for the past 6 years now, I have been extremely tired. It's very hard for me exercise, even though I miss it so much. I never get a refreshing sleep, my hands feet are cold 80% of the day, I have dark bags under my eyes and I always crave some type of carb. I started feeling this way when I was working out a lot and extrememly healthy. I can't figure out what is wrong, at all. I have a great new doctor and the labs below are from 8 weeks ago. My recent labs I will get in 5 days and I will post them, then. I'm also having another ZRT saliva cortisol test done this weekend. I'll post those results, as well. I've been through every test under the sun and don't feel any better and everything comes back fine.
I have taken my basal temp in the mornings (still in bed, left there for 10 minutes, glass-non-mercury thermo) and it's usually between 96.4 and 97.2. However, 3 hours after that it's between 98.3 and 98.5 for the rest of the day (3 times, every 3 hours).
Labs : I will post when I can, now, since I'm at work. I had a lot of lab work ran, so please ask if you would like to see something.
Ferritin was 130 (20-345)
morning cortisol was 19
Vitamin D was low 21 (30-100) (been taking 10,000iu of D3 for 2 months, now)
Reverse T3 was HIGH - 35 (11-32)
TSH - 0.95 (0.40-4.50)
Free T3 - 3.4 (2.3-4.2)
Free T4 - 1.3 (0.8-1.8)
I'm currently taking a multi, EFA-Omega 3's, Mag-chelated, D3, and 50 billion probiotic
Thanks!
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Last edited by AlwaysTired247; 12-29-2011 at 10:14 AM.
THY PER AB - <10 (Less than 35)
THY GLOB AB - <20 (Less than 20)
Iron was 118 (45-175)
TIBC was 312 (250-425)
I should also note that my doctor prescribed me Armour to try and see if we could get the Reverse T3 down, but I'm hesitant on taking it based on these labs... i thought it was my vitamin D for the longest time, but I still don't feel well after over two months on 10,000iu (yes I take it with a meal and cal/mag). I'll have to see what my labs are when I get them back for this.
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Last edited by AlwaysTired247; 12-29-2011 at 10:12 AM.
Sorry... I keep forgetting things (see... Brain fog!)
I always wake in the middle of the night, for no reason. I usually fall back asleep within minutes, but every single night, it never fails. (yes, I've been tested for sleep apnea and it was negative). I do tend to have anxiety and depression, but I've been on over 5 different types of SSRI's, and nothing helped.
Sorry for the reason you're here but, glad you found us.
First off, I only know thyroid stuff so, will defer to others in regards to your "non-thyroid" bloodwork.
I can tell that you had adrenal testing done - mkgbrook on here is very well-versed on adrenal issues. She's not always on here but, searching old threads of hers might prove helpful.
OK...one more comment before I comment on your thyroid labs
Please know that thyroid textbooks confirm that each of us has his/her own "setpoints". These are optimal thyroid hormone levels that meet the individual's specific needs.
Also, those same textbooks indicate that most healthy people have FreeT4 levels towards the higher end of the range....and FreeT3 levels above mid-range.
Unfortunately, based upon my experience and that of countless other thyroid forum members, it seems that most of the doctors we've seen were sleeping during thyroid class.
*But* there are doctors out there that "get thyroid" and it seems you might have found one.
OK..onto your thyroid labs:
I'll cover the easier ones first.
THY PER AB - <10 (Less than 35)
THY GLOB AB - <20 (Less than 20)
These are antibody tests for the antibodies most commonly seen in Hashimoto's thyroiditis, an autoimmune disorder that is the most common cause of hypothyroidism (the others being either medicine-induced or a rare pituitary disorder).
Just because you are currently testing negative for Hashi's doesn't mean you don't have it. Many people test negative for the antibodies. The only definitive test for Hashi's is biopsy. Since hypothyroidism is treated the same, regardless of cause, there's no need for biopsy. Hashi's might be evident if you have any nodules that get FNA'd....or a thyroid ultrasound reveals the cellular changes seen in Hashi's.
Now the thyroid function tests....
Reverse T3 was HIGH - 35 (11-32)
TSH - 0.95 (0.40-4.50)
Free T3 - 3.4 (2.3-4.2)
Free T4 - 1.3 (0.8-1.8)
You are a perfect example of the people endo Dr. Ken Blanchard writes about in his book "What Your Doctor May Not Tell You About Hypothyroidism".....suffering with raging hypothyroidism while having "normal" (aka in-range) labs.
However, if you think about the thyroid textbook concepts I shared with you, two things should be clear to you: 1. your levels aren't at YOUR setpoints because you are having obvious hypothyroidism symptoms and, 2. your FreeT4 level is smack at mid-range when most healthy people would have a FreeT4 level much higher and your FreeT3 level is just above mid-range (but is obviously too low for you)
Your rT3 is high because your FreeT3 level is low....this should correct itself with proper treatment.
Now, Armour is made from porcine thyroid that has a larger proportion of T3 compared to T4 than human thyroid. This can result in proportionately higher FreeT3 levels compared to FreeT4 levels. Most people are fine with this.
Those that aren't will still have hypo symptoms after their FreeT3 level has been optimized (towards the high end of the range). In cases such as these, the doctor can add some T4 in the form of Synthroid/levothyroxine to balance things out.
And, to help you understand your symptoms and know what to expect as you adjust to Armour and future dose increases, you might want to read this thread:
(waking during the night as you describe it is called "interrupted sleep" ....yep, pretty annoying - been there, done that)
Please know that it's entire possible to feel well while dealing with hypothyroidism. I have been symptom-free ever since I stabilized at my optimal levels. It's awesome.
We'll be looking for an update from you with your next set of labs.
Thank you SOOOOO MUCH For that awesome reply and info!
I will report back on Monday as to what my doctor said, recommends, what approach we're taking (most likely starting Armour) and what my lab results were.
Do you think I should ask for the Armour, or just T3?
Have a happy new year!
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Last edited by AlwaysTired247; 12-29-2011 at 01:22 PM.
Do you think I should ask for the Armour, or just T3?
Most people don't take T3 by itself.
You see, T3 is our active hormone. We do need a "base" of storage hormone, T4, to function properly.
Certain body systems (such as the brain and our muscles) need "fresh" T4 to convert to T3.
Since your FreeT4 level is actually proportionately lower in the range than your FreeT3 level, Synthroid/levothyroxine (T4) could very well be all you need.
However, many people fare very well with Armour so, if your doctor is willing to Rx it for you, I'd say take it.
Well, got my vitamin D up, but still feel the same. It's at 68.5 now.
Here are the rest of my recent labs
TSH 1.350 (0.450-4.500)
Free T4 1.39 (0.82-1.77)
Free T3 3.8 (2.0-4.4)
DHEA-S 344.1 (160.0- 449.0)
Reverse T3 371 (90-350)
My doctor still wants me to try the Armour, which I have (started taking today) based off my symptoms at this point (Still having cold hands/feet, 96.0-97.2 morning temps, and exhausted no matter what)
I'm not sure what else to do, at this point. She wants me to take 1/4 grain (15mgs... I believe) for 4 weeks-6 weeks, then retest and see how I feel and where my levels are.
15mg Armour is a very small dose....you might feel something and you might not.
But, with your labs, it's hard to find a doctor willing to help so, at least you have a start.
It would be a good idea for you to keep track of your symptoms so you can give a comprehensive report to your doctor.
Please realize that it's not uncommon for symptoms to worsen after starting meds...it's all part of the body's adjustment process to new amounts of thyroid hormone.
The best we can do is get labs every 6 wks. and continue to ask for dose adjustments until levels have been optimized.
My friend and I have both been hypo and on meds for 20 years. She recently started taking a time released T3 and said she has had significant improvement with her energy level. I personally haven't taken that, but she's been very pleased with how much better she feels. Not sure if you would need that, but it's something to consider just in case. Best of luck to you!
You see, T4 is our storage hormone and our bodies convert it to T3, our active hormone.
Your FreeT4 level is a measurement of all the T4 that is available for your body's needs....same concept for the FreeT3 level/T3 needs.
Your FreeT4 level is actually proportionately lower in the range than your FreeT3 level.
Right now, your FreeT4 level is at 60% of range and your FreeT3 level is at 75% of range.
Most people need both their FreeT4 and FreeT3 levels at least 60-80% of range.
For whatever it's worth, I need my FreeT4 level at least 95% of range and my FreeT3 level at least 75% of range to be symptom-free.
So, if anything, this means you could benefit from a T4 med (such as Synthroid/Levoxyl or their generics - levothyroxine).
Some of that T4 would get converted to T3 so, by taking a T4 med, you should see improvement in both your FreeT4 and FreeT3 levels.
Taking a T3 only med will increase your FreeT3 level and, due to a biochemical response, might actually lower your FreeT4 level.
Hmmmm... i get what you're saying, but what I'm concerned about is the high RT3. this is the second lab now in 2 months that has shown it being too high. From everything I have been reading and a few people I've talked to online, including one doctor, they believe that taking T3 will remove the T4 from my system, thus removing the high reverse T3 from my blood. They said this can be done in a matter of months, then lowering T3 until completely off, allowing T4 to rebuild naturally in the body. Not saying what you're saying is wrong, by any means... I'm just so confused with this. RT3 is the only thing showing issues in my blood work.
My friend and I have both been hypo and on meds for 20 years. She recently started taking a time released T3 and said she has had significant improvement with her energy level. I personally haven't taken that, but she's been very pleased with how much better she feels. Not sure if you would need that, but it's something to consider just in case. Best of luck to you!
Kab164:
Thank you for your reply!
I'm going to stay on Armour for now, at least until my next lab work (5 weeks). From there, I will see what my levels are and work with my doctor on possibly going T3 only.
Hmmmm... i get what you're saying, but what I'm concerned about is the high RT3. this is the second lab now in 2 months that has shown it being too high. From everything I have been reading and a few people I've talked to online, including one doctor, they believe that taking T3 will remove the T4 from my system, thus removing the high reverse T3 from my blood. They said this can be done in a matter of months, then lowering T3 until completely off, allowing T4 to rebuild naturally in the body. Not saying what you're saying is wrong, by any means... I'm just so confused with this. RT3 is the only thing showing issues in my blood work.
I'm back
This post isn't as long as my original attempt because I realized I was repeating much of what I said already.
I understand the concepts behind clearing high rT3.
Based upon my understanding of rT3 issues and related labs, I don't see you having one.....this is only my opinion.
If you are comfortable with what others have told you and, the solution can be achieved in a matter of months, you would know soon enough whether or not you have an rT3 issue.
This post isn't as long as my original attempt because I realized I was repeating much of what I said already.
I understand the concepts behind clearing high rT3.
Based upon my understanding of rT3 issues and related labs, I don't see you having one.....this is only my opinion.
If you are comfortable with what others have told you and, the solution can be achieved in a matter of months, you would know soon enough whether or not you have an rT3 issue.
What does your doctor have to say?
Sammy,
Sorry, been a busy weekend!
She is concerned, but only for the RT3 numbers not the other thyroid tests since like you said, everything looks just about normal. I'm still taking the Armour, but I'm not really sure what else to do, at this point. I guess just wait and see what the labs say when I get them back. It's getting harder and harder for me to be patient, at this point. Everything I try never works. It's so frustrating.
She is concerned, but only for the RT3 numbers not the other thyroid tests since like you said, everything looks just about normal. I'm still taking the Armour, but I'm not really sure what else to do, at this point. I guess just wait and see what the labs say when I get them back. It's getting harder and harder for me to be patient, at this point. Everything I try never works. It's so frustrating.
I just realized I missed your post - sorry.
I really didn't say everything looks just about normal.
While some people might feel well with your Free T4/T3 levels, they are at the lower end of the types of levels people need to be symptom-free.
As I mentioned, I wouldn't feel good with your levels - I need mine much higher in the range to stay symptom-free.
Since you do have symptoms, it's clear to me that your levels are too low for you.
Treating thyroid disease requires a patient patient.
Quite frankly, I'm not so sure what 15mg Armour will do for you - it's a micro dose. It just might lower your TSH enough to reduce your pituitary gland's stimulation of your thyroid to produce hormone. This could actually lower your thyroid hormone levels (FreeT4/T3).
When will you see the doctor next? And, what is the plan the doctor has for you moving forward?
Also, what have you tried in the past that hasn't worked?
I really didn't say everything looks just about normal.
While some people might feel well with your Free T4/T3 levels, they are at the lower end of the types of levels people need to be symptom-free.
As I mentioned, I wouldn't feel good with your levels - I need mine much higher in the range to stay symptom-free.
Since you do have symptoms, it's clear to me that your levels are too low for you.
Treating thyroid disease requires a patient patient.
Quite frankly, I'm not so sure what 15mg Armour will do for you - it's a micro dose. It just might lower your TSH enough to reduce your pituitary gland's stimulation of your thyroid to produce hormone. This could actually lower your thyroid hormone levels (FreeT4/T3).
When will you see the doctor next? And, what is the plan the doctor has for you moving forward?
Also, what have you tried in the past that hasn't worked?
The plan moving forward is to try a T3 only compound, slow release. How this will work, I have no idea.
Things I've tried before... hmmm... everything?? ;-)
I've been through so many studies (Heart, lung, sleep, allergies, Infectious disease) I've tried so many different supplements. I managed to get myself some cortef but it did nothing (even at 20mgs in a single dose)
The one thing I could never explain is when I took a vacation when this first started, it went away after 7-8 days. After being back home, it returned. This lead me to believe this was stress related, however everythign Ihave tried for adrenal fatigue left me exactly where I am... no where. I've tried every supplement out there. Probably have spent close to $3,000 on adrenal supplements.
Not sure what else to do, at this point. But, thank you!
Thanks for clarifying the various things you've tried....I wasn't sure if you tried some of the OTC thyroid preparations that are out there (and not too useful).
Since it's highly likely that you have Hashi's (the most common cause of hypothyroidism), there's no wonder the things you tried haven't worked since they didn't correct your hypothyroidism.
I can't explain why things were better when you were on vacation (although everything should be better when on vacation ).
It's really too bad that you haven't found a doctor that can recognize what is obvious to us. My labs were very similar to yours (without a rT3 test) when I started thyroid hormone replacement.
I must admit, I'm still liking the idea of you trying to find yet another doctor. Have you tried getting contact info from local pharmacists (including compounding pharmacists) for doctors that Rx Armour and/or Cytomel?
Doctors that prescribe these meds tend to be more thyroid-savvy. I will not deny that some doctors seem to get fixated on the rT3 issue but, I still believe from my research that correcting the hypothyroidism should take care of any rT3 issues.
Bottom line, you just might have better luck with yet another doctor. I think I told you I saw 4 different doctors (including 3 endos) before finding one that "gets thyroid". My situation isn't unusual - in fact, it's not uncommon for patients to see 6 (or more) doctors before getting a proper diagnosis/treatment.
Before the invention of thyroid blood tests, doctors diagnosed and treated based upon symptoms. The invention of the TSH test in the 1970's set things back a LOT for thyroid patients.
I wish you the utmost success with your new treatment - I hope you'll continue to keep in touch on here to let us know how things go.
