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Advice needed asap, Endo appt tommorow
Endo appt tommorow. Here were labs taken Friday:
TSH 0.718
Free T4 1.06 (0.89--1.76)
Free T3 3.2. (2.3--4.2)
Vitamin D 62 (30--100)
I feel fatigued and can't lose the rest of the weight I gained from having a baby a year ago. Just feel unwell. and want to ask what will it take to get my T4 and T3 higher into ranges. I feel better when they are in higher ranges. I Keep asking Endo for increase in med and she keeps saying there is no room to increase bc TSH is too low.
Can someone shed any light or give advice on what to say tommorow?
TSH 0.718
Free T4 1.06 (0.89--1.76)
Free T3 3.2. (2.3--4.2)
Vitamin D 62 (30--100)
I feel fatigued and can't lose the rest of the weight I gained from having a baby a year ago. Just feel unwell. and want to ask what will it take to get my T4 and T3 higher into ranges. I feel better when they are in higher ranges. I Keep asking Endo for increase in med and she keeps saying there is no room to increase bc TSH is too low.
Can someone shed any light or give advice on what to say tommorow?
Thanks for the feedback.
If she should happen to read the paper you gave her (doubtful), she can find many references to scientific evidence that TSH does not correlate at all with tissue thyroid levels and effects, which are all important. It will be interesting to see what she says at next appointment. At lease you got an increase in your T4 med. Does that mean you take 75 mpg 5 days a week and 100 the other 2 days?
If she should happen to read the paper you gave her (doubtful), she can find many references to scientific evidence that TSH does not correlate at all with tissue thyroid levels and effects, which are all important. It will be interesting to see what she says at next appointment. At lease you got an increase in your T4 med. Does that mean you take 75 mpg 5 days a week and 100 the other 2 days?
2 Comments
Yes! I'm happy about the increase. I currently take 50 Mcg 5 days a week, 100 2 days a week and now new dose will be switching to just 75 Mcg a day . It's a small increase, but I'll take it. Like I mentioned, she was very adamant about the TSH and kept suggesting there were other reasons for every symptom I mentioned. We will see what happens, I'm optimistic b/c prior to having the baby my FREE T4 and FREE T3 were in the mid to high ranges and I truly felt the best I'd ever felt in decades.
If I was you, I'd go to a holistic dr and get on natural dessicated thyroid. Your child will start walking any minute (if not already), and you'll need TONS OF ENERGY just to keep up. I've been raising my grandson (currently 6) since he was 10 months: it hasn't been long since I had to deal with it. Thankfully, I had more energy then. If you are interested, there's a pharmacist, Dr Izabella Wentz, who says she's in remission from Hashi's. Her website is thyroidpharmacist.com, you may want to check it out. I was watching the interviews she did with quite a few other medical professionals (from the top veterinary endocrinologist in the U.S., to psychiatrists, doctors, RNs, and other patients); They were REALLY INFORMATIVE; I learned so much in just 2 of the seminars, I wanted to buy the series (but couldn't afford it). Her books are highly rated on Amazon. I'm not affiliated with her in any way, I just found out about her last week, but honestly, I got so excited, I really wanted to buy the whole series just so I could rent a public meeting room and show it to other thyroid patients!
****UPDATE*****
I am back from my Endocrinologist appt. I talked to her about the low T4 and T3 levels despite the low TSH. She was agreeable to increasing the Synthroid part of my medication, but she gave me pushback about the T3 and T4 levels repeatedly stating that she has been down the path Numerous times with patients wanting to add more medication to increase these FREE T4 and T3 levels but not getting results or feeling better. She still holds that the TSH is the best indicator of thyroid health. She kept staring that the FREE levels fluctuate up and down throughout the day --and I told her instead of doing morning labs, I'd come in the evening bc I want to see this for myself. I gave her the document to review that GIMEL suggested.
She feels the nasty symptoms I have are all related to my anemia from heavy periods. Although my OBGYN thinks thyroid is to blame. (Ping pong between docs).
So.....she DID increase my daily dose of synthroid from 50 Mcg to 75mcg and she said lets see what happens and re-test all your labs in 8 weeks. Also gave me advice on taking iron consistently (which admittedly I dropped the ball on).
I always like to give updates in case people stumble on these posts. I hope it helps someone else.
And I will update more in 8 weeks after my next scheduled labs.
I am back from my Endocrinologist appt. I talked to her about the low T4 and T3 levels despite the low TSH. She was agreeable to increasing the Synthroid part of my medication, but she gave me pushback about the T3 and T4 levels repeatedly stating that she has been down the path Numerous times with patients wanting to add more medication to increase these FREE T4 and T3 levels but not getting results or feeling better. She still holds that the TSH is the best indicator of thyroid health. She kept staring that the FREE levels fluctuate up and down throughout the day --and I told her instead of doing morning labs, I'd come in the evening bc I want to see this for myself. I gave her the document to review that GIMEL suggested.
She feels the nasty symptoms I have are all related to my anemia from heavy periods. Although my OBGYN thinks thyroid is to blame. (Ping pong between docs).
So.....she DID increase my daily dose of synthroid from 50 Mcg to 75mcg and she said lets see what happens and re-test all your labs in 8 weeks. Also gave me advice on taking iron consistently (which admittedly I dropped the ball on).
I always like to give updates in case people stumble on these posts. I hope it helps someone else.
And I will update more in 8 weeks after my next scheduled labs.
I wouldn't see an endo. I would advise you to see a holistic, naturopathic, or functional medicine doctor.
Your endo didn't text for thyroid antibodies or TPO (Thyroid peroxidase antibodies). These indicate automimmune conditions, such as Hashimoto's thyroiditis and Graves disease. The problem is that endos believe that TSH is the primary indicator of thyroid health. It isn't. You could have perfectly normal TSH levels, yet your thyroid could be under attack from your immune system.
The problem is that until your thyroid has lost apotox. 70% of its function, your TSH probably won't indicate anything wrong.
I am a 20+ year thyroid patient with tons of experience I wish I didn't have. You have a baby, you're young. There's NO REASON you should have to suffer. I know I saw this too late for you to cancel your appointment. That's fine: maybe you have a GOOD endo. I've heard some exist. BUT if she puts you off AGAIN, I hope you read this and take what I've said to heart. You have to take control of YOUR HEALTH, because it's YOUR LIFE.
Here are a few sites that will help you. *************************; thyroidchange.org; thyrophoenix.com; hypothyroidmom.com; thyroidpharmacist.com. You can also search on YOUTUBE.COM for hypothyroid and see lots of other patients telling their stories. There are many alternative medicine doctors there, too, with tons of free info.
DON'T BE DEPRESSED. YOU CAN GET THRU THIS. DON'T WAIT!
Your endo didn't text for thyroid antibodies or TPO (Thyroid peroxidase antibodies). These indicate automimmune conditions, such as Hashimoto's thyroiditis and Graves disease. The problem is that endos believe that TSH is the primary indicator of thyroid health. It isn't. You could have perfectly normal TSH levels, yet your thyroid could be under attack from your immune system.
The problem is that until your thyroid has lost apotox. 70% of its function, your TSH probably won't indicate anything wrong.
I am a 20+ year thyroid patient with tons of experience I wish I didn't have. You have a baby, you're young. There's NO REASON you should have to suffer. I know I saw this too late for you to cancel your appointment. That's fine: maybe you have a GOOD endo. I've heard some exist. BUT if she puts you off AGAIN, I hope you read this and take what I've said to heart. You have to take control of YOUR HEALTH, because it's YOUR LIFE.
Here are a few sites that will help you. *************************; thyroidchange.org; thyrophoenix.com; hypothyroidmom.com; thyroidpharmacist.com. You can also search on YOUTUBE.COM for hypothyroid and see lots of other patients telling their stories. There are many alternative medicine doctors there, too, with tons of free info.
DON'T BE DEPRESSED. YOU CAN GET THRU THIS. DON'T WAIT!
2 Comments
Thank you! I am headed out the door to the appt now and will update. One last note---she does test for antibodies periodically, mine were negative. But, she still diagnosed me with Hashimotos 2 years ago bc both my mom and sister have it and their thyroid is already dead and non functioning.
BTW, had anyone told you that having Hashi's puts you at much higher risk for developing OTHER autoimmune conditions? I found that out yesterday, and it was a shock!
Your ferritin is terribly low. It should be at least 70. And I think it is unbelievable that the doctor said your "body adjusted to the anemia over time". You also need to test for Vitamin D and supplement as needed to optimize. It should be at least 50. Very important.
Many members find that their Free T4 needs to be at least mid-range, and their Free T3 in the upper third of the range, and then adjusted as needed to relieve hypo symptoms. A good thyroid doctor will treat a hypothyroid patient clinically, by testing and adjusting Free T4 and Free T3 as needed to relieve symptoms without being influenced by resultant TSH levels. Symptom relief should be all important, not just test results.
With the expectation of having your doctor disagree with the need for an increase in your meds, I would take along a copy of the paper and references, and give it to her and ask her to review it. Point out that the paper recommends clinical treatment, combined with biochemical testing, and that everything is supported with extensive scientific evidence. And see if she can agree to treat you clinically, rather than mainly by TSH levels. You can emphasize ALL the symptoms you have. Don't let her think it is all about your weight gain. Also point out that your Free T4 and Free T3 are not even in the upper half of their ranges, so there is plenty of room to increase dosages. Also, that the information in the paper shows that there is no reason for concern with a suppressed TSH, unless there are hyper symptoms due to excessive levels of Free T4 and Free T3.
If you cannot get the help you need then you will need to find a good thyroid doctor that will treat clinically, as described.
Many members find that their Free T4 needs to be at least mid-range, and their Free T3 in the upper third of the range, and then adjusted as needed to relieve hypo symptoms. A good thyroid doctor will treat a hypothyroid patient clinically, by testing and adjusting Free T4 and Free T3 as needed to relieve symptoms without being influenced by resultant TSH levels. Symptom relief should be all important, not just test results.
With the expectation of having your doctor disagree with the need for an increase in your meds, I would take along a copy of the paper and references, and give it to her and ask her to review it. Point out that the paper recommends clinical treatment, combined with biochemical testing, and that everything is supported with extensive scientific evidence. And see if she can agree to treat you clinically, rather than mainly by TSH levels. You can emphasize ALL the symptoms you have. Don't let her think it is all about your weight gain. Also point out that your Free T4 and Free T3 are not even in the upper half of their ranges, so there is plenty of room to increase dosages. Also, that the information in the paper shows that there is no reason for concern with a suppressed TSH, unless there are hyper symptoms due to excessive levels of Free T4 and Free T3.
If you cannot get the help you need then you will need to find a good thyroid doctor that will treat clinically, as described.
1 Comments
Thank you for all the information, this has been tremendously helpful and I will cite the document and present it to her is she gives me any pushback. I'm a bit nervous about tommorow, but I feel so strongly about the need to increase my meds to optimal levels that I'm not taking no as an answer!
Thank you again for the info. I will update.
Thank you again for the info. I will update.
I would give the Endo a copy of the following link on Diagnosis and Treatment of Hypothyroidism: A Patient's Perspective.
http://www.thyroiduk.org.uk/tuk/TUK_PDFs/diagnosis_and_treatment_of_hypothyroidism_issue_1.pdf
In preparation for the appointment, I highly recommend reading at least the first two pages plus Recommendation 10, page 13, which deals specifically with the unnecessary concern with suppressed TSH, and provides scientific evidence supporting the recommendation.
I would tell the doctor that there is scientific evidence that patients taking thyroid hormone adequate to relieve hypothyroid symptoms frequently find their TSH becomes suppressed. That is because the body evolved with a continuous low flow of thyroid hormone. A single large dose will thus suppress TSH for an extended period. That does not mean hyperthyroidism, unless there are hyper symptoms due to excessive levels of Free T4 and Free T3, which you are not even close to. Your Free T4 is only about 20% of its range, and your Free T3 is only about 47% of its range, so there is lots of room to raise your med/dosage to relieve symptoms.
What med and dosage are you taking daily? Have you been tested for Vitamin D, B12 and ferritin? What symptoms do you have besides weight gain?
http://www.thyroiduk.org.uk/tuk/TUK_PDFs/diagnosis_and_treatment_of_hypothyroidism_issue_1.pdf
In preparation for the appointment, I highly recommend reading at least the first two pages plus Recommendation 10, page 13, which deals specifically with the unnecessary concern with suppressed TSH, and provides scientific evidence supporting the recommendation.
I would tell the doctor that there is scientific evidence that patients taking thyroid hormone adequate to relieve hypothyroid symptoms frequently find their TSH becomes suppressed. That is because the body evolved with a continuous low flow of thyroid hormone. A single large dose will thus suppress TSH for an extended period. That does not mean hyperthyroidism, unless there are hyper symptoms due to excessive levels of Free T4 and Free T3, which you are not even close to. Your Free T4 is only about 20% of its range, and your Free T3 is only about 47% of its range, so there is lots of room to raise your med/dosage to relieve symptoms.
What med and dosage are you taking daily? Have you been tested for Vitamin D, B12 and ferritin? What symptoms do you have besides weight gain?
1 Comments
Thank you so much for the informative and quick response!
My b 12 was tested a few months back and it was nearly OVER range. (But was told it was ok) I supplement with b12 bc I also take metformin. My ferritin level was tested yesterday and it's a 6. (10--232).
I have been anemic off and on the past decade mainly due to very heavy periods. I stopped supplementing with iron consistently and my levels plummeted again. I will say that even this past September when my iron levels were in optimal ranges my thyroid was still the SAME as above results...except TSH was up to maybe a 1.2. Iron deficiency never has caused me much fatigue...just shortness of breath. Doc said my body adjusted to the anemia over time.
I currently take synthroid 50mcg 5 days a week and then take 100 Mcg 2 days of the week. I take 10 Mcg cytomel (split in 2 doses every day). Had to BEG for the cytomel a year ago bc the T3 was in the gutter.
My b 12 was tested a few months back and it was nearly OVER range. (But was told it was ok) I supplement with b12 bc I also take metformin. My ferritin level was tested yesterday and it's a 6. (10--232).
I have been anemic off and on the past decade mainly due to very heavy periods. I stopped supplementing with iron consistently and my levels plummeted again. I will say that even this past September when my iron levels were in optimal ranges my thyroid was still the SAME as above results...except TSH was up to maybe a 1.2. Iron deficiency never has caused me much fatigue...just shortness of breath. Doc said my body adjusted to the anemia over time.
I currently take synthroid 50mcg 5 days a week and then take 100 Mcg 2 days of the week. I take 10 Mcg cytomel (split in 2 doses every day). Had to BEG for the cytomel a year ago bc the T3 was in the gutter.
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