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Old 09-17-2003, 08:48 PM   #1
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Question SkyEagle, Meep -- advice

Sky Eagle, I know you've responded to my posts before about stating that I may not be converting T4 to T3 very well. My question, to anyone who will respond, basically is how do I tell if my body is not converting? I'm worried about taking T3 if I don't have a conversion problem because I am hypersensitive and prone to heart palpitations and apparently increased blood pressure as indicated by my recent posts.

On Levoxyl 75mcg on 7/31/03 my TSH was 5.185
Increased to 88mcg on 8/10/03 and on 8/20/03 I finally got someone to test my Free T4 and Free T3 which were:
FT4 1.59 (0.89-1.80)
FT3 3.0 (2.3-4.2)

8/10/03 88mcg every day then on 8/30/03 started taking it every other day due to palpitations and increased BP so on 9/15/03 my labs were:

TSH 7.437 (0.350-5.500)
FT4 1.27 (0.89-1.80)
FT3 3.0 (2.3-4.2)

So if I have too much T4 causing my BP and HR to increase wouldn't my FT4 be higher? And what about my FT3 remaining constant?

Free T$ on 8/1/02 (75mcg Levoxyl) 1.29 (same reference ranges as above)

I'm sorry to keep bugging everyone but I'm just trying to get an understanding of this in my head before I go to my new doc next week. I want to have my ducks in a row so to speak before he starts telling me what to or not to do, etc.

I'm just confused because I thought if I had to much T4 my labs would have gone up.

Also, what can make someone not convert T4 - T3? Besides liver problems?

Sorry for all the questions http://www.healthboards.com/ubb/confused.gif

 
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Old 09-17-2003, 10:58 PM   #2
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Ok your Free T4 is a reflection of how much is in your bloodstream that's usable. This includes whatever your thyroid is able to create by breaking apart your thyroglobulin proteins and the synthroid you take. As discussed in other posts, T4 is only a storage pro-hormone which gets converted to T3 when the active form is needed. T4 in and of itself has no effect in your body, unless you get too much of it, which will give you T4 toxicity symptoms along with hyperthyroidism because of the increased T3 getting converted.

I'm saying you have a conversion problem based on looking at your labs. Looking at your 9/15/03 labs, your FT4 is 1.27. To compare it to your previous labs, this number goes up as you took more Synthroid. This is completely understandable.

Your FT3, however is not fluctuating, and really was pretty low even if we look back at your 8/10 labs, where your FT4 was almost at maximum.

Your TSH is high too, which indicates your pituitary gland thinks you're not getting enough thyroid hormones.

My conclusion is that you're having a T4 to T3 conversion problem, but now that I think about this and look at it more, with your doctor wanting to lower the thyroid hormone so quickly (and up it so quickly) is that you REALLY need to get away from your doctor.

The dosages should be adjusted gradually, and you shouldn't be tested so frequently. It takes 6 weeks for a change in T4 dosage to be totally effective (at that dose). You were tested and changed on a monthly basis, which IMO is too fast for your body to adjust.

Your hypersensitivity and heart palpations and increased blood pressure are due to this shock of going too fast too soon - your increased dosage kicks in 2 weeks after they do the other test and increase it. The every other day thing is a good idea in the face of this information.

Going to the new doc is a good thing....hopefully he'll have a better grasp on this....start back at 75 if you were OK and then go more gradually on a 6-8 week schedule.

To address your questions specifically, all of your FT4 tests were in range. The fact that your TSH is high indicates you have problems. The FT3 is too low - you want it very near to the top (with time).

Conversion problems are very typical of hypothyroidism. They don't get the T3, so the T4 doesn't convert. Often, the addition of the T3 will cause you to be able to use more T4 for that very reason. Liver problems, lack of selenium, lack of T3, lack of adrenal hormones, is the basic list of what I can think of...

HTH, basically I think you just need to make sure the doctor will start back at 75 with you and then go slower (6-8 weeks per dosage change/test instead of 4 weeks).

 
Old 09-18-2003, 09:17 AM   #3
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So you're saying it doesn't look like I"m having hypersensitivity from too much T4? My Free T4 went down, not up, from 8/10 to 9/15 tests with the higher dose of Levoxyl.

Since I went on a higher dose of T4 and my FT3 didn't budge, so that makes it look like a conversion problem?

I didn't really up my dose quickly though. I had been on 75mcg for years and years and with the lab work done on 7/31/03 she then increased the dosage to 88mcg. With the episodes of increased bp and palpitations, (which started a week after the increased dose) she suggested taking it every other day. I'm the one freaking out with the symptoms and thinking it's too much so I went back down to 75 mcg day before yesterday because my doc office STILL has not called me back and I called them on Monday.

Do you think that the increased BP and heart rate w/palpitations could be my body ADJUSTING to the higher (needed) dose at 88mcg? I have been on that dose for 5 weeks now (well 3 weeks at every day and then 2 at every other day).

I was thinking that until I go to the new doc on the 26th of this month, I would take the 75mcg every day and add a multi vitamin with magnesium and selenium and just see how that helps with conversion. I know that it won't have been long enough on that when I go to the new doc but that's the best idea that I have.

And if they increase my dose the I just kinda have to suffer through the palpitations and blood pressure changes for at least 6 weeks??

Thanks for all your help. I've learned so much and am still learning.

 
Old 09-18-2003, 09:51 AM   #4
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Please explain what "T4 toxicity symptoms" are. I'm thinking that I am getting to much T4 because even though I am hypo my TSH is .049 (.350-5.5). My doctor didn't do a free T3, should I have him do that? My free T4-Thyroxine(is this free or total?) is 1.61 (.89-.1.76) and my total T3 is 1.58(.60-1.81).
My last T3 uptake was low 30 (33.0-45.0). Does this mean that I am having trouble converting T4 to T3? Any info would be appreciated.

[This message has been edited by dlkk (edited 09-18-2003).]

 
Old 09-18-2003, 06:35 PM   #5
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Well I am saying that exactly...that it's hypersensitivity...and that you probably need to take it slower...looking at what you posted, your FT4 went down from 8/10 to 9/15, from 1.59 to 1.27.

I'm saying to be very cautious, is all. the BP and heart palps signal HYPERthyroid symptoms, which means the FT4 at 75 could very well be right for you. Then again alternating the 75 and 88 may help you tolerate the dosages too.

Then again you may need your adrenals checked, since that helps in your toleration/absorption of the thyroid hormones. I know personally I feel when I get active like my body is "jump starting", my heart rate goes up and my BP probably goes up with it. But then again, my thyroid hormones are quite low (lower than yours, and a lower TSH than yours). Likely I do know I have adrenal problems. Maybe you are the same way?

All I'm saying is take it slow, and that 75mcg may be all you CAN tolerate for right now and you do need the T3 supplementation. Too high BP and heart palpatations are signs of problems. Sticking with the 75mcg and taking the multi-vitamin would be what I would do in your position.

HTH.

Quote:
Originally posted by poizngypsy:
So you're saying it doesn't look like I"m having hypersensitivity from too much T4? My Free T4 went down, not up, from 8/10 to 9/15 tests with the higher dose of Levoxyl. Do you think that the increased BP and heart rate w/palpitations could be my body ADJUSTING to the higher (needed) dose at 88mcg? I have been on that dose for 5 weeks now (well 3 weeks at every day and then 2 at every other day).

And if they increase my dose the I just kinda have to suffer through the palpitations and blood pressure changes for at least 6 weeks??


------------------

 
Old 09-18-2003, 06:44 PM   #6
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They can be indistinguishable from hyperthyroid symptoms sometimes, but basically what is meant by that, is getting too much T4 for your body to handle and not enough T3 - T4 in and of itself is inactive, but basically the T4 levels get too high for your body to cope with. This could very well be the case for poizngypsy as well in going to 88mcg. You basically get a mixture of hyper/hypo symptoms. Same idea occurs with Armour if you get too much of it...too much T3 not enough T4, and you get the hyper/hypo thing going again.

You want Free T3, Free T4, and TSH. You got the Free T4 value, but you got TOTAL T3.

Quote:
Originally posted by dlkk:
Please explain what "T4 toxicity symptoms" are.
[This message has been edited by Sky_Eagle1 (edited 09-19-2003).]

 
Old 09-18-2003, 08:27 PM   #7
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Thanks Sky_Eagle for your response. I think I am going to have my free T3 and TSH retested before making any med adjustments, which I think I need.

 
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