Aa
Aa
A
A
A
Close
Avatar universal

Lab Result Inq

Looking for some feedback on my latest results. After a disastrous over medicated Armour experience last Fall, my doctor and I are starting over with brand name Synthroid and very slow increases of 12.5 every seven weeks or so. If I look at my results from Jan and then my most recent results I appear to still be undermedicated but things are shifting in the correct direction. My FT4 has hit the fifty percent mark with a small increase in FT3 and a fabulous ferretin increase. I've been bumped to 50 mcg Synthroid, but I'd like the feedback of more experienced folks who've been at this for awhile. I have Hashi's and despite these lowish numbers feel pretty good (hiked 11 miles today) other than some lingering anxiety and dry skin. Based off of the below are we on the right track and should I expect to see a FT3 increase with slow increases and a bit of time now that my FT4 level is finally at mid-range?

Also when adding additional Synthroid is it common for one to two weeks after the increase to have mild palpitations?

Thanks for any advice.

Jan 30 25mcg Synthroid
RT3 14  8-25 (ng/dL)
TBG  21.4 13.5-30.9 mcg/mL  
TSH 1.67 0.40-4.50
T3 Uptake 26  22-35 %
T4 6.8 4.5-12.0 mcg/dL
FT4 1.1 1.4-3.8
FT3 2.4  2.3-4.2 pg/mL
Ferritin 43  10-232 (ng/mL)  

March 16 37.5mcg Synthroid
RT3 22  8-25 (ng/dL)
TBG  18.7 13.5-30.9 mcg/mL  
TSH 1.76 0.40-4.50
T3 Uptake 28 22-35 %
T4 7.8 4.5-12.0 mcg/dL
FT4 1.3  0.8-3.8
FT3 2.6  2.3-4.2 pg/mL
Ferritin 79 10-232 (ng/mL)  woo!
8 Responses
Sort by: Helpful Oldest Newest
Avatar universal
Thanks Barb, really appreciate the advice!
Helpful - 0
649848 tn?1534633700
COMMUNITY LEADER
Alright... I think I got it - you stated your FT4 reference range for March 16 as 0.8-3.8, so I stated it accurately as 0.8-1.8...

I doubt your surgery had anything to do with the low FT3 level... Not all of us convert FT4 to the active FT3, adequately, so we have to add a source of T3 in order to bring FT3 levels up to where we need them.

I'm not suggesting that drop back to 37.5 mcg Synthroid and add a source of T3, at this point... I'm suggesting that with your doctor's okay, you hold steady at 50 mcg for a while and see if your FT3 tracks your FT4 up.  

It takes 4-6 weeks for a dosage change of Synthroid (or other T4 medication) to reach its full potential and stabilize.  It often takes FT3 much longer to track upwards.
Helpful - 0
Avatar universal
Regarding the typo - the FT4 range was correctly stated at .08-1.8. There actually was no typo. Sheesh I'm on fire.
Helpful - 0
Avatar universal
I'm actually in my mid 40s, and the surgery was elective cosmetic in a few areas.

I had such a bad reaction with the Armour - not recognizing I was over medicated because I felt so good until it  hit the fan and kind of lost my bananas.  So we started me at 12.5 Synthroid and have worked up over the past four months.

Are you suggesting drop back to 37.5 and add a  small dose of T3 or see how the 50 goes and add?

Thanks
Helpful - 0
649848 tn?1534633700
COMMUNITY LEADER
Okay, you mentioned a typo... please tell me what the typo is...

What did you have surgery on?  

For those of us over 50, it's best to start at lower doses and work up slowly, but don't continue increasing Synthroid, because your FT4 is already at mid range, which is the recommended level for FT4.  

Recommended level for FT3 is upper half of its range and you have quite a ways to go to get there.  Small amounts of T3 will increase FT3 levels and help alleviate hypo symptoms.  
Helpful - 0
Avatar universal
Thanks for catching my typo FT4 is .08-3.8.
My doctor is open to adding T3 if needed. Another item, I had surgery three weeks before this draw and I've read that it can tank FT3 levels although it's unclear how long that effect lasts.

Considering I've just begun what's a normal starting dose for non cardio geriatrics, is it prudent to hang on with the Synthroid only for awhile and see how the FT3 moves?  

There's a also good chance the palps and insomnia are related to extremely low estrogen caused by another med I was taking short term but have just continued.

Thanks
Helpful - 0
649848 tn?1534633700
COMMUNITY LEADER
Please verify the reference ranges for the FT4, particularly the one on 3/16... should that be 0.8-3.8 or 0.8-1.8?  

Heart palpitations and sleep issues can be a symptom of, either, over medication or under medication... judging from your results, it would seem that yours are from under medication.  It's not usual for symptoms to worsen or for new ones to appear when changing dosages or meds.  It may take a bit more than a week or two, because it could take longer than that for your FT3 to track your FT4 up...

You want your FT3 to end up in the upper half of its range and yours has quite a ways to go... you may end up having to add a separate source of T3 medication, in the form of cytomel or its generic counterpart, liothyronine.  The good thing about synthetics over desiccated hormones is that the T4 and T3 dosages can be controlled, easier, individually.  

Do you know if your doctor is willing to add a T3 med, if your FT3 doesn't track your FT4 up?
Helpful - 0
Avatar universal
Part 2 question: since moving from 35.5 to 50 about a week ago, I've noticed mild palpitations and trouble falling/staying asleep. Is this unusual? Should I expect it to settle down in a week or two? I have loads of energy but after the over medicated debacle, I'm nervous.
Helpful - 0
Have an Answer?

You are reading content posted in the Thyroid Disorders Community

Top Thyroid Answerers
649848 tn?1534633700
FL
Avatar universal
MI
1756321 tn?1547095325
Queensland, Australia
Learn About Top Answerers
Didn't find the answer you were looking for?
Ask a question
Popular Resources
We tapped the CDC for information on what you need to know about radiation exposure
Endocrinologist Mark Lupo, MD, answers 10 questions about thyroid disorders and how to treat them
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
STIs are the most common cause of genital sores.