help

[Durv]

I am 53 year old woman, in menopause.  Have RAI induced hypothyroidism for past 16 years.  Was on synthyroid for first 12 years, did not feel good finally got DR to prescribe dessicated thyroid medication.  Have been on it for four years and feel much better but still not 100%.  My lab results are TSH .39, FT3 4.9, FT4 7.  I have started having heart palipations and rapid heart beat, mostly in the early evening but starting to come during the day too.  I also am anxious all the time.  I am so tired of trying to be my own doctor but my GP and Endo are TSH believers only so send me home frustrated and defeated.    As well as the heart issues my biggest complaints are aches in joints, muscles, insomnia, dry skin, exema spots, carpel tunnel.  Any suggestions about my dosing?  Any suggestions period?  If you know of any doctors in the Vancouver BC area that are up to date regarding thyroid testing let me know that too.  thank you for hosting this site it is wonderful to read other posts as it just gives me a sense that I am not in this alone and that if more of us figure things out we can help others who have doctors who will not listen.  thanks, durv

[Barb135]

Your FT4 is still quite low in the range.  Rule of thumb is to adjust medication, so FT4 is about mid range and FT3 is in the upper 1/3 of its range.  

FT3 is the most important of the hormones, and really needs to be tested every time you have blood work, particularly, since you are on the T3/T4 combo.

TSH is a pituitary hormone, that is simply an indicator of actual thyroid status.  It should never be used, alone, as a diagnostic or treatment tool.  Many doctors think that if TSH goes too low, a person is automatically hyper.  That's not true.  You are only hyper if you have hyper symptoms and FT3 and FT4 tests bear that out.  Once a person is on medication, TSH, often, no longer reflects thyroid hormone status.

As soon as I was put on thyroid replacement medication, my TSH dropped to < 0.01 and has been there every since, but I've never been hyper.  My FT3 and FT4 were actually either below range, or very low in the ranges...... I've only recently gotten them to a point that's good for me.

[Durv]

Hi again, so just got me new labs back and my T4 is up to 9 but my TSH is down to .09.  My doctor won't check my FT3. I am taking both thyroid and sythroid...thyroid pills are 30mg's and sythroid are 88mcg's.  I alternate days 2.5/2.75 of thyroid and .75/.50 of synthroid.    I feel great...aches and pains almost gone, no anxiety or palpatations.  I went to a walk in clinic to get the synthroid so have to tell me family doctor at my next appointment and am hoping he is okay with mixing the two. Is it okay to have such a low TSH?  Should I aim for a higher FT4 or is this okay?  thanks so much for your input, it has made a huge difference to have someone in my court.  sandi

[Barb135]

The  pills come in different strengths, what strength are you taking 3.5 of?  Same for synthroid; what strength are you taking 1/4 of?   1/4 of a 25 mcg pill would be considerably less than 1/4 of a 50 mcg pill.

While your FT3 isn't "bad", you could use a boost in both FT3 and FT4.  Your FT3 is 60% of the range; most people find that they need it to be in the upper 1/3 of the range.  Your symptoms are still hypo - heart palps and anxiety can be either hyper or hypo - I had them both when hypo.

If you only added the T4, 2 days ago, you won't be feeling effects from it yet, as it takes approximately 4-6 weeks for a dosage change/addition of T4 med to build in the system.  

[Durv]

I am taking the canadian "thyroid" medication.  Here are my latest results and my lab ranges are as follows TSH .19 (.30-5.50) T4Free 8 (8-15) Free T3 5.2 (3.5-6.5)  The dosage I have been on is 3.5 pills but if I drop to 3 the palapations go away.  I am experimenting with 3 pills of thyroid and 1/4 of synthroid, trying to get my free T4 up to mid range.  Just started that two days ago.  Anxiety seems a bit better.  Will see what happens.  thanks for the reply, was away for a few weeks or would have emailed sooner.  durv

[Barb135]

Reference ranges vary from lab to lab, so we will need for you to post them from your own lab report.  This will help us see where you fall within the ranges.  You seem to have symptoms of both hyper and hypo, so once we see your reference ranges, we can further assess your situation.

What medication are taking?  Armour, ERFA, etc? What's the dosage?

While thyroid issues can cause anxiety, so are there a lot of other things that do too.  Is there anything else going on in your life that could cause/contribute to it?