressing that with the new endo would be good to do. You could certainly try some T3 meds to counter-balance and see if this helps.

[froggy0936]

Thank you for your input Stella and a big thank you to Goolara for posting my labs! You guys are all such a help, as I'm trying to learn as much as I can!

Yes, Goolara...I am going to wait to see the new endo..what's another week of crud? Lol.

Stella...what are your thoughts after reading Goolara's reply?

Thank you much!

[goolarra]

I think it's a good idea to wait to see your new endo and get her input...it's only a week.  You might as well have as much information available as you can.  

Stella, FT3 is at 56% of range, FT4 at 89% and TSH at 0.47.  My feeling was that FT4 needed to come down a bit and FT3 go up a bit...also get the FT3 a little higher in its range than FT4 is in its.  Although I know its possible to have RT3 dominance at higher FT3 levels, I'm thinking that this just looks like a conversion issue.  What do you think?

[stella5349]

Froggy - I see what the plan may be for meds - but I don't recall the lastest labs results you had..

At least for me - I need to know the labs you recently had done to suggest a theory on how to dose on your meds.

All I read was FT4 was high - FT3 was low. Where are you really at those levels. Also a TSH lab too. I know we talk alot about not needing that but in this case I'd like to see it.... Why? - well.. depending on the frees.... and that - an RT3 test may be needed here - AND that would require a different dosage of meds entirely too.

[froggy0936]

Thank you so much for your input. You have a very good memory..no brain fog with you, I see! :-)

As far as Selenium..i don't think it's on any of my lab work, but I'm going to double check. It would be wise to at least get tested for it, Thank you both for suggesting that.

I'm still going to see the new Endo behind the current ones back! At least to test her out. It's my money, right? He doesn't have to know. Haha. I just feel with him that it takes him forever to get back to my concerns. I literally have been leaving messages for him for probably 2 months. My trust in him is shaky, because I'm not a Dr! I appreciate that he finally listened to me...but originally, when he looked at my horrible labs he said "no change." Is he not looking at what I'm looking at?? And then to have a patient suffer for months and not get back to them is unprofessional and ridiculous! Just venting here...lol.

So you are saying to just try half of the 2.5 for a couple of weeks? Makes sense to me.

Im due to see the new Endo next Tues and I wonder if I should just keep doing what I'm doing until then and show her my bloodwork from the beginning of Sept and see what she thinks. What's another week...I've really been feeling like poop...and I have some kind of chest cold on top of it! I pray for better days!!

Thanks again and I hope you are well :-)

Lynda  

[goolarra]

I've been the doctor for a long time...I just had to find the doctor who would let me take over the role!  LOL

Yes, I know that you haven't posted your labs on this thread, but I remember them from a previous thread.  Your FT4 was too high, and your FT3 was too low.  Lowering your T4 meds will make it easier for your body to accomodate adding the T3 meds.  Just remember that T3 meds have an almost immediate effect, whereas lowering T4 meds will take some time to adjust.  You might try adding half the T3 in to begin with and then adding the other half a couple of weeks later as your FT4 levels drop a bit.

Selenium has done wonders for my conversion (at least I can attribute it to nothing else).  The enzyme that converts T4 to T3 is a selenium-based enzyne, so it makes perfect sense.  However, as gimel suggests, have your selenium level tested first...I think it will only help if there is a deficiency.  I didn't have my selenium tested before supplementing, so I'm guessing at this point.

If your doctor is willing to listen to your input, he might be a keeper.  With all the resources available to us today, informed patients SHOULD be able to tell their doctors what they need.  Keep at it!

[froggy0936]

Thank you for your reply and I couldn't agree more! The endo I have now did test the Free's but I had to INSIST on it. I mean, really INSIST.

The problem is...it takes WEEKS to get a return call out of him and it's as if when I talk to him..he doesn't even know who I am! I realize the practice is very busy..but hello? I work in the same hospital as he does!!!!

I wanted to know what you thought about dropping the Synthroid dose and then adding the Cytomel. Also, if I will have a bad adjustment period. I know you don't have a crystal ball..but just wondering if you've ever gone thru anything similar. I just thought it was "interesting" that I was the one bringing up the ideas..(from the forum)...and he was just like oh ok..well, then lets see? Almost as if I was the doctor and he was the patient!

What do you think about all that?

Thank you!

[gimel]

Depending on you luck, you might be seeing an Endo that is a good thyroid doctor.  Then again you might not.  Many specialize in diabetes, not thyroid.  Many also have the "Immaculate TSH Belief" that prevents them from helping many patients who don't fit right into their preconceived beliefs.  I think the main thing you need to find out from the Endo is whether he is willing to test and adjust the biologically active thyroid hormones, free T3 and free T4, with whatever type of medication is necessary to relieve symptoms, without being constrained by resultant TSH.  I would ask that very question and if the answer is no, or he is hesitant to commit to that, then the probability is that you will have to keep looking for a good thyroid doctor that will do so.

Another thing I would ask about is testing for selenium, to determine your current level.  After hearing from several members that they were taking selenium and finding it beneficial, I did some searching and found some info that seems to confirm that low selenium may inhibit the conversion of T4 to T3.  So if your selenium is low, supplementing it could be helpful to you as well.