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Can't seem to get an answer

I keep fighting the same issues.  I'm told I really don't have much of a thyroid left due to Hashimoto's Disease so I take medication for both T3 and T4.  I "think" I have a pituitary problem but am told I do not, but I am constantly tired, I can't lose weight, I gain weight just by looking at food etc.  Here are my last labs.  T3 Free 2.21; Free T4 0.75 and TSH 0.01.  Any ideas or thoughts would be welcome.  All labs were fasting if that makes a difference.  I am a 54 year old woman.  
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Avatar universal
Are you menopausal? Are you taking any hormones for that?

Helpful - 0
649848 tn?1534633700
COMMUNITY LEADER
T3 meds, such as liothyronine, do not have to be taken on an empty stomach; they can be taken with/without food... I take my second dose with lunch every day.  

Just make sure thyroid meds are taken 4 hours away from vitamin/mineral supplements, particularly, calcium and iron, but most minerals...  I do NOT separate my thyroid med from dairy, except in the morning, with the 30-60 minutes between my med and eating/drinking, because the amount I'm eating/drinking does not contain enough calcium to prevent that much absorption of my med.  
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Avatar universal
Your taking of the T3 medication has resulted in your TSH to be suppressed.  It is likely that this is the ONLY thing your Dr has looked at. And is why he or she may be reluctant to raise your dosages.  And if they are not aware that the taking of the amount of thyroid meds and especially T3 can artifically suppress TSH would be a good indication that you may want to find another Dr!

As stated above you are WOEFULLY low in BOTH FT3 and FT4.  And you are taking a fair dose of both which as stated indicates an absorption issue.

I too have a couple of questions:

1) Did you take your meds (expecially the T3) prior to having your blood test taken.  T3 levels peaks in the blood about 2 to 4 hours after taking it.  So if you were in that time window, it is likely that your FT3 results are even lower than what the test shows.

2) Do  you take your thyroid meds at least an hour away from eating any food?  It is recommended to take on a completely empty stomach but that is pretty difficult if you are taking the T3 four times a day. Food in the stomach dramatically cuts down on the absorption

3) are you taking your meds within about 4 HOURS of having Calcium (milk/cheese) or dietary supplemnts?  Again the Calcium or supplemnets bind to the thyroid (I think expecially T4) and thus prevents it from being absorbed properly.

Helpful - 0
649848 tn?1534633700
COMMUNITY LEADER
I'm sorry to keep answering you with more questions, but how long have you been on these dosages of medication?  

It certainly appears that you need higher dosages.  But it also appears that, for some reason you aren't properly absorbing the medications and/or converting the T4 (levothyroxine) medication to Free T3, which is the hormone that's used by every cell in your body ...

Have you had vitamin D and ferritin levels tested?   Ferritin is the storage hormone for iron and both iron and vitamin D are necessary for the proper metabolism of thyroid hormones.  

Were you told what pituitary problem you were border line for?  What things seem to fit you completely?  Your symptoms of being tired, gaining weight easily and being unable to lose weight are classic symptoms of hypothyroidism and with your low levels of FT3 and FT4, it doesn't surprise me a bit that you'd have symptoms of being hypo.  

Most of us find that we feel best with FT4 about mid range and FT3 in the upper half of its range... Neither of your levels are even "in" range let alone close to where we'd recommend they be...  

It's not unusual for TSH to be suppressed when one is on high levels of thyroid hormones like you are, so we don't even worry about that.
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Avatar universal
Free T4 range 0.85 - 1.71 ng/dl   mine 0.75  
T3 Free range 2.20 - 4.10 pg/ml  mine 2.21
TSH  range   0.27  - 4.20  ulU/ml mine 0.01

Currently taking:  Levathyroxine 225 mcg daily and Liothyronine Sodiam 5 mcg 4 tablets per day

Why I think it is pituitary? Approx 5 years ago I was told I had a "boarder line" pituitary problem.  In addition things I have read that seem to fit me completely.  
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649848 tn?1534633700
COMMUNITY LEADER
Your post begs a lot more questions, so before I comment too much, if you can answer those, it will be most helpful...

What are the reference ranges for your Free T3 and Free T4?  Ranges vary lab to lab and have to come from your own report.  

What medication are you taking for "both T3 and T4"?  What dosage and how long have you been on it?  

What makes you think you have a pituitary problem?  
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