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labs/symptoms
Hi. My friend has been offered Cytomel by a doc, based on symptoms and labs. She also has multiple thyroid nodules. She is afraid to take the Cytomel because she can't afford to feel worse. Her labs are Free T4 is 1.6, Ref. Range .82-1.16, Free T3 is 3.0 Ref. Range 2.0-4.4. She is currently on no thyroid meds. Her symptoms are: dizziness,cognitive and perceptual and chronic fatigue and too many to mention [she says] She, like myself has the added complication of having been made ill by prescribed drugs first before any symptoms, but that was 11 years ago. I really want to help her as she has been ill for so long and I'm hoping thyroid treatment would help. Your guidance in the matter is deeply appreciated!
I don't really see her FT3 as that low. It's higher than her FT4, which is the way it should be.
The symptoms COULD be thyroid related, but if they are, both FT3 and FT4 are a little low, so a T4 med would probably be the better choice, especially in light of the POTS.
I have a heart arrhythmia as well (tachycardia, but from a different cause), and the thought of a T3 med terrifies me. T3 meds have a very direct effect on the heart, and it could really make her condition worse. I really wouldn't take Cytomel (just my opinion as a fellow patient) without another opinion. Perhaps she could ask her cario about this if her options as far as doctors are concerned are running out...
What about vitamins D and B-12? Has she ever had those tested? Deficiencies of those can cause hypo-like symptoms. Also, iron and ferritin?
The symptoms COULD be thyroid related, but if they are, both FT3 and FT4 are a little low, so a T4 med would probably be the better choice, especially in light of the POTS.
I have a heart arrhythmia as well (tachycardia, but from a different cause), and the thought of a T3 med terrifies me. T3 meds have a very direct effect on the heart, and it could really make her condition worse. I really wouldn't take Cytomel (just my opinion as a fellow patient) without another opinion. Perhaps she could ask her cario about this if her options as far as doctors are concerned are running out...
What about vitamins D and B-12? Has she ever had those tested? Deficiencies of those can cause hypo-like symptoms. Also, iron and ferritin?
Forgot to ask but do you think any of her symptoms could be related to the lower FT3? She has the thyroid nodules too. I don't remember if she was tested for Hashi's or not. Ill ask.
The original FT4 was posted as 1.6 with a range of 0.82-1.16, which would make her FT4 over range (1.6 is greater-than 1.16). However, that FT4 was later corrected to 1.16 with a range of 0.82-1.77, which puts her very much in range. Make sense?
I think im confussed once again the range for FT4 is .82-1.16, her range is 1.6 how is that way too high.. what am I missing?
Thanks! I'm going to relay all this to her. I know she's have a hard time dealing with finding another doc! She's been to so many over the past 11 or so years.
That does change things significantly...nice catch on gimel's part.
Her labs don't look all that bad, especially for someone not on thyroid meds. Her FT4 is at 36% of range, which is a little low, since 50% is the rule of thumb for FT4.
FT3 is at 42%, once again a little on the low side, since the target for FT3 is upper half of range (50+%).
However, the balance of FT4 to FT3 looks good, with FT3 higher in its range than FT4 is in its. I don't see any kind of conversion problem here.
She could feel better with a low dose of thyroid meds, but, in my opinion, it's iffy. I know she's lower than the rules of thumb on both FT3 and FT4, but I tend to think there's a little more leeway in those rules when not on meds because your hormones are constantly being produced throughout the day as opposed to getting them once a day in a pill. When we only get them once a day, we have to run them a little higher (generally).
Cytomel is usually contraindicated with any kind of heart arrhythmia. Both her FT4 and her FT3 could use a nudge up, so I'd opt for a T4 med. I think your friend should get a second opinion. That a doctor wants to give her Cytomel with POTS scares the heck out of me, especially since I don't see a clear need for any meds, let alone Cytomel only.
Her labs don't look all that bad, especially for someone not on thyroid meds. Her FT4 is at 36% of range, which is a little low, since 50% is the rule of thumb for FT4.
FT3 is at 42%, once again a little on the low side, since the target for FT3 is upper half of range (50+%).
However, the balance of FT4 to FT3 looks good, with FT3 higher in its range than FT4 is in its. I don't see any kind of conversion problem here.
She could feel better with a low dose of thyroid meds, but, in my opinion, it's iffy. I know she's lower than the rules of thumb on both FT3 and FT4, but I tend to think there's a little more leeway in those rules when not on meds because your hormones are constantly being produced throughout the day as opposed to getting them once a day in a pill. When we only get them once a day, we have to run them a little higher (generally).
Cytomel is usually contraindicated with any kind of heart arrhythmia. Both her FT4 and her FT3 could use a nudge up, so I'd opt for a T4 med. I think your friend should get a second opinion. That a doctor wants to give her Cytomel with POTS scares the heck out of me, especially since I don't see a clear need for any meds, let alone Cytomel only.
That FT 4 is 1.16 [.82-1.77] Whoops! Symptoms are;dizzy, cognitive and perceptual problems, difficulty focusing eyes, racing heart while standing [diagnosed with POTS] fatigue, hyper sensitive to odors,cold and heat. Hair loss, very dry skin, weakness in arms and legs, burning feet [neuropathy], clogged ears and adrenaline rushes. She sees her test results as both middle of range which is perfect? I don't know exactly how to read the labs either. Also has a T4RR at .82-1.77 and a T3, which I wrote wrong, I'll provide it if necessary. Thanks.
Thanks for your speedy reply. I emailed her for more details and to recheck the FT4 results and range. I told her she may want to join the group if it gets too hairy. She just keeps being told that the thyroid isn't likely the problem and tests are normal, except just now the slightly low FT3. I'm actually hoping it is because it's treatable. I'll get back to you shortly!
As I read goolarra's post, it occurred to me that i have never seen an FT4 range like that one. Could you please double check to assure it is correct?
Your friend's FT4 is way above range. While her FT3 is quite low in the range, especially relative to her FT4, I'd really worry about adding Cytomel. If she were on meds, I'd suggest lowering T4 meds and adding Cytomel, but her FT4 is that high without meds.
Can you more speciafically list her symptoms...if there are too many to mention, the top ten will do.
Has she ever had any antibody testing?
Can you more speciafically list her symptoms...if there are too many to mention, the top ten will do.
Has she ever had any antibody testing?
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