I am sure this is open to anyone's advice you were just trying to get a quick answer. But I will give you my opinion since I am puttering about at the moment. Do you have any suggestions as to why the T4 levels would drop from 22.4 (68.1%) to 19.3 (51.1%) or what I could do to bring it back up.
First some questions to ask yourself. DO you still have your thyroid and do you have Hashimoto's thyroiditis? Are you on any thyroid supplementation? Thyroid hormone production can be affected at many loops in the chain. The only thing that is standing out is that the ft3 level is steady and the FT4 level has dropped. The deviation is 15.6% between your latest Ft4 and FT3 result. This isn't too bad.. but it does hint and a T4 to T3 conversion imbalance. The question is why?
I felt better when the levels were higher.
Optimal range for childbearing females is 60-80% so speakest my MFM. I feel better around 70% in both my Ft3 and Ft4 levels. SO I understand where you are coming from. If I am at 50% I still have hypoT symptoms. I am not saying that if you are not on medication that you should jump on the thyroid supplemental band wagon at this time. That is a permanent step and must be thought over carefully. So refresh my mind on your status.. are you taking thyroid meds and if yes what and how much? Okay.. brain gas. Just noted the 112 mcg by the lab results. It is a blonde day and the Ac is one.. my thoughts float about the room as a result of periodic room cooling. I assume this is 112 mcg of a pure T4 supplement... noted.. and processing. I haven’t changed anything that I'm aware off and have consistent with vitamins, minerals, omega, exercise etc.
It may not be a diet or exercise thing. Our natural thyroid need and output fluctuates over time. Illness and stress have some effect, but over all the ability of our thyroid to output the needed T4 and T3 can change. This is especially true if you are genetically predisposed to be hypoT and still are relying on your thyroid for some of your thyroid hormone. In the case where T3 levels begin to climb higher than T4 levels.. there are two main issues that may be happening.
1) Adrenal fatigue or insufficiency. Low cortisol production will result in over conversion of T4 to T3. Tests for this are the ACTH, ACTH stim test, and Cortisol (blood AND saliva in my opinion). I am not saying this is what you have.. but it can be a factor given the numbers. If it is.. it is mild and early in the process.
2) Poor conversion of T4 to RT3 in the liver. For some reason your liver may have started to improperly convert you T4 into the inactive Reverse T3. Most of these cases the T3 levels are lower than the T4 levels.. this is not your case. The only thing I've noticed is at times my throat is sore, but not enough to bother me but just enough so that I know it's there. (upper part of throat)
The upper part of your throat is indicating a lymph node response to some aggravant. I can not say it is thyroid. It may be viral or allergic in origin. Thyroid pain and interference tends to manifest low in the throat at the junction of the base of the neck and your torso. Inflammation due to my thyroiditis causes issues with my swallowing and gives me a continual aching throb on my right thyroid lobe.. where my little nodule likes to make itself known. When I mentioned it to my doctor she said, you are still in the normal range. I’ve asked for a referral to Endocrinologist again and she has agreed to make a referral, but the waiting list for an appointment is a year.
Do not put all your eggs in the Endo's basket. They may not be helpful. So far I am batting zero on good thyroid managing Endos. Is there another specialist that would be helpful? My doctor suggested we try the home sleep apnea test, as the clinic wait time is well over a year.
Sleep hygiene and habits can affect your thyroid repair and work cycle. It is a known and documented fact. This said the only way to tell if you have one of more than 80 sleep disorders is to have a CERTIFIED sleep lab testing. The home tests appear to only test for hypopnea or OBSTRUCTIVE sleep apnea. there are many flavors of apneas. I have one.. my husband has another, and my son has both of ours. Sleep apnea does trend in families by the way. I also don't think this is the problem, I don't wake up gasping, startled, nothing like that. I’m still having a very difficult time with sleep, waking up repeatly at night and never refreshed in the morning, always tired.
THE GASPING AND CHOKING ARE NOT NECESSARY. Waking up more than once a night every night is a major indicator of sleep apnea. Snoring is not necessary for sleep apnea either. You should have a study done given your sleep issues. I've been taking zopiclone nightly, for the past couple of months and still wake up a few times a night - and this is a good night.
Sleep apnea.. ESPECIALLY obstructive sleep apnea is aggravated by sleep meds. You should get off of them until you rule sleep apnea out. Sleep meds prevent you from waking up as your body needs to do to an apnea event. Prescription sleep meds should only be prescribed after consultation with a sleep specialist and a sleep study has been performed. This is my personal opinion and the opinion of my sleep specialist who is a pulmonologist, internal medicine, and neurological sleep specialist.
The main issue I see here is that you Ft3 and T4 levels have fallen out of balance. This can be an indicator of adrenal issues, illness, poor sleep.. the list goes on.. I need a few answers before I can speculate further. Given your T4 supplement regime and an assumption that you still have your thyroid.. I think you might want to get your ACTH and Cortisol levels checked out. You may just have a cold or virus, but if a week goes by and the symptoms persist. I would get my adrenals checked out. Worse comes to worse.. you know how well they are behaving.
Aug15/08 - 112 mcg
TSH .138 (0.46-4.68)
Free T3 - 5.5 (3.5 -6.5)pmol/l -66.7%
Free T4 19.3 (10.0 - 28.2) pmol/l 51.1%
These labs look GREAT. They are optimal in range and balanced. These are the levels that my mom and her four sisters love to exist at... I would too if I could keep my Ft3 and Ft4 levels balanced.
May 15/08 - 112 mcg
TSH .144 (0.46-4.68)
Free T3 - 5.5 (3.5 -6.5)pmol/l - 66.7%
Free T4 -22.4 (10.0 - 28.2) pmol/l -68.1%
I wish I could have helped more.