The first thing I would like to do is review your thyroid related test results and reference range shown on the lab report. Just because the lab results fall within the so-called "normal" range does not mean that is adequate for you. The ranges are far too broad to be functional across their entire breadth for everyone.
Hullo. Thank you for your reply. I have the results. How do I attach them?
Click on your name and then try uploading it in the photo section of your personal page.
morning. I have attached the results. I hope they are clear and you are able to read the results. Look forward to hearing from you.
Having a hard time reading the lab report. Can you confirm the actual Free T4 number. It looks like it says below 1.
Hullo. The test taken 29/04/2015 says: TSH >100 (0.27-4.20); Free T4 is <1 (12-22) comments at the bottom read: the results are typical of primary hypothyroidism, determination of thyroid antibodies is recommended, if not already available. Then the test done on 17/07/2015 says: TSH 0.65 (0.27-4.20); Free T4 19 (12 - 22); Free T3 3.5 (3.1-6.8) comments at the bottom read: thyroid function is biochemically normal.
hope that helps. Thanks for assisting - much appreciated.
Results from after starting on the thyroid med are obviously improved but not yet high enough to relieve hypo symptoms. Your thyroid function may be biochemically normal, but you need for it to be clinically adequate. Your Free T4 is adequate, but your Free T3 is only at about 11% of the range, far too low, indicative of inadequate conversion of the T4 med to T3. Many members say that relief from hypo symptoms required Free T4 at the middle of its range, at minimum, and Free T3 in the upper third of its range. Note this info in the link following. "The TSH level tells us nothing about the physiology of a person on thyroid replacement therapy. In tests done about 24 to 28 hrs after their last daily dose, most people on adequate NDT therapy have a suppressed TSH. They usually have FT4 levels that are 1 to 1.3ng/dL, and free T3 levels that are rather high in the range or even slightly above the range. The higher FT3 level compensates for the lower FT4 levels on NDT."
http://www.hormonerestoration.com/Thyroid.html
So you need to add a source of T3 to your meds and gradually increase the dose until symptoms are relieved. Also, hypo patients are frequently too low in the ranges for Vitamin D, B12 and ferritin. Deficiency in either can cause symptoms that mimic hypothyroidism. Low D or ferritin can adversely affect metabolism of thyroid hormone. D needs to be about 55-60, B12 in the very upper end of its range, and ferritin should be 70 minimum. If you can get those tested, then you can supplement as needed to optimize.
morning. Thank you for that information. At least I know what the problem is now. I will have the test of the Vit D, B12 and ferritin done. I have two questions if you don't mind. 1. Do I need to make an appointment with an Endocrinologist in another city or can I sort this out without his/her assistance? Will my body weight go up? I don't mind my current weight but my muscle mass has gone. Thank you for take the time to help me. Have a great day.
You don't have to have an Endo. First, many of them specialize in diabetes, not thyroid. Then we find they are often very rigid in their "Immaculate TSH Belief" and only really pay attention to TSH, which doesn't work. If they go beyond TSH testing they also have a tendency to use "Reference Range Endocrinology", by which they will tell you that a thyroid test that falls anywhere within the range is adequate. That also is wrong.
You need a good thyroid doctor that will treat clinically by testing and adjusting Free T4 and Free T3 as necessary to relieve symptoms. Symptom relief has to be all important, not just test results, and especially not TSH results. So if you can use all this info and get a doctor to treat clinically, then together you can get what you need.
Body weight is affected by a number of things. Among those of course is diet and exercise. Also very important is resting metabolic rate (RMR), which is very much affected by thyroid levels. Once when my med, Armour Thyroid was taken off the market for close to a year due to issues with the FDA, I had to revert to Synthroid, and I became hypo again due to low Free T3. . In about 8-9 months I gained about 18 pounds, without changing anything else. When Armour was again available, I switched back and in about 8 months I lost all 18 pounds without any other change. So getting your thyroid levels optimized will just bring your RMR to normal, all other things considered, like diet and exercise.
thank you for all your help. I have found a new specialist physician (new to our city) and have made an appointment and I am going with my blood results and all the info from the website you gave me. Apparently this doctor has a special interest in thyroid. My appointment is 31 August 2015. I will keep you posted. Best regards..
I feel so terrible today. I am really afraid. The feelings of being breathless and tight chested that were coming and going and now permanent. It started yesterday here at work. It usually only came on when in the gym but yesterday I was just working at my desk and it came on. Along with it I feel lightheaded and dizzy. It took a while and eased off but came back during the night and today I woke up and it has not gone at all. I had some pur-bloka at home and took a half one with my Eltroxin this morning. The heart rate has slowed down but Im dizzy, lightheaded, my lips feel tingly and my eyes feel strange....I have a prickly sensation on my scalp and I feel tight and anxious and now I have heartburn which I have only ever had when pregnant and my appointment is only for the 31st. What can I do? I am so afraid because we live far out of town and it is weekend..........what the heck is happening to me? I cannot work like this and it has already cost me so much time off........
Is there a hospital or clinic that you can get to and let them try to help? The problem that I see in your Free T3 level being so low in the range. At 3.5 it is only at about 10% of the range, which is much too low.
Lacking that possibility is there any way you could get thyroid med with T3 without a prescription? Also, can you get Vitamin D3 and an iron supplement needed to raise your ferritin level?
I am going to try. Thank you. I will let you know how I do. Have a great weekend.
Great to hear, after all this time, that you have found a doctor that is willing to pay attention to symptoms and also test for Free T4 and Free T3. Before further discussion, please post your FT4 and FT3 results along with reference ranges shown on the lab report. Also, your Vitamin D. What dosage of Eltroxin are you taking?
I have reviewed your test results and noted the following. Your FT4 is at mid-range, which is adequate. As you have noted, your Free T3 is terribly low, due to inadequate conversion of T4 to T3. There are many different causes for this, including low ferritin, which you do not have. Many of us have found that FT3 needed to be in the upper third of the range, and adjusted from there as needed to relieve hypo symptoms. So you need to add a source of T3 to your med and raise dosage to get into the upper part of its range, and relieve symptoms. Here, Cytomel is a frequently prescribed T3 med, and there are also several generic versions listed as Liothyronine. Another possibility is desiccated porcine thyroid med sold here as Armour Thyroid and NatureThroid, among others.
In addition, Vitamin D is very important to thyroid hormone metabolization at the cellular level. D needs to be at least 50 ng/mL, so you need to supplement with 2000 IU of D3 daily and re-test after a couple of months to see if more is needed. Your B12 level seems adequate. I am somewhat puzzled by your high ferritin level, since other iron tests appear normal, so that is something to discuss with your doctor.
A good thyroid doctor will treat a hypothyroid patient by testing and adjusting Free T4 and Free T3 levels as needed to relieve symptoms. Symptom relief should be all important, not just test results, and especially not TSH results when already taking thyroid med. I say that because most often hypothyroid patients taking doses of thyroid med adequate to relieve symptoms find that their TSH is suppressed below range. That does not mean hyperthyroidism, unless you have hyper symptoms due to excessive Free T4 and Free T3. Many doctors don't understand that our bodies normally function with a continuous low flow of thyroid hormone which establishes an equilibrium among TSH, FT4 and FT3. and that when a hypo patient takes the daily dose of thyroid hormone all at once, the equilibrium is affected, such that an adequate dose typically will suppress TSH. I am sending you a PM with some info on that. To access, just click on you name and then from your personal page, click on messages.
You are very welcome. So happy to hear you are feeling much better. Now that you have a doctor that is willing to test and adjust Free T3 in addition to Free T4, and you supplementing Vitamin D, I am sure you will continue to improve until you are totally normal again.
Before commenting on your T3 dose, please confirm what dosage of T3 you were taking and how long on that dose, when the Feb. tests were done.
First thing to note is that you need to settle in on your daily dose of T3 and stay consistent with it for a while. It is not an immediate fix for how you are feeling at the moment. It takes 4-5 days to reach full effect on serum levels. Also, when you have been so sick for so long, it takes a while for your body to heal and reflect the full effect on symptoms. In other words, symptom changes tend to lag changes in serum thyroid levels.
Regarding your question about T3, you will have to stay on T3 meds unless something changes that causes you to start converting enough T4 to T3. Even if the conversion improves, I think you will always require some amount of T3. I haven't previously mentioned it, but if possible to get a test for Reverse T3 (and a Free T3 from the same blood draw), it would be good to determine the ratio of FT3 to RT3.
Hormone levels diminish as we age, requiring supplementation to maintain good function. What hormones are you taking and what brand are they? The reason I ask is provided in this link to a site of an excellent thyroid/hormone doctor.
http://www.hormonerestoration.com/Aging.html
Gastritis, or IBS, as sometimes known is a symptom that can be related to hypothyroidism. I have also had what the doctor called gastritis. It was a while ago and I think it was when I was going through a hypothyroid period. At any rate, after getting my FT4/FT3/RT3 levels optimized I have had no further problem with it.
I meant to mention that if not tested for cortisol, that needs to be done. Note the following info.
http://www.hormonerestoration.com/Cortisol.html