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New Results - Is It a Pituitary Issue or T3 Syndrome?

Greetings,

I just received a new set of labs in which I was tested 4 or 5 weeks apart from the last test. My dosage of WP Thyroid did not change (97.50 mg) and my T3 Free is through the roof. I feel as though I am not on anything: no energy, fatigued, memory problems, speech problems, etc.No heart issues or palpitations, either.

I will be seeing a new endocrinologist in October (it's the soonest I can get in) and my PCP had been treating me since last September because they're more functional than traditional. I had mentioned to my PCP that with all the odd swings in my numbers that I wonder if it's indicative of a pituitary issue or T3 Syndrome which is why they said I need to see a specialist.

I also must note that I was off of my birth control pill , Trinessa, for a month (wouldn't renew script without an exam) and just started it back up on July 12th. I am wondering if that has any correlation with my thyroid hormone numbers being out of whack when I took the last test.

Below are my last three labs (I retain all my lab history):

July 11th, 2016 - WP THYROID 97.50 MG
TSH 0.09 (range 0.40-4.50)
FREE T4 1.0 (range 0.8-1.8)
FREE T3 6.7 (range 2.3-4.2)

June 8th, 2016 - WP THYROID 97.50 MG
TSH 0.54 (range 0.40-4.50)
FREE T4 0.7 (range 0.8-1.8)
FREE T3 2.7 (range 2.3-4.2)

April 19th, 2016 - WP THYROID 85.25 MG
TSH 3.56 (range 0.40-4.50)
FREE T4 0.8 (range 0.8-1.8)
FREE T3 2.4 (range 2.3-4.2)

I see my PCP on Tue (July 19th), so I will see what happens from here.
8 Responses
Avatar universal
With no changes in meds, yet a significant increase in Free T3 level, but not Free T4, the only thing that comes to mind is the possibility of "pooling of T3 in the blood", and not getting into cells.   The cause of T-3 pooling can be any one of the following or a combination of the following:

    High cortisol
    Low cortisol
    High iron
    Low iron
    Medications
        beta blockers
        Amiodarone
        Iodinated contrast media
        Lithium

Have you been tested for morning serum cortisol and also ferritin?  How about the medications?
1 Comments
Hi Gimel,

Thank you for responding. Besides WP and Trinessa, I have been seeing a GI doctor and she has me on a daily regime of stool softeners and miralax (only until September follow up).  I am not on any other medications apart from the ones I just mentioned.

I had my cortisol checked at the lab I work at but it as saliva not serum. Those results were within normal range used at work but I still have adrenal fatigue despite the numbers.

Ferritin was last checked on 2/23/2016 and it was 15 (range 10-232), so I am taking 25 mg of iron daily now with 1500 mg of Vitamin C [to prevent constipation issues I had two months ago].

Other than that, nothing in my routine of meds and supplements have changed. Should I ask my PCP to repeat Ferritin check and serum cortisol check? I am stressed out all the time and have a busy life, so trying to lower my stress levels and easing adrenal fatigue are next to impossible at this stage :(
Avatar universal
What was the saliva cortisol test result and reference range?  

That was an extremely low ferritin test result.  Doubtful that the 25 mg is anywhere near enough to adequately raise your ferritin level.  It needs to be 70 minimum.  

Also, have you tested for B12 and Vitamin D?
1 Comments
I don't have the cortisol results on hand at the moment but I supplement B12  every other day and take Vitamin D3 daily and get tested for it regularly.

At last check (2/24/16), my B12 was 1330 (range is 200-1100) and my Vitamin D level is at a steady 78 (30-100). I maintained that same level for over a year and take 5000 IU daily, so I'm not having any deficiencies.

What do you personally recommend for a daily iron intake when supplementing? My PCP has me on 25 mg daily for the time being.
Avatar universal
Can't say for sure, but my ferritin was at 40 and I was supplementing 50 mg daily and it went up to 80.

Yes, I would ask to repeat the serum cortisol and ferritin tests.  BTW I have read that it is a good idea to not take your iron supplement for a few days before the blood draw for the ferritin test, in order to avoid false high result.
1 Comments
Thanks for mentioning it. I will post an update after I meet with my PCP on Tuuesday and post my cortisol results for you tomorrow morning.

I appreciate your feedback.
Avatar universal
I am retesting in two weeks (TSH, FT3 & FT4). I also asked for serum cortisol, too. I don't trust the high FT3 value as I have not changed medications nor changed anything in my supplement routine. The very high FT3 reading from last week's test could be indicative of a lab error because my symptoms are consistent with low FT3.

My practitioner suggested I not take my NDT meds for the two week interim until the draw, but I was hesitant to do so considering I am barely functioning now and I react to subtle changes quickly, so I don't wish to make my symptoms worse.

After this next test (draw is on Aug 2nd), if my FT3 comes back low [like the June test], then I will ask to either up my dose of WP one more time OR ask for them to compound my NDT meds. My practitioner is aware we need to maintain my levels in the interim until my endo appointment.

I am so disappointed :(
Avatar universal
Not taking your NDT for two weeks is a bad suggestion.  I would make sure to supplement the ferritin.  Will know more when you can get the morning serum cortisol done.  

Being an Endo does not guarantee a good thyroid doctor.  I am going to look around and see if I can suggest some doctors in your area.  
Avatar universal
Thank you, Gimel. I would appreciate more thyroid doc information. I am not following their recommendation to stop the meds. I am dealing with a whole new set of problems which I get when my levels are low, particularly FT3. I am experiencing a rapid resting heart rate, daily headaches, nausea, increased fatigue, I feel oxygen starved and I am having significant issues with my neck.

I feel as if I'm choking, particularly in the area on on the right side (it's been an area of concern that requires a ct scan w/contrast). I am actually quite frightened by this because I can't function, let alone get sleep and am pondering an ER visit to recheck my labs sooner and get the scans done.
Avatar universal
I just sent a PM with info.  To access, click on your name and then from your personal page, click on messages.

Sounds like a visit to ER might be a good idea.  You might have to push them to get Free T4 and Free T3 tests done.
Avatar universal
I got it :)

Ironically enough, one of the endos you sent (Anna Frisch) is the doctor I will be seeing in October. I am checking with them constantly if there's a cancellation to get it sooner.
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