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17309899 tn?1455663717

help with symtoms from thyroid labs

I am having awful fatigue and numbness tingling muscle pain latest labs tsh1.89 ft3 2.5 range 2.2-4.4 ft4 .7 range..6- 2.0 I upped my dose of naturethroid 7 wks ago 1/4 grain now taking 1.75 grains but my ft4 did not change my ft3 went down. any thoughts is my ft3 shouldbe higher andft4.I had RAI ten years ago for graves.



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Avatar universal
Your free T3 is at only about 18% of its range and Free T4 is only at about 7% of its range.   Both are much too low.  Members say that FT4 should be at least mid-range, and Free T3 in the upper half of its range, and adjusted from there as needed to relieve symptoms.  Also, with you not having a thyroid gland, the 1.75 grains is not anywhere near what would be considered an adequate daily replacement amount of thyroid hormone.  

A good thyroid doctor will treat a hypothyroid patient clinically by testing and adjusting Free T4 and Free T3 as needed to relieve symptoms, without being constrained by resultant TSH levels.  Symptom relief should be all important, not just test results and especially not TSH results.  

I say that about TSH because I expect that your doctor is adjusting your dosage based on your TSH level.  That strictly does not work.   For the majority of people taking adequate thyroid med, the TSH becomes suppressed below range.  You can read about this in Recommendation 10, page 13 in the following link.  

http://www.thyroiduk.org.uk/tuk/TUK_PDFs/diagnosis_and_treatment_of_hypothyroidism_issue_1.pdf

I recommend that you read also the first two pages, and you will find in Suggestion 6 on page 2, "TSH should not be used to determine the medication dosage."

Since hypo patients are so frequently too low in the ranges for Vitamin D, B12 and ferritin, if not tested for those I highly recommend it, and then supplement as needed to optimize.  D should be at least 50, B12 in the upper end of its range, and ferritin should be at least 70, and some sources say 100.  Tingling can sometimes be related to low B12.  

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