T3 TOTAL LOW

[Shae280]

Been taking Synthroid for 45 yrs. For several years taking 75mcg. 8/2021 TSH 0.13L,T4 free 1,4, T3 Free 3,1, T3 Total 99.
Based on those results the Dr. said I am on too much Synthroid and wanted it lowered to 50 mcg. I always thought you do not change meds based on TSH alone which someone here agreed with. I have continued on the 75mcg and just had blood tests 6/2022 and now, TSH 2.70, T4free 1.1, T3 Total 68L. I never had my TSH rise so much or the T3total go so low with no change in dosage. Based on the new numbers should the dosage stay the same? I def. feeling off, mainly pressure in my head, sort of dizzy.  I am so confused

[gimel]

Can't answer your questions about ANA.  Why would you think you have Erythromelagia?

I agree that your thyroid results could have been affected by stress.  Regardless, with those symptoms and test results it seems you are hypothyroid again (or still).  You do need some additional tests.  You should always make sure they test for Free T3, not Total T3.  I also suggest tests for Vitamin D, B12 and ferritin.  Those are important for a hypothyroid patient.  Can you get those done?

By the way, if your doctor thinks you need to reduce medication because of TSH, I am not confident you will be treated adequately there.  You may have to find a doctor that will treat clinically, based on symptoms, along with Free T4 and Free T3 levels.  

[Shae280]

I take 2,000iu Vitd. My current level is 42. Ferritin was 19, He did not test b12,or free T3. Free T3 last August was normal. With the TSH now within range I would not think he is going to tell me to lower the dosage. My concern is the low Total t3. I was wondering in general with my current results what the dose should be. I have the exact symptoms of Erythromelagia. Burning, painful feet turning red, even blackish when cold. It is amazing how the drs disregard everything. I have been sick, not feeling well for 20 yrs with no help, just aggravation. Goid luck trying to find a dr. to take you seriously.

[Shae280]

"Good"

[gimel]

For D I suggest that you add about 3000 IU spread over the week.  Your ferritin is terribly low.  It should be at least 100You need to supplement with iron.  I suggest a generic form from CVS that is not expensive.  It is called Iron plus C.  You should start with one pill daily for a couple of weeks and then add another and then after some time add a third pill..  If it causes stomach problems, take as much Vitamin C as needed to stay regular.  I would not consider adding any T3 med until you get your ferritin much higher.  To add T3 now might cause a reaction.  

Low ferritin is reported to cause symptoms like weakness, fatigue, difficulty concentrating, cold hands and feet, poor short term memory, dizziness, pounding in the ears, shortness of breath, brittle nails, headaches, restless legs.  

So I suggest that you go to work on the D and especially ferritin levels for now.  Along with that I suggest that you do everything possible to de-stress.s.  That is all I suggest for now, and then see how you are doing and see what additional tessts you need.  

I have no idea about Erythromelagia.  I read that it is very rare.   If there is any chance it is being triggered/affected by your other issues, you should be able to tell when you get everything optimized.  

[gimel]

TSH is frequently suppressed when taking significant doses of thyroid med,  Thyroid med dosage should never be adjusted based on TSH.  TSH is affected by so many variables that it has only a weak correlation with the actual thyroid hormones, and a poor correlation with symptoms, which thyroid patients are concerned about.  I expect that your dose of 75 mcg of t4 has never been adequate to relieve symptoms.  Lowering it would only make it worse for you.  

There is much to discuss, but first please review the following list of typical hypo symptoms and tell us which ones you have.  

Fatigue
Increased sensitivity to cold
Constipation (have to use laxatives or fiber)
Dry skin (need to use skin creme)
Weight gain (difficulty losing weight)
Puffy face
Hoarseness
Muscle weakness
Elevated blood cholesterol level
Muscle aches, tenderness and stiffness
Pain, stiffness or swelling in your joints
Heavier than normal or irregular menstrual periods
Thinning hair
Slowed heart rate
Depression
Impaired memory
Enlarged thyroid gland (goiter)

[Shae280]

Hi Gimel, Now I remember you. I should mention that I lost my Mother 9/1/21 which has affected my whole being. I am tired and have trouble sleeping. I do have joint pain, swelling in some fingers, have hair loss and my Cholesterol has gone up alot. My diet is better than most and why it rose so much I can only attribute to stress and maybe these test results. What is also interesting is that My ANA has been positive/ speckled for over 20 years. Now it came back Negative. How can that be? I also though not diagnosed believe I have Erythromelagia which most know nothing about.