High Free T3 panhypopituitary

[maggie7386]

I am panhypopituitary because of pituitary surgery in 2004.  Every-
thing has become symptomatic again -- my doctor felt my Free T4
was too high at 1.36 -- my endo wanted  it at the upper end of
normal but we went from 4 levexoy tablets to 3 (150 mcg).  He ran
a Free T3 and Free T4.  The Free T4 was only 0.96 this time but
the Free T3 was 3.56, which is high on our range.  It did something
we have never seen it do before.  In the past two weeks, it has gone
crazy -- one minute I am very hypo and the next I am very hyperpitui-
tary -- what do you suggest we do next?  

[maggie7386]

I have central hypothyroidism.  My FT4 was 1.36.  My family doc then ran a Free T3
and a Free T4, thinking he would put me on T3.  The Free T3 came back hyperthyrooid.  
The Free T4 came back 0.96.  

I am so tired I cannot stay awake.  I am taking 200 mcg of Levoxyl.  Adding more
Levoxyl will cause the Free T3 to go higher and the Free T4 to go lower.

I am panhypopituitary and we are replacing everything but the prolactin.  Meanwhile I keep passing out.   I am also a diabetic type 1 and have immune failure for which I
am on privigen.   We do not have any endocrinologists who treat pituitary failure
in Michigan.  

Any ideas?

Maggie7386  

[Mark Lupo, M.D.]

the other, less likely, possibility is a thyroid condition separate from the pituitary problem that would cause the thyroid to produce excess T3.

[Mark Lupo, M.D.]

not sure what you meant by the follow-up post 4 hours ago.
I just saw the initial post now and have made no reference to "thyroid cancer" in regards to your post.

The treatment of thyroid hormone in hypopit patients depends on the FT4 and FT3 levels - keeping them in the reference range and assessing for symptoms/signs of over/under replacement.

Thyroid levels do not fluctuate "moment to moment" - would look into other issues and other components of the hormone replacement if needed.  Would see an endocrinologist to help guide you.

[maggie7386]

Dear Dr. Lupo:
Where did  you come up with "thyroid cancer"?  

It is an answer I could not come up with last night but I knew it was something
out there for an answer.  

Could you give me some kind of direction.   I live in MIchigan.  Thank you.

Maggie Fuss