Aa
New labs, some advice please
TSH 0.96 (.35-5.5)
FT3 28 (24-39)
FT4 1.06 (.58-1.6)
dx hypo two years
synthroid 112mcg 4days a week, 100mcg the other two. At this dose for 6 months
cytomel 5mcg..dose split in two...some days just a half a dose of 2.5mcg. At this dose for 6 months.
My CBC results are all inside the ref range...my D is 80 (50-83)
I'm still having trouble concentrating, staying on task and generally caring. Not depressed but uninterested in things I used to do...ie, paint
Having some good days, but lately I have had cold spells, my eyes are dry and tired and I'm still anxious.
My throat seems full occasionally and I have almost nightly indigestion.
My question...should I up my dose of Synthroid or am I having a conversion problem with T3?
Thank you, Debbie
FT3 28 (24-39)
FT4 1.06 (.58-1.6)
dx hypo two years
synthroid 112mcg 4days a week, 100mcg the other two. At this dose for 6 months
cytomel 5mcg..dose split in two...some days just a half a dose of 2.5mcg. At this dose for 6 months.
My CBC results are all inside the ref range...my D is 80 (50-83)
I'm still having trouble concentrating, staying on task and generally caring. Not depressed but uninterested in things I used to do...ie, paint
Having some good days, but lately I have had cold spells, my eyes are dry and tired and I'm still anxious.
My throat seems full occasionally and I have almost nightly indigestion.
My question...should I up my dose of Synthroid or am I having a conversion problem with T3?
Thank you, Debbie
I have made it a practice to always ask the lab person what tests are going to be done. You'd be surprised how often they operate on auto pilot and do the same old tests as usual.
The thyroid gland produces mostly T4 and a small amount of T3. Most T4 and t3 is bound to protein molecules and thus rendered biologically inactive. Only the small portions that are not bound, thus referred to as "free", do anything for you. Free T3 largely regulates metabolism and many other body functions. Most Free T3 comes from conversion of T4 to T3, a large part of which takes place in the liver. Under some conditions, the body does not adequately convert the T4 to T3. This occurs quite frequently when taking thyroid meds. When you get a Free T3 test done, I expect that you will find that your Free T3 is in the lower half of its range, and is the cause for those symptoms.
T3 has a half life of less than a day. So it takes about 4-5 days to reach 90% of its final effect on serum levels. Free T4 has a half life of about a week, so it takes 4-5 weeks to achieve similar effect. I think it takes a body some time to adjust to changes in meds, and symptoms tend to lag changes in blood levels. That is one of the reasons we always suggest that "slow and sure" is the best approach to making med changes.
The thyroid gland produces mostly T4 and a small amount of T3. Most T4 and t3 is bound to protein molecules and thus rendered biologically inactive. Only the small portions that are not bound, thus referred to as "free", do anything for you. Free T3 largely regulates metabolism and many other body functions. Most Free T3 comes from conversion of T4 to T3, a large part of which takes place in the liver. Under some conditions, the body does not adequately convert the T4 to T3. This occurs quite frequently when taking thyroid meds. When you get a Free T3 test done, I expect that you will find that your Free T3 is in the lower half of its range, and is the cause for those symptoms.
T3 has a half life of less than a day. So it takes about 4-5 days to reach 90% of its final effect on serum levels. Free T4 has a half life of about a week, so it takes 4-5 weeks to achieve similar effect. I think it takes a body some time to adjust to changes in meds, and symptoms tend to lag changes in blood levels. That is one of the reasons we always suggest that "slow and sure" is the best approach to making med changes.
Will ask for Ferritn and B12 tests..and find out who $crewed up the T3 test.
I do split the 5mcg, morning and before 2PM.
I cant say that I completely understand T3.
I understand what it is/does, but its fast acting and depleted.
I don't take it before a blood draw, so how do you get an accurate count?
How does it get built up in your system and does a body need to adjust to it like T4? Do I have to give my body time to understand new T3 like I did T4?
After two years of Synthroid wouldn't my T3 be stable and I be able to determine if I needed supplementation?
Sorry, your "there" and I have questions.
T3 uptake is a useless test nowadays. Don't know how your doc would have any idea about your cells not showing any sign of a B12 deficiency. Best to have it tested. You also really do need to get the Free T3 test done. Excess Reverse T3 is not a normal problem, but I thought it would be good to document. The way to use it is to calculate the ratio of Free T3 to Reverse T3. There are numerous reports saying that the ratio is the best measure of tissue thyroid levels, as opposed to serum thyroid levels that are determined from blood tests. The ratio is reported to be best around 1.8 and higher.
Do you take your T3 med all at once? If so, you might have better results by splitting it in half for morning and early afternoon.
Do you take your T3 med all at once? If so, you might have better results by splitting it in half for morning and early afternoon.
Thank you for the quick reply.
Checked the T3 units.
I expressly asked for FT3, the form says T3 Uptake.
I realllly don't want to get blood drawn again.
Can you determine if my T3 is still off from this test?
The numbers I posted are what are on the form, no units just a % sign.
My iron has always been good, I will ask for a test.
Doc says my cells don't show any sign of a B12 deficiency, so no specific test has been done. Does that sound sensible?
He has mentioned to me that if I want/need a RT3 test that he would not know how to interpret it. I would need to see an Endo.
The partial doses of T3 are because I get back pain and loose stools when I take the 5mcg a day. Just trying to figure out which devil I can live with :)
Thank you for your time, Debbie
Checked the T3 units.
I expressly asked for FT3, the form says T3 Uptake.
I realllly don't want to get blood drawn again.
Can you determine if my T3 is still off from this test?
The numbers I posted are what are on the form, no units just a % sign.
My iron has always been good, I will ask for a test.
Doc says my cells don't show any sign of a B12 deficiency, so no specific test has been done. Does that sound sensible?
He has mentioned to me that if I want/need a RT3 test that he would not know how to interpret it. I would need to see an Endo.
The partial doses of T3 are because I get back pain and loose stools when I take the 5mcg a day. Just trying to figure out which devil I can live with :)
Thank you for your time, Debbie
I've not seen a Free T3 range like that. Would you please post the measurement units that go with that. The ones we usually see are expressed in pg/dl or pmol/L. Just curious about that.
From your test results, I'd say that your Free T4 is fine, but your Free T3 is not high enough to relieve hypo symptoms. Scientific studies have shown that Free T3 correlated best with hypo symptoms, while Free T4 and TSH did not correlate at all. Due to the erroneous method used to establish the reference ranges for FT3 and FT4, we find that symptom relief frequently requires Free T3 in the upper third of the range and Free T4 around the middle of its range.
It is kind of interesting that your doctor is trying to be so precise in your dosage that he has you drop down to 100 mcg of T4 two days a week. Looks like maybe he is dosing you based on TSH. That doesn't work. Also, why are you reducing your T3 med on some days?
Doctors like to think that TSH accurately reflects levels of the biologically active thyroid hormones, Free T3 and Free T4; however TSH cannot be shown to correlate well with either, much less correlate well with symptoms, which should be the main concern.
A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels. You can get some good insight into clinical treatment from this letter written by a good thyroid doctor for patients that he sometimes consults with after initial tests and evaluation. The letter is then sent to the participating doctor of the patient to help guide treatment. In the letter, please note the statement, "the ultimate
criterion for dose adjustment must always be the clinical response of the patient."
http://hormonerestoration.com/files/ThyroidPMD.pdf
So it appears to me that you need to talk with the doctor and request an increase in your T3 med and then continue to increase as required to relieve symptoms.
Another thing to check out is your Vitamin B12 and ferritin levels. B12 deficiency can mimic some hypo symptoms. B12 needs to be in the very upper part of its range. Ferritin is very important for proper metabolizing of thyroid hormone. Ferritin should be up around 80 for best results. So, it would be a good idea to test for both, if not done previously. Also, it will blow your doctor's mind, but I would also ask to be tested for Reverse T3.
When you have further info, please post and members will be glad to help interpret and advise further.
From your test results, I'd say that your Free T4 is fine, but your Free T3 is not high enough to relieve hypo symptoms. Scientific studies have shown that Free T3 correlated best with hypo symptoms, while Free T4 and TSH did not correlate at all. Due to the erroneous method used to establish the reference ranges for FT3 and FT4, we find that symptom relief frequently requires Free T3 in the upper third of the range and Free T4 around the middle of its range.
It is kind of interesting that your doctor is trying to be so precise in your dosage that he has you drop down to 100 mcg of T4 two days a week. Looks like maybe he is dosing you based on TSH. That doesn't work. Also, why are you reducing your T3 med on some days?
Doctors like to think that TSH accurately reflects levels of the biologically active thyroid hormones, Free T3 and Free T4; however TSH cannot be shown to correlate well with either, much less correlate well with symptoms, which should be the main concern.
A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels. You can get some good insight into clinical treatment from this letter written by a good thyroid doctor for patients that he sometimes consults with after initial tests and evaluation. The letter is then sent to the participating doctor of the patient to help guide treatment. In the letter, please note the statement, "the ultimate
criterion for dose adjustment must always be the clinical response of the patient."
http://hormonerestoration.com/files/ThyroidPMD.pdf
So it appears to me that you need to talk with the doctor and request an increase in your T3 med and then continue to increase as required to relieve symptoms.
Another thing to check out is your Vitamin B12 and ferritin levels. B12 deficiency can mimic some hypo symptoms. B12 needs to be in the very upper part of its range. Ferritin is very important for proper metabolizing of thyroid hormone. Ferritin should be up around 80 for best results. So, it would be a good idea to test for both, if not done previously. Also, it will blow your doctor's mind, but I would also ask to be tested for Reverse T3.
When you have further info, please post and members will be glad to help interpret and advise further.
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