Check your FT3 values and range.
Are you sure the T3 is the "Free" and not "total" test?
It is not uncommon for your symptoms to get worse when starting thyroid medication as your body is attempting to adjust to the medication.
Were you on any previous medication or was the NT ar 81.25 mg the initial dose? I'm not familiar with NT dosing increments but 81.25 seems to be an odd amount. Many times NDT is prescribed in grains. With a grain equalling approximately 60 mgs. With quarter and half grain increments.
It is possible that your hair is a response to the still rock bottom Free T4 level. It is not uncommon for a person on natural dessicated thyroid (NDT) to have sufficient Free T3 but very low Free T4 levels since the NDT has a lot of T3 in it compared to T4 that your thyroid gland normally would put out. So some people need to have to add synthetic T4 as well as NDT in order to feel the best.
How do you know the B12 levels are "fine" have you had B12 tested. many people need to be WELL up towards the very top end of the range in order to feel well. In the USA the range is huge from low to high with the low end of the range starting as low as 200. Where many countries start the low end at 500. And many people do not feel well until above 700 of not 900. So do not simply take your Dr's word for it. Always ask for your lab results.
And if you have never been tested for B12, then how in the world would your Dr know if you don't need B12. That is an opinion based upon nothing.
I was started on 65 MG of NDT then my doctor told me to alternate
Between 65 and 81.25 every other day. The test results say FT 3 COPC and Free T4 so I am unsure if it is the Free T3. The last time u had my B12 tested was in August 2014 and it was 475 and then in
February 2015 it was tested again and it was 360 reference range 2
230-1050. So it looks like it was falling back then I don't know why would my doctor think that T4 is ok she called and said my labs were fine and if I felt fine did not need to come in.. I am going to ask her how to get that T4 up see what she says
Please verify the reference range for the FT3 and yes, FT3 stands for Free T3; it's just that, apparently, the result is in different units than the reference range, so you need to verify the range..
Your doctor makes me very nervous... Obviously, she knows very little about desiccated hormones. When taking hormones with a T3 component, it does absolutely NO good to alternate dosages; you have to take the same dosage every day in order to keep the T3 stable in your blood.
I'm also wondering if you're taking your full dose all at once or if you're splitting your dose in half and taking part of it in the morning and part of it later in the day. Most of us taking medication with T3 find that we have to take it in multiple doses.
Your B12 level is way too low in the range... As flyingfool mentioned, most of us have to have B12 levels near the top of the range in order to keep symptoms at bay. My lab even puts a note on the report stating that anything less than 500 can produce symptoms of deficiency. If I were you, I'd be supplementing whether the doctor thought I needed it or not...
The reason your doctor thinks your FT4 is "fine" is because it's "in range"... that's another clue that she's not a real good thyroid doctor. A good doctor would know that FT4 should around mid range to be optimal.
I also think your FT3 is too low in the range, but before I say too much on that, I'd like you to verify that range, particularly checking the units of measure and making sure about the decimal in the result and whether or not there should be a decimal in the range, as well.
Ok sorry for the confusion the current labs are as of 2/10/16
TSH 1.65 reference range 0.50-6.00
FT3 347 reference range 200- 490
Free T4 0.9 reference range 0.7-1.8
The earlier results were from 1/8/16
And yes I split my dose because if I take it all at one time it make my arms hurt badly... How do you find a good Thyroid doctor?
Okay, those results make more sense... Your FT4 is only 18% of its range and most of us find that we do best with FT4 at about mid range. Your FT3 is only at 20% of its range and most of us do best with FT3 in the upper half to upper third of its range. You have a long way to go with them both.
Again, your doctor thinks your levels are "fine" because they fall within the reference ranges, but for most of us, it's simply not good enough to be in the bottom half of the ranges.
If you can tell us what cities you can travel to, we might have the name of a patient recommended doctor, in your area, otherwise, we can help you find a good thyroid doctor...
Often you can interview doctors over the phone via a nurse or office manager. The questions you want to ask is whether they routinely test Free T3 and Free T4, along with TSH, whether or not they're willing to prescribe all types of thyroid hormones, including those with T3, such as Cytomel and desiccated hormones, and whether or not they treat by symptoms, as opposed to simply going by whether the labs are "in range"...
Thanks everyone for the feed back. I live in Groveport Ohio but am
really Close to Columbus Ohio do you know of any in those area's?
Would the low T4 cause my hair loss? And my weight issues?
Symptoms correlate best with Free T3, but, since both your FT4 and FT3 are too low in the ranges, it's not surprising you have hypo symptoms.
I'll do some checking and see what I can find in your area for doctors. Some doctors don't like their names put on open forums, so I'll send you a Private Message, with whatever I find.
Current labs TSH 0.67 reference range 0.50 to 6.00
FT3 283 reference range 200 to 490
T4 1.0 reference range 0.7 to 1.8
Any help understanding these would be greatly appreciated
FT3 and Both your FT3 and T4 (assume it's FT4 from the reference range?) are "in range", but both are way too low in the ranges. Most of us find that we feel best with FT4 about mid range and FT3 in the upper half to upper third of its range. Your FT4 is only at 27% of its range and your FT3 is only at 29% of its range. Both have a long way to go to reach the target areas...
Is your doctor willing to increase your med dosage?
Thyroid question
My current labs are TSH 0.65 refrence range 0.5 to 6.00
Free T4 0.7 range 0.7 to 1.8
T3 254 range 200 to 490 I am having alot of hypo systems when I first found out that I was hypo my tongue was swollen and mouth was really dry and that is what'd going on now.. I asked my Dr to raise my dose from 81.25 to 97.50 she really did not want raise it because my TSH was at the low end of normal what are your thoughts.. my last labs were TSH 0.67
Free T4 1.0
FT3 283 on April 25,2016
I just don't understand why my TSH is so low but so are my free T4 and T3 any help would be greatly appreciated
Our bodies evolved having a continual flow of a small amount of thyroid hormone throughout the day. When we take the entire dose of thyroid med once daily, the TSH becomes suppressed for a full day or so. In addition there are scientific studies that have shown that with central hypothyroidism, the TSH becomes suppressed when taking an adequate dose of thyroid med. Even with Hashi's, studies have shown that the majority of those hypo patients taking doses of thyroid med adequate to relieve symptoms will have their TSH suppressed.
TSH suppression when taking thyroid med is entirely different from having a suppressed TSH due to excessive levels of Free T4 and Free T3; however, many doctors don't understand that. TSH suppression when taking thyroid med does not indicate hyperthyroidism, unless there are hyper symptoms due to excessive levels of Free T4 and Free T3, which you certainly don't have. When taking thyroid med, the TSH test is basically a waste of time and money.
If your doctor also claims that a suppressed TSH can cause osteoporosis or other symptoms, I can give you links to a number of scientific studies that prove differently.
So you should use this information and offer more proof if needed, and push your doctor to raise your med dosage.
In addition hypo patients are frequently too low in the range for Vitamin D, B12 and ferritin. If not tested for those, you should do so and then supplement as needed to optimize. D should be about 50 min. and B12 in the upper end of the range, and ferritin should be about 70.
In order to assess your test results we need to know the reference ranges shown on the lab report. Do you have any other symptoms besides the cold intolerance?
I thought your med dosage had been increased to 97.5 mg.
Your recent labs show that your Free T4 is only at 18% of its range, and your Free T3 is only at 27% of its range. Both are too low for many people. It is unfortunate that your doctor thinks those are great because they are not, since you still have hypothyroid symptoms. A good thyroid doctor will treat a hypothyroid patient clinically by testing and adjusting Free T4 and Free T3 as needed to relieve symptoms, without being constrained by resultant TSH levels. Symptom relief should be all important, not just test results. In the words of an excellent thyroid doctor, " in tests done about 24 to 28 hrs after their last daily dose, most people on adequate NDT therapy have a suppressed TSH. They usually have FT4 levels that are 1 to 1.3ng/dL, and free T3 levels that are rather high in the range or even slightly above the range. The higher FT3 level compensates for the lower FT4 levels on NDT. These patients have no symptoms or signs of hyperthyroidism--if such occur the dose is reduced."
In your most recent post you stated, " I have never had a problem with cold intolerance but since my TSH has been on the low end I have noticed that I am super cold all the time. My doctor said my numbers look great but I feel like poop! I was taking Nature Thyroid 81.25 Split half in the morning and half in the afternoon. she has changed me to Amour Thyroid 60mg split half in the morning and half in the afternoon about a week ago. I am also taking 500mg metformin, 40 mg omeprazole, 10mg lisinopril, 5mg potassium. please give me your feed back on what is going on with me and my numbers . Thanks in Advance."
As I previously stated, "TSH is a pituitary hormone, not a thyroid hormone... it neither causes nor alleviates symptoms, nor does it correlate with symptoms. When one is on replacement thyroid hormones, TSH, often becomes totally irrelevant." In addition, the 81.25 of NatureThroid was not adequate, and the change to a reduced dosage of Armour was the wrong direction. If you want confirmation of all this, I suggest reading at least the first two pages of the following link. In the paper you will find what is needed in the way of testing and treatment that your doctor should be doing. You could give a copy of the paper to the doctor and request to be treated clinically, as described, but I doubt that the doctor is going to change, so you really need a good thyroid doctor.
http://www.thyroiduk.org.uk/tuk/TUK_PDFs/diagnosis_and_treatment_of_hypothyroidism_issue_1.pdf
For your consideration. just sent you a PM with info on a doctor in your area. To access the info, just click on your name and then from your personal page click on messages.