New here and looking for advice

[Rene76]

Hi everyone!  About ten years ago I had a subtotal thyroidectomy for a very large goiter.  Up until a couple years ago I never was prescribed synthroid despite having hypothyroid symptoms, because my TSH was in the normal range (2).  Then, I started developing more nodules, and my doctor prescribed my .05 mcg of synthroid.  For these last two years I've really put forth my best effort to lose extra weight I've been holding on to (50 lbs).  I've tried low carb, low calorie, paleo...every diet you can think of.  I saw a nutritionist who put me on a thyroid diet, and still no luck. She accused me of not adhering to her plan, so I quite seeing her. :-/ I even did a juice fast for seven days and lost a whopping total of 1 lb!  I also exercise 5-6 days a week for 45 minutes.  I do circuit training, weights, and jogging. I weigh exactly the same as I did two years ago.  A couple months ago my doctor changed my synthroid to .112 mcg.  Still no weight loss, but my levels now show me being hyperthyroid.  I'm at .15 with T4 1.3 and T3 2.94.
My doctor wants to reduce my dose now.  I'm at my wits end and was just hoping one of you may have an idea.  If my issue isn't thyroid, is there something else it could be? The extra weight really bothers me, and while I'm proud of how hard I've worked, I'm getting discouraged.  Thanks

[Rene76]

I just received an email from my doctor. Despite my specifically requesting it, apparently she didn't order the T3. The email said my TSH was 1.2, so nearly the same as the last reading was 1.15. The thyroxine free was 1.2, down slightly from 1.75. She also said my C-reactive protein was high at .9 but she wasn't concerned because it was a low high. I'm so confused by all of this. I'm going to look in to ordering my own labs tomorrow.

[gimel]

I would not even think about Reverse T3 unless you continued having hypo symptoms after getting your Free T3 into the upper part of its range, along with Free T4 around the middle of its range.  And don't forget about Vitamin d and B12.  Very important to find out those and supplement, if necessary.

[Rene76]

Thanks! I'll print those. I wish you were an endo. ;)

I've been reading about reverse T3, and wonder if that's why I've gained weight on Armour. Maybe the dose is too high. When she switched me from 112 mcg synthroid to Armour she said bc I was so hyper she was reducing my dose to 90 mcg. However, the conversion of synthroid to armour she actually increased it. When I tried to explain this she disagreed and said it was lower. If that hows what I'm dealing with....

[gimel]

You might give a copy of this link to the doctor and point out the majority of people in the study, with suppressed TSH, had normal FT4 levels.  Here is a quote," When TSH was suppressed, FT4 was elevated in 30.4% but normal in 69.6% of patients."

http://www.ncbi.nlm.nih.gov/pubmed/1366242

Further evidence from the British Medical Journal, in the following link.  Note the statement, " Measurements of serum concentrations of total thyroxine, analogue free thyroxine, total triiodothyronine, analogue free triiodothyronine, and thyroid stimulating hormone, made with a sensitive immunoradiometric assay, did not, except in patients with gross abnormalities, distinguish euthyroid patients from those who were receiving inadequate or excessive replacement."  

http://www.bmj.com/content/293/6550/808

And last this link to a scientific study that concluded that Free T3 correlated best with a composite score of the main hypothyroid  symptoms, while Free T4 and TSH showed no correlation at all.  So that is the reason that Free T3 is the most important thyroid test; however, the most effective treatment is clinical, based on testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms.  

http://informahealthcare.com/doi/abs/10.1080/13590840050043521

[Rene76]

Thanks. :) My doctor here order labs and may decrease my dose because she thinks I'm hyper. She also says the the FT3 levels are irrelevant. So, I'm hoping to get someone more knowledgeable when I move. I'm starting to feel desperate.

[gimel]

Don't be discouraged.  As long as your current doctor is willing to work with you by increasing your meds, as necessary to relieve symptoms, you can look forward to feeling better and better.  And I'm sure we can find a good thyroid doctor for you in the New Orleans area.