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Avatar universal

hypoalbuminemia

Is hypoalbuminemia common in hypothyroidism? I have my plasma albumin level a little under the reference range. I am sometimes hungry and have craving for cream. My latest thyroid labs are as follows: Free T4 13.3 (ref. 12-22), free T3 5.6  ( 3.1-6.8).
At the beginning of September I had microcytosis, lymhocytosis and neutropenia. I had a period of easy bruising.

I am using Thyroid Erfa, but since the latest labs I have additionally taken a bit of Thyroxine tablet.
15 Responses
Avatar universal
It's not a symptoms we hear often.

Your FT4 is only 13% of range.  The guideline is 50%, but that can be difficult to achieve on desiccated.  Ft3 is at 68%, which is good.

I think the addition of a little thyroxine was a good move.  It should nudge your FT4 up a little.  
Avatar universal
New labs on  October 30:
Free T4 is 13.7 and FT3 4.8. FT3 has possibly dropped, because I  lowered the Thyroid dose a small bit. Should I increase more Thyroxine, and not decrease Thyoid? A doctor said that I should gradually aim to mere Thyroxine. I am not sure.

I had some infection in late summer. Additionally I have thought that I may have aphthous stomatitis many times per year. Recently I again had sores in my throat. My Lyme disease  is still uncertain. I have heard that hypoithyroidism could be caused by Lyme. Could the canker sores, too, be from Lyme disease? Immune system disorder.

A physiatric expert examined my feet and backbone and thought that I should have an MRI on my backbone and ultrasound study of the blood vessels in my legs.
Avatar universal
I think you could comfortably increase your thyroxine a little.  Have you ever been on thyroxine only before?

Some people have canker sores as a symptom of hypothyroidism.
Avatar universal
I was on Thyroxine for one year, and all my symptoms did not go away. When I was gradually changing from Thyroxine to Armour, they together were not good. Armour was better. Then I have a few times tested to add a small amout of Thyroxine to Armour or to Erfa Thyroid, and I think that it sabotaged the effect of the desiccated medicines.

In 2013, according to my Endo, I had to drop Thyroid from 150 mg to 120 mg. The lowering was very difficult and took almost the year. I have tried to increase the dose back for many times, but have not succeeded. I have many diseases, eg. infections, even Lyme is possible. That is why it is difficult to know what is the cause of my symptoms, the thyroid dose or the other diseases.

Because my free T4 dropped below the reference range in summer, I thought that I should add some T4 to my dose. I did not add a bit earlier than the change of September and October.

I have been losing hair for many months, similarly as in summer months of 2013. My situation is mysterious. I have been on thyroid medicines from December 2006, and still I have difficulties in adjusting my docing. My highest dose, 180 mg, was in early 2010, and I was fine, except fot AF. I had to dop the dose to 150 mg. If I think of the best time now, I may have been hyperthyroid. Now I may be more susceptible to dose changes than during the early years of the medication. The reason might be that my cells take the hormnones easier. But I feel that I am not as fine as I could be. I don't know what part of my symptoms are caused by my other diseases.

Even during the low thyroid hormone values I have had heart rhythm disorders: extrasystoles and episodes of SVT.

I cannot see my Endo earlier than near Christmas.
Avatar universal
How much Erfa are you taking now and how much thyroxine?

Why did your endo lower your dose from 150 to 120 in 2013?  Were you having hyper symptoms?  Why have you not been able to succeed in raising the dose again?

Did you have SVT prior to being on thyroid meds?  Have you ever asked your doctor about adding a beta blocker to your meds so that you can tolerate the higher dose of meds you seem to need?  
Avatar universal
Before this morning I was taking 60mg Erfa Thyroid and 6mcg Thyroxine in the morning and the same in the evening, total dose 120 erfa ans 12,5 Thyroxine.
In this morning I took 90mg Erfa and 12.5mcg Thyroxine.

When I have tried to increase my Erfa dose, then I have gathered water, my weight has begun to increase. It is the opposite to the normal reaction to dose increase. I don't want to gain weight and become puffy. I also became sleepy.

My vitamin D dose  has been lowered from 50 mcg to 25 mcg in August 2014 because of too high S-D1,25. According a doctor, high S-D1,25 can increase loss of calcium from bones. I am thinking wheter I have microalbuminemia in urine. Because I have hyperparathyroidism, it can affect to kidneys. My Erythrocyte size, MCV is always at the lower reference limit, often below. But my total hemoglobin is goos. Doctors say that I don't need extra iron.

My Erfa dose was 150mg from May 2010 to February 2013. In January 2013 I got atrial fibrillation and infections. Maybe some infection preceded the AF, and possibly caused(?) the AF. I got  cardioversion.

My Endo wanted to decrease the Erfa Thyr dose fron 150 to 120 in February 2013, merely to raise my TSH. I did not have symptoms of hyperthyroidism. TSH did not rise clearly. I think that I am still lost at the fork in the road.

I have not had SVT prior to spring 2013. I had lots of sinus tachycardia in the eighties. Long lasting AFs began in spring 2010, the second was in summer 2013 and the third in January 2013. Maybe, because early in 2013 I had lots of infectons, I got the first episode of SVT. I also got chronic pain around my left ear.

It was an internal medicine doctor, not an Endo, from whom  I myself asked Thyroxine. Recently she proposed that I could return to mere Thyroxine. T3-only medication has got here severe criticism. Some doctors who have treated patients with T3-only have even lost their permission to treat with that. Maybe desiccated thyroid medicines also get part of the criticism.

I am afraid of possible onset of AF. In the eighties many different beta and calcium blockers were tested for my sinus tachycardia. Atenolol is best and I am still using a small amount of it. I have lots of diseases. One doctor said that a sinle doctor cannot clear up my situation. Thus I myselft am holding the whole in my hands.
Avatar universal
When you increase your dose, it's not unusual for symptoms to get worse or new symptoms, like water retention and weight gain, to appear for a while until your system rebalances.  You have to give the new dose some time to settle.

"My Endo wanted to decrease the Erfa Thyr dose fron 150 to 120 in February 2013, merely to raise my TSH. I did not have symptoms of hyperthyroidism. TSH did not rise clearly. I think that I am still lost at the fork in the road."

Your dose should never be decreased simply to raise your TSH.  Once on meds, especially meds like Erfa with T3 in them, TSH often becomes unreliable.  As you have discovered, it sometimes goes down very low and doesn't come back up again.  It sounds like you were doing well before the decrease.  

Have you had more SVT episodes since cardioversion?

You do have a lot of issues going on.  So, it's hard to advise you what to do.  With a heart rhythm issue, T3 is not always recommended.  Perhaps that's why your doctor wants you to go back on T4.    
Avatar universal
"When you increase your dose, it's not unusual for symptoms to get worse or new symptoms, like water retention and weight gain, to appear for a while until your system rebalances.  You have to give the new dose some time to settle."
- You may be right, I should give more time to a new dose.

I have had different kinds of rhyhm disorders: sinus tachycardia, extrasystoles, atrial fibrillation, SVT. Sinus tachycardias (mostly during the eighties) have been treated with a beta blocker, atrial fibrillation cardioverted, one after six months and another after six weeks and the last after seven weeks with Marevan anticoagulation. SVTs are new, occur every now and then (appeared first when I was on 120mg Erfa). I can cure them with hard blowing against shut lips and nose (Valsalva manoevre). Sometimes I get SVT in our garden. I have had two worse SVT episodes when I have ben out on the town. After Valsalva manoevre, the SVT probalby changed to a longer sinus tachycardia. I had to go to see a doctor. Extrasystoles are not very frequent, but certain type of extrssystole can provoke SVT.
Avatar universal
As to hypoalbuminemia, albumin has been at the lower limit even bofore many years. In this autumn, I wanted to test also prealbumin. It was the same as the lower limit of the range. Prealbumin, also called transthyretin, is one protein which binds thyroid hormones.
Avatar universal
Ganglion cysts may cause carpal tunnel syndrome. I got a cyst in my left wrist in September. It causes sometimes tingling sensation in my fingers or pain in the wrist.

Does this suggest hypothyroidism?
Avatar universal
I wish I could tell you more, but while I know something about thyroid, I'm afraid all your other issues are totally out of my league.  With so many things going on, I don't dare comment due to lack of knowledge.

I used to have SVT (Wolff-Parkinson-White Syndrome), too, and I'm very familiar with controlling it with the Valsalva maneuver.  

So many things can be symptoms of hypothyroidism, but you also have many other things going on, so it's hard to say which symptom is from which.  I had carpal tunnel when hypo, but I've never heard of a cyst being caused by being hypo, which doesn't mean it's not related, just not something we hear about often.

The guidelines for FT3 and FT4 are 50+% and 50% respectively.  Practically speaking, people on desiccated thyroid often have a difficult time getting FT4 to 50% without getting FT3 too high due to the high T3 content in desiccated.  Your FT3 and FT4 that you posted in your original post are pretty typical of people on desiccated.  
Avatar universal
Thank you for your posts. I have desided to keep my dose at 120mg Erfa and 18.5mcg Thyroxine.
Avatar universal
I am feeling better now. I give the following link, because Lyme disease is possible for me.

http://www.lymeneteurope.org/forum/viewtopic.php?f=5&t=4617

Avatar universal
I have a new albumin result: 35.7 (ref. 36-45).

I have had a Mycoplasma infection early in this year. It left a few additional symptoms.  

My ionized calcium and PTH are above the refrerence. E-MCV has incresed to 84. It has long been at the lower limit of the reference or lower.

In early June my plasma cortisol was 179 (ref. 150-650). Previously it has always been over 300, and recently, on 31st July it was even 471.

Doctors have not paid attention to the low albumin. The albumin concentrations are fasting values. In every day I eat meat or fish and sour milk products, sometimes eggs, thus I am wondering why I could have shortage of albumin.
Avatar universal
How are you feeling?

I really don't know enough about these tests to comment.  While I can see whether or not you are "in range', if there's an art to interpreting these tests, like there is thyroid tests, I have no idea how they might be biased.

You might try posting a new thread to see if someone else can be more helpful.  Be sure to get your major issue into the title.
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