Why am I getting hypo again?

[1Kel12]

Hello,

I could use some help, I was feeling wonderful for 2 months and then hypo symptoms started again - not as bad as before but sleepiness and my weird throat issues and tingling extremeties.... fyi I am non-hashi's hypo.

Any ideas? Do I just need to increase my NDT a bit? I've been supplementing vitamins and iron and they look good now, perhaps my Vit D could be a little higher? I have also been taking a thyroid support which includes Selenium etc for 6 months now.

Labs below, thank you for your time! Kel


2016 Feb;
FT4 1.3 (0.8-1.8 ng/ml)
FT3 3.6 (2.3-4.2 pg/ml)
RT3 20 (8-25 ng/dl)

2015 Nov labs; (felt wonderful Nov/Dec)
FT4 1.4 (0.8-1.8 ng/ml)
FT3 3.8 (2.3-4.2 pg/ml)

Ferritin (10-200 ng/ml)
-2016 Feb; 119
-2015 May; 43

B12 (200-1100 pg/ml)
-2016 Oct; 2000 (high due to injections)
-2015 Aug; 203

Vit D, 25-OH (30-100 ng/ml)
-2016 Feb; 46
-2015 Aug; 32

DHEA (Saliva) (3-10 ng/ml)
-2015 May; 14

**adrenal panel very normal so not posting results

[1Kel12]

Thank you! That really helps to hear because I feel fine. I was surprised by my docs concern ...which then makes me uneasy. Working on Vit D, 10000 IU per day now, hoping that will do the trick.

Thank you for your time! Kel

[gimel]

It is quite normal for FT3 to be at the high end of the range or slightly above when taking enough NDT to relieve symptoms.   Along with that,  FT4 will be right around the middle of the range, like your result.  So I think you should be please with your current status, so hopefully your doctor is pleased as well and does not want to make any changes there.  I would make sure to get your Vitamin D up to optimal of about 55.  

[1Kel12]

My blood draw was at 11am, I took my thyroid the day before as my usual split dose; 2/3 at 6am and 1/3 at 3pm. I did not take thyroid the morning before my test. Thank you.

[gimel]

Before commenting further, I want to confirm whether you took your med the morning of the blood draw, and if so, how long after was the blood draw?

[1Kel12]

Hello, I am feeling well again but I still feel lost as to what is going on with me. I increased my NDT to 2.5grains as I needed to travel and didn't want to risk an unknown T3 med this was a short term solution my doc and I decided, along with some rhodiola and milk thistle to improve my RT3. Continuing my D3 supplementation and some healthy sun exposure.

2016 mid March; @ 5 weeks on 2.5grain.
FT4 1.4 (0.8-1.8 ng/ml)
FT3 4.5 (2.3-4.2 pg/ml)
RT3 20 (8-25 ng/dl)

So it seems my RT3 is fine now? but my FT3 is high, its another month later so 2 months on 2.5 grain and I feel fine, my BP a month ago was 95/60, low as usual.

My neck/arm issue has resolved yet again with a med increase and I am sleeping well, energy feels normal again, etc.

Is my high FT3 cause for concern? I don't have hashi's and I worry a bit about what is really going on with me sometimes.

Thanks for any advice, Kel

[1Kel12]

added;

No, I did not take my thyroid meds that morning.

[gimel]

I'd request addition of some T3 med to.raise FT3 level.
Also, do you.have test results on progesterone and estradiol levels?

[1Kel12]

I have progestone saliva results somewhere...lol. It was normal, mid range but I was and am on progesterone cream. No estradiol but it is likely high normal, and I will have higher end testosterone. Fyi I have had this hormone issue my whole life.

[gimel]

The only thing I would do right  now is ask for an increase  in your med dosage or ask for T3 med to be added.  also I would increase your  Vitamin D level.

[1Kel12]

Thanks Gimel, here you are....

I am on Nature-throid, 2.25grains.

I had my adrenals checked in July 2015, they said they were fine except
"transient elevation of DHEA" but no cause or concern.

fyi I have never taken DHEA only OTC progesterone cream.

If it helps, here is my full adrenal panel (saliva). My "graph" of results was a nice curve so they said it was good despite the higher mid day.

6-8am; 21 (13-24nM)
11-1pm; 11 (5-10nM)
4-5pm; 4 (3-8nM)
10-midnight; 1 (1-4nM)

DHEA + DHEA-S; 14 (3-10ng/ml)

Insulin - fasting and non; less than 3 (borderline elevated is greater than 3-11uIU/ml) (elevated 6-25)

Thank you, Kel

[gimel]

What thyroid med and dosage?
Do you take your med the morning of blood draw?
If not tested for cortisol, I highly recommend the 4 panel diurnal tests.  I suggest those because cortisol is an antagonist of thyroid and high levels will offset the effect of what might appear to be adequate thyroid levels.