Aa
I'm Losing It
I'm having a nervous breakdown. I don't know what else to say. I have difficulty swallowing (sort of), I feel like I have to gag all of the time and I'm nauseated and my TSH is the lowest it's been since I've been diagnosed on only 25mcg of levothyroxine. My GI symptoms are causing me to lose my mind. Maybe it's something bad. No one cares.
Whether you convert more T4 to T3, or take T3 medication, the end result is the same, namely higher T3 levels. Symptom relief for you will require the higher FT3 level.
I think you need to also see a cardiologist to find what meds he would recommend to prevent your palps from being a problem for you when increasing your thyroid meds. It doesn't make any sense to continue to suffer with hypo symptoms in order to avoid the palps. There has to be something that would help in that area.
As far as your doctor, yes it is too bad when doctors continue living off what they learned in med school all those years ago. There was a study that I recall concluded that doctors are either too busy , or don't have the inclination, to keep up with the latest medical information and that as a result they typically are reliant on what they learned 20 years ago.
Here is the link to that.
http://nahypothyroidism.org/why-doesn%E2%80%99t-my-doctor-know-all-of-this/
I think you need to also see a cardiologist to find what meds he would recommend to prevent your palps from being a problem for you when increasing your thyroid meds. It doesn't make any sense to continue to suffer with hypo symptoms in order to avoid the palps. There has to be something that would help in that area.
As far as your doctor, yes it is too bad when doctors continue living off what they learned in med school all those years ago. There was a study that I recall concluded that doctors are either too busy , or don't have the inclination, to keep up with the latest medical information and that as a result they typically are reliant on what they learned 20 years ago.
Here is the link to that.
http://nahypothyroidism.org/why-doesn%E2%80%99t-my-doctor-know-all-of-this/
Everyone,
I've been on 25mcg of levothyroxine for a year and I asked my endocrinologist to add a T3 med a long time ago but she said that they are contraindicated in people with heart issues. I have slight mitral valve regurgitation, and a slight increase in a T4 med is enough to make me experience palpitations. I've read that selenium can help your body convert FT4 to FT3. Should I try this route first?
Gimel, Madison is too far away for me to travel to see an endocrinologist but I will give my physician a copy of that information knowing that she won't read it and if she does read it she won't implement it into her practice. She's been an endocrinologist for decades and is a professor and not too open to new ideas.
I've been on 25mcg of levothyroxine for a year and I asked my endocrinologist to add a T3 med a long time ago but she said that they are contraindicated in people with heart issues. I have slight mitral valve regurgitation, and a slight increase in a T4 med is enough to make me experience palpitations. I've read that selenium can help your body convert FT4 to FT3. Should I try this route first?
Gimel, Madison is too far away for me to travel to see an endocrinologist but I will give my physician a copy of that information knowing that she won't read it and if she does read it she won't implement it into her practice. She's been an endocrinologist for decades and is a professor and not too open to new ideas.
There is definitely a connection between being hypo and having acid reflux. A while back I was trying to adjust my Synthroid and Cytomel meds, I ended up hypo for a while. Along with being hypo I developed acid reflux that was just awful, even though I was taking 20 mg of Prilosec twice a day. Fortunately I was able to get some Armour again, and in just two days of a good dose of Armour my acid reflux was gone, as a result of getting some additional T3 into my system and raising my FT3 level. I even quit taking Prilosec for a few days and still had no problem.
That is exactly where we are at. If no Free T3 & Free T4 this time on the lab results, we will go to the on-line lab method you suggest.
Then I wonder if the battle will be to actually get the Dr's to believe that fine tuning dosage within the "normal range" will take place.
We did go to the on-line way to look at her test results. And it does appear that they have fairly regularly tested for Free T4. But not a single test for free T3. Last lab result when we BEGGED to get both Free's we only got Free T4 and TOTAL T3. Maddening to no end!
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In the above discussion is there some connection between being Hypo and acid reflux? reason why I ask is that my wife also has this and is on medication (very strong) for acid reflux. It would be great if we could get the Thyroid regulated so that a reduction or elimination of the acid reflux meds could happen.
Then I wonder if the battle will be to actually get the Dr's to believe that fine tuning dosage within the "normal range" will take place.
We did go to the on-line way to look at her test results. And it does appear that they have fairly regularly tested for Free T4. But not a single test for free T3. Last lab result when we BEGGED to get both Free's we only got Free T4 and TOTAL T3. Maddening to no end!
----------------
In the above discussion is there some connection between being Hypo and acid reflux? reason why I ask is that my wife also has this and is on medication (very strong) for acid reflux. It would be great if we could get the Thyroid regulated so that a reduction or elimination of the acid reflux meds could happen.
COMMUNITY LEADER
How long have you been on your medications? It takes approximately 5-6 weeks for a dosage to take effect
I agree that your levels, especially FT3 are too low. You almost certainly need an increase in your T4 med and might very well benefit from addition of a T3 med, whether it be a combo such as Armour, NaturThroid, as gimel suggested or the simple addition of cytomel.
I've been on generic T3 med, along with my T4 med, for over 2 yrs and it's made a huge difference in the gastro area; whereas I was on very strong acid reducers, I now seldom have to take anything unless I eat too close to bed time.
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Flyingfool -- if you are having so much trouble getting your wife's FT3 and FT4 tested, why not try one of the online labs. For < $100, you can get a TSH, FT3 and FT4. You order the labs online, they e-mail a lab order to take to your local lab, you get the blood drawn and in a couple days, they e-mail the results. You could, then, take this to her doctor to show that she needs something further, if the tests so indicate. There are a number of tests you can order in this manner.
I agree that your levels, especially FT3 are too low. You almost certainly need an increase in your T4 med and might very well benefit from addition of a T3 med, whether it be a combo such as Armour, NaturThroid, as gimel suggested or the simple addition of cytomel.
I've been on generic T3 med, along with my T4 med, for over 2 yrs and it's made a huge difference in the gastro area; whereas I was on very strong acid reducers, I now seldom have to take anything unless I eat too close to bed time.
*************************************************************************************************
Flyingfool -- if you are having so much trouble getting your wife's FT3 and FT4 tested, why not try one of the online labs. For < $100, you can get a TSH, FT3 and FT4. You order the labs online, they e-mail a lab order to take to your local lab, you get the blood drawn and in a couple days, they e-mail the results. You could, then, take this to her doctor to show that she needs something further, if the tests so indicate. There are a number of tests you can order in this manner.
Agree your free T3 7 Free T4 show dramatic under medicated.
You could try a much larger dosage of straight T4 medication only and see what happens. This will have to occur in steps as making large change in Thyroid meds can cause some side effects. But you very well may need a combo T3/T4 med as gimel suggest and frankly I think that may be the better route.
My wife has thyroid problems & I live in the Madison, WI area. With our HMO we're having problems getting a good Dr. My wife just had blood drawn yesterday and yet again the lab order did NOT have the Free T4 and Free T3 on the order. My wife had to ask that it be added. We have not gotten back the results so we don't know if they in fact did add the tests. If they don't, I think I will blow a freaking gasket! And we are so out of there it is not funny. We'll have to pay out of pocket I guess in order to get what we need. We or at least I am so frustrated by this I could punch someone in the nose! It is like the Dr's are paying for the tests out of their own pocket not MY insurance company and our co-pay. Why the hell it is so difficult to get them to check two additional boxes on a thyroid lab order for a patient that is known to be Hypo for years is completely beyond comprehension! It is not like we are asking for an MRI of her right knee or something totally unrelated for God's sake!
Anyway be glad that you have a Dr. that at least is testing for both the Free T3 & T4. You must continue to insist to keep testing these and that he be aware to treat your symptoms and tweak dosage based upon the FREE T's results. NOT, absolutely NOT on TSH.
Also understand that when on T4 meds or thyroid meds in general, it is not uncommon and in fact very common for the TSH to be suppressed. Meaning that TSH will go under 1 and even near zero for many patients. This will freak out many Dr's and they will cut the medication dosage thinking that you're going hyPER. Even though you are not showing a single sign of being hyper and in fact improving and may in fact even need MORE medication, not less. let your Dr know this TSH suppression is possible and that you want to be treated on symptoms, not on some particular magic number OR if a number gets into "normal" range. That symptom relief as pointed out above may have to be mid or higher in the range. Just getting into the bottom of the range will often NOT relieve you of feeling like crap. But many Dr's are perfectly happy leaving you there and telling you that in so many words, "you're normal so get used to it!" Well you DON'T have to "get used to feeling" like crap. The Dr's should "get used to" taking the time necessary to get the individual patient to where they are feeling well. Not to just bring a number into a certain range. Especially when the range is set up erroneously from the start!
If your Dr. needs more information as to where you got this information we can help you out here with some links to MD's etc. it is amazing that Dr's don't know this stuff.
You could try a much larger dosage of straight T4 medication only and see what happens. This will have to occur in steps as making large change in Thyroid meds can cause some side effects. But you very well may need a combo T3/T4 med as gimel suggest and frankly I think that may be the better route.
My wife has thyroid problems & I live in the Madison, WI area. With our HMO we're having problems getting a good Dr. My wife just had blood drawn yesterday and yet again the lab order did NOT have the Free T4 and Free T3 on the order. My wife had to ask that it be added. We have not gotten back the results so we don't know if they in fact did add the tests. If they don't, I think I will blow a freaking gasket! And we are so out of there it is not funny. We'll have to pay out of pocket I guess in order to get what we need. We or at least I am so frustrated by this I could punch someone in the nose! It is like the Dr's are paying for the tests out of their own pocket not MY insurance company and our co-pay. Why the hell it is so difficult to get them to check two additional boxes on a thyroid lab order for a patient that is known to be Hypo for years is completely beyond comprehension! It is not like we are asking for an MRI of her right knee or something totally unrelated for God's sake!
Anyway be glad that you have a Dr. that at least is testing for both the Free T3 & T4. You must continue to insist to keep testing these and that he be aware to treat your symptoms and tweak dosage based upon the FREE T's results. NOT, absolutely NOT on TSH.
Also understand that when on T4 meds or thyroid meds in general, it is not uncommon and in fact very common for the TSH to be suppressed. Meaning that TSH will go under 1 and even near zero for many patients. This will freak out many Dr's and they will cut the medication dosage thinking that you're going hyPER. Even though you are not showing a single sign of being hyper and in fact improving and may in fact even need MORE medication, not less. let your Dr know this TSH suppression is possible and that you want to be treated on symptoms, not on some particular magic number OR if a number gets into "normal" range. That symptom relief as pointed out above may have to be mid or higher in the range. Just getting into the bottom of the range will often NOT relieve you of feeling like crap. But many Dr's are perfectly happy leaving you there and telling you that in so many words, "you're normal so get used to it!" Well you DON'T have to "get used to feeling" like crap. The Dr's should "get used to" taking the time necessary to get the individual patient to where they are feeling well. Not to just bring a number into a certain range. Especially when the range is set up erroneously from the start!
If your Dr. needs more information as to where you got this information we can help you out here with some links to MD's etc. it is amazing that Dr's don't know this stuff.
No wonder you are feeling so bad with hypo symptoms. You are way under medicated. Many of our members report that symptom relief for them required that Free T3 was adjusted into the upper part of its range and Free T4 adjusted to at around the midpoint of its range.
I won't bore you with why the current ranges are too broad, but suffice to say that being in the low end of the ranges does not work, especially with free T3, which largely regulates metabolism and many other body functions. FT3 has also been shown to correlate best with hypo symptoms, while FT4 and TSH correlated very poorly.
A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels. Symptom relief should be all important, not just test results. Test results are valuable mainly during diagnosis and then afterward to track FT3 and FT4 as meds are revised to relieve symptoms. You can get some good insight into clinical treatment from this link to a letter written by a good thyroid doctor for patients that he consults with from a distance. The letter is sent to the PCP of the patient to help guide treatment. You might also consider giving a copy of this to your doctor to try to persuade him to treat you clinically.
http://hormonerestoration.com/files/ThyroidPMD.pdf
In my opinion you need an increase in meds and also a change in meds to a T4/T3 combo type, like Armour thyroid, or Nature-Throid. If you doctor is unwilling to prescribe meds with T3 in them , or if unwilling to treat you clinically, then you need to find a good thyroid doctor that will do so.
If needed, and if you are interested, I have the names of two doctors in Madison, Wi. These doctors were recommended by other members. Are they close enough to you to be of interest?
I won't bore you with why the current ranges are too broad, but suffice to say that being in the low end of the ranges does not work, especially with free T3, which largely regulates metabolism and many other body functions. FT3 has also been shown to correlate best with hypo symptoms, while FT4 and TSH correlated very poorly.
A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels. Symptom relief should be all important, not just test results. Test results are valuable mainly during diagnosis and then afterward to track FT3 and FT4 as meds are revised to relieve symptoms. You can get some good insight into clinical treatment from this link to a letter written by a good thyroid doctor for patients that he consults with from a distance. The letter is sent to the PCP of the patient to help guide treatment. You might also consider giving a copy of this to your doctor to try to persuade him to treat you clinically.
http://hormonerestoration.com/files/ThyroidPMD.pdf
In my opinion you need an increase in meds and also a change in meds to a T4/T3 combo type, like Armour thyroid, or Nature-Throid. If you doctor is unwilling to prescribe meds with T3 in them , or if unwilling to treat you clinically, then you need to find a good thyroid doctor that will do so.
If needed, and if you are interested, I have the names of two doctors in Madison, Wi. These doctors were recommended by other members. Are they close enough to you to be of interest?
Sorry to hear you feel so lost!! Unfortunately I dont have too much to say about your lab results (I'm not too good at understanding my own labs let alone anyone elses!!) But I know how all of those symptoms feel (except the constipation)...I hope you feel better soon!! It's not fun feeling bad!!
Hang in there...hugs!! :)
Hang in there...hugs!! :)
Thanks for the comments. This is just so frustrating to deal with. I have fatigue, dizziness, a lot of GI problems like really bad constipation and difficulty swallowing sometimes, depression, anxiety, heavy menstruation sometimes, and I just feel horrible.
My latest labs on 7/05/11 were:
TSH 1.700 0.450 - 4.500
T4 FREE 1.07 0.82 - 1.77
T3 FREE 2.1 2.0 - 4.4
FOLLICLE STIMULATING HORMONE 3.3
LUTEINIZING HORMONE 2.9
PROLACTIN 14.9 2.8 - 23.3
I had an ultrasound of my thyroid on 4/28/11 and these are the radiologist's findings:
Findings: The right thyroid lobe is normal in size, contour
and echotexture, measuring 2.0 x 1.8 x 5.7 cm. Multiple tiny
scattered colloid cysts are noted throughout the lobe. These
all measure less than 5 mm. The isthmus measures 4-5 mm.
The left thyroid lobe is either markedly atrophic or absent.
Only a small amount of thyroid tissue extends to the left of
midline within the isthmus.
No morphologically abnormal cervical lymph nodes are
identified.
Impression:
1. Unremarkable right thyroid lobe and isthmus. No
sonographic findings of Hashimoto's.
2. Markedly diminutive or absent left thyroid lobe, which
may be postsurgical or developmental. Please correlate with
history.
3. No cervical lymphadenopathy.
I'm so lost.
My latest labs on 7/05/11 were:
TSH 1.700 0.450 - 4.500
T4 FREE 1.07 0.82 - 1.77
T3 FREE 2.1 2.0 - 4.4
FOLLICLE STIMULATING HORMONE 3.3
LUTEINIZING HORMONE 2.9
PROLACTIN 14.9 2.8 - 23.3
I had an ultrasound of my thyroid on 4/28/11 and these are the radiologist's findings:
Findings: The right thyroid lobe is normal in size, contour
and echotexture, measuring 2.0 x 1.8 x 5.7 cm. Multiple tiny
scattered colloid cysts are noted throughout the lobe. These
all measure less than 5 mm. The isthmus measures 4-5 mm.
The left thyroid lobe is either markedly atrophic or absent.
Only a small amount of thyroid tissue extends to the left of
midline within the isthmus.
No morphologically abnormal cervical lymph nodes are
identified.
Impression:
1. Unremarkable right thyroid lobe and isthmus. No
sonographic findings of Hashimoto's.
2. Markedly diminutive or absent left thyroid lobe, which
may be postsurgical or developmental. Please correlate with
history.
3. No cervical lymphadenopathy.
I'm so lost.
We care Coco. If you will post your thyroid test results and reference ranges, we will try to assess the adequacy of testing and treatment. Also, for what reason were you put on your small dosage of levo? Was that intended to be a starting dosage?
Also, have a look at this listing of signs and symptoms of hypothyroidism and tell us of any others that you have.
http://endocrine-system.emedtv.com/hypothyroidism/hypothyroidism-symptoms-and-signs.html
Also, have a look at this listing of signs and symptoms of hypothyroidism and tell us of any others that you have.
http://endocrine-system.emedtv.com/hypothyroidism/hypothyroidism-symptoms-and-signs.html
Nope I care because I have this going on right now waiting to see the dr Friday again. I had RAI to kill my thyroid and now it is swelling and choking me. I find that the dr gave me what I call "f' it pills" lorazepam so when it gets real bad I will take one and the. I can handle it with out freaking out. I find that taking my mind off it by repeating what is great in my life helps, it's a relaxation thing that seems to help with me. But I have the pictures tooting that there is some major swelling going on mostly in the afternoon.
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