need some suggestion on my thyriod condition

[ignitecivic]

I always been a hyper and hypo when I was a kid. I am 30 no.About 4 years ago, the Endo suggested that I do RAI on my thyriod because I was too high which was Hyper. Since then, I have not recovered due to poor medication treatment or the right dosage. Last month I finally decided to try a new Endo which he went by how I felt and not by the blood test. I am taking 75 synthriod and 5 cytomel now. As soon as I felt better 2 weeks ago I end up getting really depressed. Now I am on anti-depressant. I still felt that 75 synthriod may be a tad low for me because by the 5th day, i felt down and slower. I just adding 88mcg once every 6 days. It has been a week now. I felt better with 88mcg every 6 days. Should I continue this for the next 6 weeks and see the result?

I know the anti-depressant will take some time since it has only been a week since I start it.

Any suggestion would help. I hate feeling slow and down.

Thanks .

[ignitecivic]

Thanks Gimel. Always been a great help for everyone. My symptoms have got much better since Sept 2013 when I crashed into depression. I actually can do stuff now and be active. I will wait until 6 weeks to see what he can do for me on the next visit.

[gimel]

I expect that is the reasoning of the Endo.  I think the over-riding question is how you are feeling.  If you can wait for the additional time, that would certainly prevent any problem with the doctor.  Since the doctor has been working with you to add in some T3 to raise your Free T3 level, that is a good sign that he may continue working with you, which is important.

If you still have intolerable symptoms, then you should make the doctor aware of that and mention that you understand it only takes one week to see full effect of T3, and about 5 weeks to see full effect of T4 changes, on your serum levels.  And since it has been almost 6 weeks, you wondered if you could go ahead and get re-tested, to assess your current levels of Free T3 and Free T4.  

So I think the direction you take really depends on how you are feeling.

[ignitecivic]

The Endo called today he wanted to be on the same dosages for another 6 weeks then he will have me come in again. Does he wants me to be more stable before another increase?

[ignitecivic]

I will do some testing again on the Vitamins. I will definately have my Endo do an increase again.

Thanks guys

[gimel]

Very glad to hear that you are feeling better.  You are definitely on the right track.

Since you are still having hypo symptoms and your Free T3 is not even above the middle of the range, I'd say that you are due for another increase in Cytomel.  Your Free T4 is fine, but you need to increase Free T3 as necessary to relieve symptoms.  Many members have found that they needed Free T3 in the upper third of the range to relieve symptoms.

Also, if not tested recently for Vitamin D, B12 and ferritin, it would be a good idea to do so, in order to determine the effect of the supplements.  

[bedheadblonde]

From what I understand, FT4 will drop once things are getting more balanced out with T3 meds added in.

[ignitecivic]

Hi guys,

Hope everyone had a good Christmas. I just got back a new test result. Still taking Synthroid 75 and 15 cytomel a day.Also taking vitamins to increase my level of D3, b12, and ferritin. I am feeling better and better. still mild depression and tiredness. Been a roller coaster ride for 3 years.

My new test result went down from last month for FT4. Can it be because my body is absorbing the meds better now or can vitamins causing it to drop? I know it's not all about test result, its about how you feel. Just want to make sure I am still on the right track.

synthriod 75 with 5 cytomel at 7am
10 cytomel at 2pm
Vitamins 4 hours away from the meds.

FT4 1.20  range 0.82-1.77
FT3 3.0    range 2.0-4.4

[gimel]

Looks like it has all the important ingredients.  The only issue might be cost.  The bottle shown is 180 tablets, which covers 90 days for $24.99.  A viable alternative might be Centrum Silver, which seems quite comparable in its content, and I can find a bottle of 220 tablets, or 110 days worth, for only  $20.49.  

[ignitecivic]

I am thinking of getting this multivitamins :)

http://www.vitaminshoppe.com/p/ultimate-woman-multivitamin-easy-to-swallow-180-tablets/vs-2752

[gimel]

Not being a doctor I cannot recommend dosages for you.  I can only relate my own experience.  I found that it has taken 2000 I. U. daily to raise my Vitamin D from low 30 level up to middle of the range.  My ferritin has gone from 40 up to 80 by starting at 28 mg of ferrous fumarate daily and increasing every couple of weeks to a total of 84 mg daily.  Along with the iron supplement it is good to take some Vitamin C to prevent possibility of constipation.  As you get your Free T3 and Free T4 up to adequate levels you may find that you can reduce supplements.  You can verify your Vitamin D and ferritin level each time you go in for new tests, and then adjust accordingly, in conjunction with your doctor.  

[ignitecivic]

Thank you! How long should I take the Vitamins D3 and Ferrous fumarate or Ferrous glycinate for to raise both level up to optimal range? I assume low doses on both

[gimel]

Your Free T4 level is fine.  Your Free T3 was a bit low, if having symptoms.  The 5 mcg increase should move it up a bit and further help with symptoms.  Symptom relief should be all important, not just test results, as you know.  

Your Vitamin D is too low.  You can supplement with D3 to move it closer to the middle of the range.  Ferritin is not bad.  Recommended range for women is 70-80.  A good iron supplement for that is ferrous fumarate, or ferrous glycinate.  A low dose should bring your ferritin up to good level.  On the B12, as you can see the range is enormous.  Usually recommended to be in the upper part of the range, and your result is above the middle of the range.

[ignitecivic]

Happy Thanksgiving guys! I just got my new test results  and my vitamins test done. The endo has increase  my meds to 75 mcg synthroid and 15 mcg cytomels a day. one 5 mcg in the morning and two 5 mcg around 2-3pm range.

FT4 1.36  range 0.82-1.77
FT3 3.0    range 2.0-4.4
TSH 0.015  range 0.450-4.500

The FT3 drop a little. I believe might be more stable.

Vitamin D  31.1 range  30.0-100.0
Ferritin Serum  53   range 15-150
Vitamin B12 620  range  211-946

Seem like the levels for the Vitamins are low. Not sure what is the optimal range. Let me know what I need to do.

Thank you guys!

[gimel]

The best answer to your question is yes; however, symptom relief can lag somewhat behind changes in serum levels of thyroid hormone. So patience is the key.  My suggestion would be to make sure you are feeling better all around, before dumping your antidepressant.  In my opinion that would be the best way to evaluate.  

[ignitecivic]

Thanks Gimel,

I am about to do my testing next week. Does depression usually alleviate when my dosages are getting closer? I am still taking anti depressant and don't want to depend on it any longer.

Thanks

[gimel]

Glad to hear you are doing better.  I think you need to give the dosage change a bit more time to evaluate fully.  In a few weeks you should also be ready for new round of tests of Free T3 and Free T4.  Tests for Vitamin D, B12 and ferritin should also reveal if they are contributors.  

[ignitecivic]

or is it a waiting game since the new dosage.

[ignitecivic]

I am about to take my test for vitamin D, B12, and ferritin and new test result for the endo soon. I am still having symptoms of tiredness and depression. My skin, hair, weight has been much much better.

[gimel]

Yes.

[ignitecivic]

which one do I need as for vitamin D
https://directlabs.com/OrderTests/tabid/55/language/en-US/Default.aspx

i am thinking the  Vitamin D, 25 Hydroxy.

[gimel]

There should be no pressing need to switch to Armour.  You are getting both T4 and T3 now, and your levels can be adjusted independently.  It is sometimes much harder to reach desired levels for both when taking an NDT type med like Armour.  As we know, depression can sometimes be related to low levels of thyroid hormone.  Your FT4 level is adequate.  Your Free T3 level has plenty of room for increase.  By the way, it is a good idea to not take T3 meds until after blood draw.  Since T3 acts so fast, delaying taking the med prevents possible false high Free T3 result.  


Any test results on Vitamin D, B12 and ferritin?

[ignitecivic]

The new endo said he will wait it out after he figure out a formula. Hoping he switch me to Armour. Hate feeling depressed.

Thanks Gimel. Always been a great help. I wish I've founded this site 3 years ago. Everything would have been better.

[gimel]

The T3 in Cytomel has a half-life of less than a day, so it only takes 4-5 days to see the full effect on serum levels.  Symptoms are another matter.  Changes in symptoms tends to lag somewhat the changes in serum thyroid levels.  So, be a bit patient and give it some time and see how the new dosages work for you, before considering further increase.  

Without looking back through prior posts, have you any test results for Vitamin D, B12 and ferritin?

[ignitecivic]

just got my test result today. I am taking 75mcg synthriod and 88 mcg once every 6 days. just started cytomel 5mcg twice a day 10 days ago.

FT3 3.3  range 2.0-4.4
FT4 1.34  range 0.82-1.77

How long does it normally takes for the cytomel to absorb better?