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Thyroid lab and medication
Hi, I have fibromyalgia with all the symptoms of hypothyroidism. I am always cold/ freezing, my hair are falling and my skin and hair are very dry. I am fatigued and tired. IBS and brain fog and I am unable to get preg. My face and hands/ feet were always puffy. My TSH was 3.6 and 2.5 in two lab tests before i started taking medication.
Dr. prescribed 5mg twice a day hydrocortisone/ cortef along with half grain (30 mg) of "thyroid" twice a day. I have been taking it for three months now. my new lab result is
FT4: 1.0 0.8-1.8 ng/dl
FT3: 382 230-420 pg/dl
T3 uptake: 33 22-35%
T3 reverse: 23 11-32 ng/dl
Thyroglobulin AB <20 <20 IU/ml
TPO AB 11 <35 IU/ml
TSH 3rd gen: 0.09 .4-4.5 mIU/L
I know that TSH is very low but maybe it doesnt matter. Dr said its fine.I am stiff cold and have all other symptoms, the only difference i get is that my face and hands are not puffy/ swollen like before, which was a big problem.
can anyone please comment on this lab work, as I dont see any improvement in my symptoms other then face and hand puffiness.
Are my T3 and T4 levels good....how should i change my thyroid med?
Dr. prescribed 5mg twice a day hydrocortisone/ cortef along with half grain (30 mg) of "thyroid" twice a day. I have been taking it for three months now. my new lab result is
FT4: 1.0 0.8-1.8 ng/dl
FT3: 382 230-420 pg/dl
T3 uptake: 33 22-35%
T3 reverse: 23 11-32 ng/dl
Thyroglobulin AB <20 <20 IU/ml
TPO AB 11 <35 IU/ml
TSH 3rd gen: 0.09 .4-4.5 mIU/L
I know that TSH is very low but maybe it doesnt matter. Dr said its fine.I am stiff cold and have all other symptoms, the only difference i get is that my face and hands are not puffy/ swollen like before, which was a big problem.
can anyone please comment on this lab work, as I dont see any improvement in my symptoms other then face and hand puffiness.
Are my T3 and T4 levels good....how should i change my thyroid med?
COMMUNITY LEADER
I don't know if HC retards the conversion of T4 to T3 or not - in your case, your FT3 is higher in its range, while your FT4 is low in its range. I'm just wondering if a T3/T4 combo is really right for you, or if they should add more T4 and less T3 to it. If you are converting properly, you might not need as much T3.
Now, mind you, if I could get my FT3 up where yours is, I'd be in 7th heaven, but we are all so different that what's good for me, could make you hyper or hypo.
As I said, hyper and hypo symptoms can cross over and we are all affected differently. I used to have sweats really bad when I was hypo, even while I was cold; so yes, you can be cold and still be hyper - I used to be all the time, when I was swinging back and forth, before I went completely hypo.
Are you continuing to supplement for the B12 and vitamin D? If your levels were low once, most likely, they will drop again if you don't continue taking them.
Making too many changes too quickly, can really confuse things, so maybe you need to get back on your HC and give everything a chance to stabilize for a few weeks, then see how you feel, also, you would want to retest after several weeks to see where your levels are. If you haven't been on the thyroid med for very long, it could take a while for things to level out, plus making the other changes.
Now, mind you, if I could get my FT3 up where yours is, I'd be in 7th heaven, but we are all so different that what's good for me, could make you hyper or hypo.
As I said, hyper and hypo symptoms can cross over and we are all affected differently. I used to have sweats really bad when I was hypo, even while I was cold; so yes, you can be cold and still be hyper - I used to be all the time, when I was swinging back and forth, before I went completely hypo.
Are you continuing to supplement for the B12 and vitamin D? If your levels were low once, most likely, they will drop again if you don't continue taking them.
Making too many changes too quickly, can really confuse things, so maybe you need to get back on your HC and give everything a chance to stabilize for a few weeks, then see how you feel, also, you would want to retest after several weeks to see where your levels are. If you haven't been on the thyroid med for very long, it could take a while for things to level out, plus making the other changes.
Hi, thanks for replying! The thyroid my doc prescribed is called "thyroid". Its a combination of T3 &T4 and I get it from a compounding pharmacy. This is the first time I am taking thyroid so I dont have any experience with cytomel or levo.
Vit D was low but now getting better. Vit B12 was also low at 217 but like a miracle it shot up to 1017 after 1 shot and a month of supplementation. Ferritin is still low at 10 (10-154) so I need to supplement that too.
Could I be hyper even if I am cold? I am always freezing especially hands and feet and nose. I only get comfortable when summer is in full bloom :).
I am also taking cortef/ Hydrocortisone. Last week I ran out of it and had some problem in filling the prescription. So I was taking thyroid without cortef. In the first few days I felt really bad....Dizzy, fainting like feeling, headache, heart palpitaions and breathing problem. But yesterday and today I am quiet warm. I infact checked weather twice as I am never this warm/ comfortable at 74 degrees. Cant tell if brain fog is better too or not.
HC retards the conversion of T4 to T3 but aids in absorption. Is that correct? so when I stopped taking it, Did i get too much hyper from more T4 converting to T3? why am I feeling so much better now? I am going to start taking HC from tomorrow again, I'll see what changes.....
By the way the lab test was done way before I stopped HC/ cortef.
Vit D was low but now getting better. Vit B12 was also low at 217 but like a miracle it shot up to 1017 after 1 shot and a month of supplementation. Ferritin is still low at 10 (10-154) so I need to supplement that too.
Could I be hyper even if I am cold? I am always freezing especially hands and feet and nose. I only get comfortable when summer is in full bloom :).
I am also taking cortef/ Hydrocortisone. Last week I ran out of it and had some problem in filling the prescription. So I was taking thyroid without cortef. In the first few days I felt really bad....Dizzy, fainting like feeling, headache, heart palpitaions and breathing problem. But yesterday and today I am quiet warm. I infact checked weather twice as I am never this warm/ comfortable at 74 degrees. Cant tell if brain fog is better too or not.
HC retards the conversion of T4 to T3 but aids in absorption. Is that correct? so when I stopped taking it, Did i get too much hyper from more T4 converting to T3? why am I feeling so much better now? I am going to start taking HC from tomorrow again, I'll see what changes.....
By the way the lab test was done way before I stopped HC/ cortef.
Hi, thanks for replying!
I didnt have any pituitary testing done....Can you please name the tests which I should ask for from my doc.
My Vit D was very low a few months ago...10 when it was supposed to be 50 or above. I had two courses of prescription Vit D and still take D3 4000 mg a day. Now it is 30 ng/ml....low normal but getting better.
Metabolic Panel:
Glucose fasting: 91 65-99 mg/dl
Sodium: 138 135-146mmol/L
Potassium: 4.2 3.5-5.3 mmol/L
Chloride107 98-110mmol/L
Carbon Dioxide: 24 21-33mmol/L
Urea Nitrogen: 12 7-25 mg/dl
Creatinine: 0.67 .58-1.06mg/dl
Calcium: 9.3 8.6-10.2 mg/dl
Protein, Total:6.9 6.2-8.3 g/dl
Albumin: 4.5 3.6-5.1 g/dl
Globulin calculated 2.4 2.2-3.9 g/dl
A/G ratio :1.9 1.0-2.1
Bilirubin, Total:0.6 0.2-1.2mg/dl
Alkaline Phosphatase: 49 33-115 U/L
AST: 20 10-30 U/L
ALT:14 6-40 U/L
EGFR>60 >=60
I would get the AB tested again certainly.
I didnt have any pituitary testing done....Can you please name the tests which I should ask for from my doc.
My Vit D was very low a few months ago...10 when it was supposed to be 50 or above. I had two courses of prescription Vit D and still take D3 4000 mg a day. Now it is 30 ng/ml....low normal but getting better.
Metabolic Panel:
Glucose fasting: 91 65-99 mg/dl
Sodium: 138 135-146mmol/L
Potassium: 4.2 3.5-5.3 mmol/L
Chloride107 98-110mmol/L
Carbon Dioxide: 24 21-33mmol/L
Urea Nitrogen: 12 7-25 mg/dl
Creatinine: 0.67 .58-1.06mg/dl
Calcium: 9.3 8.6-10.2 mg/dl
Protein, Total:6.9 6.2-8.3 g/dl
Albumin: 4.5 3.6-5.1 g/dl
Globulin calculated 2.4 2.2-3.9 g/dl
A/G ratio :1.9 1.0-2.1
Bilirubin, Total:0.6 0.2-1.2mg/dl
Alkaline Phosphatase: 49 33-115 U/L
AST: 20 10-30 U/L
ALT:14 6-40 U/L
EGFR>60 >=60
I would get the AB tested again certainly.
COMMUNITY LEADER
What is the "thyroid" that your doctor put you on? Is this a prescription med? Does it have a name? Can you let us know what's in it? I'm wondering if it's a T3/T4 combo, which I suspect, since it's dosed in 'grains'?
Your FT3 is near the top of its range, but your FT4 is close to the bottom of its range. Your TSH is also low, which is usually not an issue, so long as both FT3 and FT4 are good and you don't have symptoms; that's not the case for you.
Symptoms of hypothyroid and hyperthyroid can "cross over", think fatigue, brain fog, etc. I'm wondering if you might be slightly hyper, even though your FT3 is "in range", and would do better on a straight T4 med, such as synthroid, tirosint or generic levothyroxine. That might bring your FT4 up a bit and let the FT3 go down slightly. Later on, if it turns out that you need the T3 med, you could add a low dose of cytomel.
I agree that you should have your vitamin D tested, along with particularly, vitamin B12, which will also cause horrifying fatigue.
Your FT3 is near the top of its range, but your FT4 is close to the bottom of its range. Your TSH is also low, which is usually not an issue, so long as both FT3 and FT4 are good and you don't have symptoms; that's not the case for you.
Symptoms of hypothyroid and hyperthyroid can "cross over", think fatigue, brain fog, etc. I'm wondering if you might be slightly hyper, even though your FT3 is "in range", and would do better on a straight T4 med, such as synthroid, tirosint or generic levothyroxine. That might bring your FT4 up a bit and let the FT3 go down slightly. Later on, if it turns out that you need the T3 med, you could add a low dose of cytomel.
I agree that you should have your vitamin D tested, along with particularly, vitamin B12, which will also cause horrifying fatigue.
I would do a retest of the Thyroglobulin AB in 6 mos....you are right on the line there. Your actual thyroid labs are fine, but would redo those with the antibody test.
You could be on the verge of showing antibodies, or not., Yes your TSH is a little low...hmmmm. Have you had any other pituitary function tests?
Have you had any testing done for Vit D3 or a Metabolic Panel done?
You could be on the verge of showing antibodies, or not., Yes your TSH is a little low...hmmmm. Have you had any other pituitary function tests?
Have you had any testing done for Vit D3 or a Metabolic Panel done?
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