Latest labs are in...

[medicmommy]

Hi all!
So, my latest labs are in...I FEEL like I'm going back to hypo again (at least the symptoms are returning) and oddly, it seems to go in cycles. In December 2010 I began using Thyroid Plus -a thyroid support supplement with a bit of bovine thyroid in it. After about a week of taking it, I began to feel the hypo symptoms melting away. -I had more energy, I was sleeping better, and my joints and muscles no longer hurt. Also, the palpitations disappeared. That lasted about 6 weeks, and then the hypo symptoms came back and my thyroid started to enlarge. The I was started on the levothyroxine. About a week after starting, again -I felt great, hypo symptoms went away, and life was good (except the thyroid continued to get bigger). This lasted about 5 weeks. Now the hypo symptoms are returning again. Weird, huh? Anyhow, here's my last two sets of labs. Maybe someone can see a pattern I can't...

                                             Jan 20, 2011             March 11, 2011
Vit D 3          (range 30-100)        46                        62
TSH              (range .40-4.50)     1.58                      1.48
Free T4         (range 0.8-1.8)       1.3                        1.5
Free T-3        (range 2.3-4.2        2.7                        
T3 Total         (range 76-181)                                    95

I'm afraid there are a few holes as the tests were ordered by different doctors. ~MM

[medicmommy]

Thanks for the feedback! Of course, I'd like to grab my thyroid by the reins and show it who's boss, but I have to agree...Patience is a virtue in this case...Sigh. I do have hope it will work as the 25 mcg levo seemed to help for about 2 weeks. I'll keep my fingers crossed...Know anyone who needs about 100 tabs of 25 mcg levo? LOL ~MM

[laura1967]

That sounds like a reasonable request on your doctors part, considering you are just starting out on meds and have not had a chance to try brand name instead of generic. Most people don't bind and utilize generic thyroid meds well at all. With any luck you may do very well on synthroid and convert just fine....only time will tell. Sounds like you and your doctor both are on the ball and taking it step by step!  :)
Considering the low dosage you are still taking, I personally feel that adding a T3 medication would put you over the edge at this point. I would do as you are doing and start with the T4 first then see where you need to go from there.

[medicmommy]

I'm liking my new endo...:)  I had my 2nd appt with him today. He looked at my labs and went, "Hmm, that dose of Synthroid was pretty much worthless. It didn't change much of anything." I told him that I'd been given the generic (levothyroxine) and asked about getting Armour instead or adding a T-3 med. He explained he'd like to try actual Synthroid first (he's not impressed with the effects of the generic) at a slightly higher dose (50 mcg), and check again in 6 weeks. He feels strongly that the Armour may be "too much" at this point, and that the actual Synthroid would be easier to control the dosing. He even brought out a handful of Synthroid sample packets -enough for 7 weeks to convince me to try his way a bit longer. (I would have even without the samples, -but what a nice gesture, eh?)  So, I'll try his way for a few more weeks, and we'll see what happens...Thanks again for all of your advice and insight. :) ~MM

[medicmommy]

Thanks Ladies!
My endo freaked me out a little when I called his office Friday and told the nurse that my thyroid was getting huge. She went "ummm, hang on." and then came back on a minute later and asked if I could make it in on Monday for an eval? What the hay?!? I have NEVER gotten an appointment sooner than 2 weeks out!
Ah well, at least I'll get to ask about the Armour again (or the T-3). Thanks again for all of your input...:P ~MM

[Barb135]

Since it appears that you could certainly benefit from some T3 med, it would make more sense to me, to go ahead and try the Armour now, if you're going to; otherwise, ask for a small dose (5 mcg) T3 med, added to your levo.

The advantage to using both the levo and a separate T3 med is that they can be adjusted independently, whereas with Armour, ERFA, etc, they can't.  

I'd say you might have hard time finding your "happy place" without some additional T3, so if you're going to switch to Armour, why not do it now?  Otherwise, you will just keep increasing your levo dose, without doing much for your FT3.

[medicmommy]

Hi Ladies,
I'm on 25 mcg of levothyroxine and 10,000 units/day of vitamin D3 (since last August). My D has come up from 15, but very, very slowly. I'm also on the Thyroid plus supplement which has a minuscule amount of T-3&4 in it. I started the L-thyroxine 5 weeks ago. I asked about Armour, but my endo said he'd rather get me going on the L-thyroxine and find my "happy place", and then switch if I still wanted to. Does this sound like a plausible approach?
I don't know what to make of the thyroid enlarging. It was slightly enlarged the beginning of Feb (about a week before I started the Lt), and now it has doubled in size. I thought thyroid meds would keep it smaller. My hand barely covers it now whereas before I could barely feel it.

[Barb135]

Your FT4 is right at mid range, which is what is often recommended; however, your FT3 is very low in its range.  Your vitamin D is also very low.  

It almost looks like you might not be converting T4 to T3 very well.  You might ask your doctor for a low dose of cytomel (T3 med) to go along with your levo; or as Stella suggested - go with a prescription med like Armour or ERFA that has T3 in it.  Most of us find that it's FT3 that correlates best with symptoms.  

Also, since you have Hashi's, your thyroid could be "dying off" more quickly than some of us have seen, so you need med increases more frequently, as your thyroid produces less hormones.

Are you currently on a vitamin D supplement?  If not, looks like you should be, and if so, you might consider raising your daily dose.  

What's your current dose of levo?

[stella5349]

All those labs show room for improvement MM.

So you aren't on a thyroid med? Like porcine Armour or ERFA? The OTC isn't solid ratio'd good and you can have swings and bouts of hypo even taking this daily.

.... hyper too.