I'm 27 and I've been on thyroid medicine for a little over a year now. I started out on Cytomel only (eventually increased to 75mcg, but still didnt help my fatigue and actually made me constipated and dizzy when standing too fast) because my labs were all within normal range but the doctor thought I could benefit from some T3 due to my symptoms and family history. A few months ago I still didnt feel the way I thought I should; could still use more energy and had the weight gain. I was put on 1 grain of Armour and 25 mcg of Cytomel. Well a few months of this and I didn't feel any better so I decided to try a new doctor who is an M.D. but with a more alternative side because I believe I have adrenal fatigue as well and my old doctor didn't believe in that.†
The new doctor gave me an IV of dmps for a heavy metal provocation test, and gave me Nature-throid to try (1 grain). The next day (while still on Armour even though I missed a full day's medicine) I had a blood test for my thyroid. There results were:
My heavy metals test showed no heavy metals, and I am still waiting on my saliva cortisol results to show if I have adrenal fatigue. About a week after being on Nature-throid, I started getting symptoms of what I thought were hyper symptoms (lots of anxiety/panic, nervousness, lightheadedness when standing or sitting up too long, some nausea, muscle weakness/fatigue in arms and legs, hypoglycemia symptoms if I don't eat in time, bad acid reflux, weird feeling in my vision-very hard to explain...no actual change in vision, not as tired etc.) so the next day I reduced both medicines to 1/4 of each pill, and the day after that I stopped the Nature-throid all together.†
While having these symptoms on Nature-throid and Cytomel, I went to my general practitioner to see if something else was going on. She did a metabolic panel and some other things which all came out normal except my thyroid results which were:
TSH: <.01 (.4-4.5)
Free T4: .7 (.8-1.8)
(this doctor wouldn't test free T3)
Over the next few days I started to feel better, but now I am feeling very bad again with the anxiety, nervousness, and weakness in arms and legs. I have been reluctantly taking a Xanax to help me sleep because the anxiety gets so bad until I can get to my original endocrinologist on Tuesday (today is now Sunday).†
My question is, does anyone know why all of my levels are so low, and if I should be taking my thyroid medicines? Could it be because my body was adjusting the the new T4 and I actually needed to increase my meds? I've been only taking 1/4 of my Cytomel which is 6.25 mcg because I thought these were hyper symptoms, not hypo. I can't stand this anxiety and I'm really worried something is very wrong like a pituitary problem! Please help, any info is greatly appreciated! Sorry for such a long post, thank you!
The National Institute of Health published an article in 2003 that states: "TSH determination is diagnostically misleading and only free hormone measurements are reliable for thyroid function assessment."
With that in mind, we will do what my thyroid-savvy doctor does: ignore TSH and look at your actual thyroid hormone levels.
Both your FreeT4 and FreeT3 were below-range for both sets of labs you posted - you are quite hypothyroid.
I suspect your FreeT4 level was always low and your doctor did not recognize this and just gave you Cytomel (T3 med). This could very well be the reason for continuing symptoms.
Nature-Throid and Armour are made from porcine thyroid which has a higher proportion of T3 to T4 as compared to human thyroid.
So, by you taking Nature-Throid or Armour along with Cytomel, you were getting an even higher amount of T3 than T4.
If anything, your doctor should have given you some levothyroxine/synthroid (T4 med) along with the Nature-Throid or Armour.
Endo Dr. Ken Blanchard does this in his time-tested dosing protocol that he discusses in his book "What Your Doctor May Not Tell You About Hypothyroidism".
So, while it's great your doctors wanted to start you on much-needed thyroid meds, it seems they were walking blindly in the dark.
Yes, symptoms are important but, the doctors needs to look at the actual thyroid hormone levels (FreeT4 and FreeT3) and make dosing decisions based upon those in conjunction with symptoms.
Most people feel best with their FreeT4 and FreeT3 levels in the upper half of the range.
A thyroid-savvy doctor will medicate so both levels get to mid-range and then tweak the dose(s) with the goal of complete symptom elimination.
For most of us, this will result in FreeT4 and FreeT3 levels in the upper third of the range.....some of us will feel better with slightly lower levels and some with slightly higher levels.
All what Sammy said.
Your TSH is low for no other reason than that you're taking T3. T3 suppresses TSH almost entirely. Ignore TSH now for evaluation of thyroid status.
You're very hypothyroid. Quite often, the symptoms of that will fool you into thinking you're actually hyper and vice versa. You can't rely totally on symptoms for anything, just as you can't rely on TSH. Your free T4 is actually below range. Your FT3 (when it was tested) was also low. Hypothyroid, all the way.
Yes, hopefully I'll get everything figured out tomorrow at the doctors. I'll say maybe I should just try Nature-throid alone with no Cytomel. This was supposed to be a well-known original thyroidologist! Guess that doesn't always mean anything haha. Thanks again for calming my nerves!