HELP with lab results and any suggestions for help!

[azqtpies]

Here are my  labs... I was having hypo symptoms, depression, body joint aches, tired, dry mouth eyes....
I feel my body is not converting the t4 into T3 if I up my meds I become breathless, and addiing cytomel makes me feel like I gonna have a herat attache with pressure! What do I need to do..
I am currently on levo 37.5 mcg a day except tu & fri 50 mcg levo... now I having cramping cant sleep breathless is kicking up,,, I am lost this has been almost 4 years now, I NEED to find a balance
ANY SUGGESTIONS!!!! THANK YOU =)... I knowI have hasimotos my antibodies were over 130+ decreased done to 35 then now climbed again with this last results,

T3 UPTAKE   31.3      RANGE 23.4- 42.7
T4  7.7                       RANGE 4.5-12.5

T7 INDEX    2.4           RANGE 1.2-4.3
TSH HIGH SENSTIVITY 1.87   RANGE  0.30-4.3
T4 FREE 1.3               RANGE  0.9-1.6
TPO-AB  65                RANGE <35
VITAMIN B 12  539      RANGE 243- 894
T3 FREE  2.6              RANGE 2.5- 5.7
VITAMIN D 38             RANGE  30-100

[Barb135]

Little bit of thyroid brain fog there??  This is more like it; now come out of the corner and pay attention.........LOL

Your TSH is good; your FT4 is right at mid range; and yes, I agree that your FT3 could definitely stand a boost since it's very near the bottom of the range.  

I understand that in UK doctors are very reluctant to give T3 med;  but there are a couple on the forum who live in UK and have gotten it, so you might try a different doctor if you get back to UK or take your labs along to prove that you need it.  

Do you have any connections in the US, from which you might get a trial dose of T3 med?  OR can you get a dessicated thyroid hormone in Guatemala? That would be a T4/T3 combo.  Will your doctor help you with this?  

The only other alternative would be to up your T4 med and hope you could get your levels high enough to bring your FT3 up, but I'm afraid that wouldn't happen.

This is quite a quandry you've gotten into, isn't it??

[oldie]

I confused lipids profile with thyroid tests. I'll go stand in the corner.

TSH        1.43         Range 0.49-4.67 MUI/mi
FreeT3     2.74                   2.02-4.43 ng/mi   or,   4.3pmol1/L   (3.5-6.5)
FreeT4     1.44                   0.8-1.9 ug/di

FT3 goes up and down but does not rise above the bottom third of the range. I've tried to suggest to the medics that  I'm not converting but get only a blank stare. There's no synthetic T3 in Guatemala  where I live. In the UK on a visit  recently I was told by the doc: 'There's little call for or use of it here'.

[Barb135]

What does your doctor say about your LDL.  That's the bad cholesterol, so I'm not sure how much you should have.  Your range simply says "less than" 150 and your level is certainly that.  Maybe someone else can comment on that better than I can.

Should the range on Chol Total actually be > 35?  The rest of your levels look pretty good.

What are your thyroid hormone levels?  As in TSH, FT3 and FT4? Along with the ranges.

[oldie]

you're too kind! I hesiatted to bother you, but...
Chol total        109             Range35 mg/dl
LDL                 37.47                   <150   "
Trigs              138                        25-160 "
total lipids       585.33                   400-1000 "

LDL dropped to present level from 78.83 in five months. How low can it get? The body needs some LDL, yes?
With so many meds for CAD i find it impossible to pinpoint symptoms (night sweats excepted) to show my ideal level for Levo. I just feel I need less that 100mg. Is that fantasy?

[Barb135]

Oldie - haven't seen you around for a while.  

What are your latest thyroid lab results, with reference ranges?  I had horrible night sweats when I was really hypo; it was not unusual for me to have to get up and change bedding, take a shower and put on fresh jammies, but the closer my levels get to what's right for me, the less I have the sweats.  Same goes for the tummy issues.  When my levels get off again, the issues return.

Not sure how your cholesterol ranges are there, so I can't comment on that.  My cholesterol levels go up and down with my thyroid levels: thyroid levels too low, cholesterol goes too high; thyroid levels go up, cholesterol goes down.

[oldie]

HDL this month  43.53, LDL 37.47. Total chol 109. The HDL is above the 20s for the first time in two years. What the LDL is doing below it I can't tell. There is no endo I can find in Guatemala who knows thyroid. I had what appears to  be a successful stent in May. Most of the old symptoms have gone. But there's still tum and gut malaise, hot flushes in the night up to two hours long (Levo?), grumps. I take seven medications. I don't know which are affecting me but thought I'd try a change first with Levo. I dropped it this week from 100mg to 75mg. Sensitive Goolarra I know would feel this. This dose was set two years ago as maintenance once my hypo tests got to normal. since then docs have upped it to 150, down to 125, until I returned myself to 100. What d'you say I stay at 75 for a month and test again? And these hot flushes? Often I have to pull off  my sweat-wet pajamas. and sit on the cold loo for an hour to cool off. Then I can't go back to sleep.They've come and gone for a year or so. Any other victims out there?

[Barb135]

I have a lot of different dosages in my medicine cabinet as well, but I would not go back and try them without  my doctor's blessing.

Generic levo is supposed to be the same as synthroid - strength should be the same for each.  

I do agree that you need a med change and I know doctor's are expensive; however, once again, I caution against self medication.

[azqtpies]

correct my doctor did not increase my levo dose with the cytomel.....
your dosage is right where i think i should go.. its very expensive to keep going back to the doctor just to say i wanna  try this dose. He knows im a self  medicator as this has been a long battle, and i can feel exactly when im off .
I have ton of 5mcg cytomel and 50 synthroid and levo?? pretty much every dose amount .. synthroid is very powerful so i feel i do better on the levo but then that seems not strong enough. I think I'll try the levio  first with the cytomel and if that dont work i'll try synthroid with the cytomel? hopefully one of these dosages will be the one =)

I appreciate all your knowledge and information, thank you  so much!!!!!!!!!!!

[Barb135]

I take it that your doctor didn't decrease your levo when adding cytomel?  It's generally recommended to drop the levo dosage approx 25 mcg for every 5 mcg cytomel (T3).  

Yes, levo is straight T4.  Yes, I totally agree that you should back your levo down.  Going back to 25 levo, with only 1.25 cytomel might be a good place to, then you can retest after a few weeks and readjust again as needed.  It takes longer go get where you need to be by going slower, but it's sure a lot easier/better than seesawing all over the charts.

I do not advocate self medicating, so please discuss this option with your doctor.  Can you get him/her to give you a script for 25 mcg levo?  Then you can split the cytomel to 1/4's.  

[azqtpies]

I am super senstive to medications...... I had my  heart checked out while having really bad pvc and racing. All came back great they actually said I had a peerfectly structured heart! so that was good news.

Now Levothyroxine is a straight T4 med correct?.... I am thinking I need to back my Levo down to 25 or lower and try adding the 1.25 of cytomel maybe once or twice a day.

I agree I need to get my T4 DOWN and my T3 UP and I cant thinkk of how else to do it.

I have not heard of selenium.. is this like a vitamin or presription med??? Right now the dr wanted me to keep the 2 day aweek increase of Levo but that is clearly  defyiing and adding to the problem as my T3 wont rise?
Do you agree?

[Barb135]

Have you tried taking a selenium supplement?  Studies are showing that selenium helps with the conversion of T4 to T3.  200 mcg/day is the recommended dose.

Often changes in med cause certain side effects; I know whenever my levo is raised, I get mouth sores, but as soon as my body adjusts, the sores go away.  Is it possible that if you stick with the 2.5 mcg T3 for a bit longer, you might get used to it?  Have you actually had your heart checked while you are on the T3 and having these symptoms to make sure there is nothing wrong?  

Are you supersensitive to meds?  You could also try quartering a 5 mcg tablet to get 1.25 mcg and see if you can tolerate that.  If so, stay at that level for a while, then try to increase to the 1/2 pill (or 2.5 mcg).  

Taking vitamin D will help with some of your symptoms; however, it won't do anything to get your FT3 up and that's really what you need.

[azqtpies]

I tryed 5 mg  cutting them in half taking 2.5 each day after a week I feel the pressure , arm pain like a heart attack symptoms. I have pvcs occassionally and this med makes them little worse on the 2.5 dose.

I am now taking 1000 mg of vitamin D with a daily multi vitamin.

I am not sure what else can I do to get my T3 up.... I agree my T3 is way too low!

[Barb135]

I agree that you probably aren't converting T4 to T3, since your FT4 is high in the range and your FT3 is very low in the range.  

What dosages of cytomel have you been on?  Did you take the entire dose at once or spread it throughout the day?  If you were on too high a dose and took it all at once, it's understandable that you have some hyper feelings.

Your vitamin D is also very low in the range.  Did your doctor suggest that you supplement that?  

[Neicey12]

My TSH3 came back 0.239
Vit D  19.0
ESR 23