OK, I'm about to lose it here. I've been fighting this battle for quite awhile and I just can't get ahead.
Labs 3/29/2012
TSH: <0.01 (.4-4.5) LOW - Out of Range
Free T4: 1.6 (.8-1.8) 80%
Free T3: 3.4 (2.3-4.2) 57.9%
Reverse T3: 40 (11-32) HIGH
4/5/2012 - Synthroid kept at 175, Increased Cytomel 10 to 15
Labs 5/22/2012
TSH: <0.01 (.4-4.5) LOW - Out of Range
Free T4: 1.3 (.8-1.8) 50%
Free T3: 3.2 (2.3-4.2) 47.37%
Reverse T3: 39 (11-32) HIGH
I INCREASE MY CYTOMEL AND BOTH FREE T3 AND FREE T4 FALL??? I am in tears. My job has been super stressful lately and I just can't handle it, I am about to quit or get fired and then I will have financial stress.
Do I need to be looking in to why my thyroid keeps slowing dying off? I thought as you got older you needed less? Granted I am only 44 but I feel a wreak hormonally and can't imagine what it will be like to go though menopause.
Any words of advise?
The following user gives a hug of support to Heckofagal: Eir33 (06-05-2012)
As you might know, it's not uncommon to happen. I don't think there is a mysterious reason as of why your thyroid is producing less, this is a common thing to happen with Hashimoto.
Due to a biochemical process it's not uncommon for FT4 to fall when adding T3either.
A little note, one might need less when growing older 1) will depend on the person 2) 44 is not even close to that category.
Yes, I was wondering if my FT4 might fall a bit, didn't think it would fall that much...and I certainly did not expect my FT3 to fall when I just had a Cytomel increase.
I've just been so sick for so long and people don't understand why I don't see a new dr. I know a new dr. is not going to keep my thyroid from dying off and most dr.s are not as accomodating as mine.
That happened to me too, although I increased my T3, my FT3 decreased till it increased. sometimes thyroid has it's own logic.
Sometimes understanding only goes that far. If one thinks about it, it's hard for others to understand, if one has not experienced it oneself. As far as the understanding with regard to doctors go, people are used to going to the doctor and he/she will solve things, it's a safe and comfortable thought, yet unfortunately not always reality.
Sometimes people are only used to taking something like an aspirin and have no clue about such a thing as meds titrating process. Maybe if you explain somethign to the extend that you need to replace your thyroid (an organ) with medication, that your body needs to time to adjust so only can be done in little adjustments (even more since it's very individual and not to be predicted how much you'll end up needing), each adjustment needs 6 weeks to stabilize in the body and after that the next adjustment can be done. That timeframe might help some understand why it takes long to get anywhere. (another doctor cannot speed that up).
Other then that , if you have a good doctor, please know that for yourself. as said earlier, sometimes understanding only goes that far. Well meant comments (done out of caring) sometimes just don't suit the thyroid picture.
Your sinking levels despite an increased dose could be accounted for by dwindling function of your thyroid due to antibody activity. In hashimoto's the antibodies are going to kill off the thyroid and they can do their work in fits and starts but they will eventually get the job done. They are not quitters!
Also depending on the time of day that you had your labs, your results may vary. And, whether you had started any other med/supplement or started eating more fiber or something else that could block your thyroid med could also be another factor.
It may be one factor that caused you to have more hypo results even with increased meds, or it could have been a combination of several factors.
Are you like clock work about taking your meds at the same time and like clock work about when you then eat after taking meds? If you changed your habits about taking meds that too will affect the results.
And, finally you would hope that your t4 and t 3 meds had the usual potency. I have been informed by a pharmacist that thyroid meds go off quicker than other meds and thus on your med bottle you should see a quicker exp. date. There have been inconsistent batches of thyroid meds and product has been recalled.
Your sinking levels despite an increased dose could be accounted for by dwindling function of your thyroid due to antibody activity. In hashimoto's the antibodies are going to kill off the thyroid and they can do their work in fits and starts but they will eventually get the job done. They are not quitters!
Also depending on the time of day that you had your labs, your results may vary. And, whether you had started any other med/supplement or started eating more fiber or something else that could block your thyroid med could also be another factor.
It may be one factor that caused you to have more hypo results even with increased meds, or it could have been a combination of several factors.
Are you like clock work about taking your meds at the same time and like clock work about when you then eat after taking meds? If you changed your habits about taking meds that too will affect the results.
And, finally you would hope that your t4 and t 3 meds had the usual potency. I have been informed by a pharmacist that thyroid meds go off quicker than other meds and thus on your med bottle you should see a quicker exp. date. Also there have been inconsistent batches of thyroid meds and product has been recalled.
Thanks Lisa - i think most of my family and friends just hate to see me suffering and want me to be better. Unfortunately some people just don't understand how it all works. And some of those people are even hypo but take their little pill and feel fine so don't understand why I don't work the same way.
Azuree - I take my meds first thing in the morning and always wait at least an hour before eating. No new meds or foods that would affect absorbtion. And this year I've started to make sure I go to the same lab first thing in the morning before I take my meds everytime I get bloodwork so I know I am comparing apples to apples.
Evidently my thyroid gland is just dying off and I wish it would just bite the dust already. I have already asked my dr. for a Synthroid increase...I just hope this is the last one for awhile.
"And some of those people are even hypo but take their little pill and feel fine so don't understand why I don't work the same way."
I am really happy for those people who have it easy with being hypo. I have run into a few of them as well. I knew one person that called her synthroid pills, happy pills. Well, synthroid never made me happy! For years I plodded along with synthroid and only recently with the addition of armour have I felt the beginning of what I hope will be something much better.
I also knew someone else who just said how it was easy for her....she just popped her pill and was fine. I was incredulous.
It makes me wonder whether that is the majority of people or the very tiny minority. Anyway, certainly not my experience.
Azuree
Heckofagal- what time of the month did you have your levels checked? I find that my Free T's are higher on cycle day 1-3 and lower later on in the month when estrogen levels are higher (they bind hormone, so you become more hypo).
If your first levels were taken on cycle day 1-3 and then next set were taken later in the month (which could make sense if you are checking every 6 weeks), that could explain the drop in free T's.
I would recommend checking your blood at the same time of the month as well as all the other stuff you are already doing consistently. This may mean getting checked every 8 weeks, instead of every 6.
Actually- I just glanced back at your labs and it looks like there was just under 8 weeks between your bloodwork- not sure if they were at the same time of the month???
Do you have TSI antibodies? Wondering why your TSH has always been so low, even before being medicated. Did they rule out central hypothyroidism?
I should add- my estrogen levels start to rise dramatically at around cycle day 4 (based on BBT), so I would recommend testing on cycle day 2 for consistency. It's not going to show your most hypothyroid state, which would be closer to mid-cycle, but I think it may be more consistent. Maybe you are doing this already.
No, I don't keep track of what day in my cycle the bloodwok was done. I've never heard that theory. And actually I started meds 6-7 years ago after it was discovered that my TSH was 7.1. It has only been suppressed After adding cytomel. Not sure what my antibodies are at. They were tested early on but were not out of range. My doc said it did not matter, that I most likely had hashimotos and the treatment would be the same regardless.
Well, I think it could make a difference, based on my own anecdotal data.
I had my TSH, FT3 and FT4 tested after 6 weeks on synthroid (25 mcg) and it was 7 days after ovulation (high estrogen).
TSH 3.31
FT4 1.2
FT3 2
T3 72
After 30 mg desiccated thyroid (in which my T3 should have gone up), my results were as follows (cycle day 2)
TSH 2.03
FT4 1 (down, probably due to T3 addition)
FT3 2.5 (up)
T3 78 (similar)
As you can see, my T3 total did not really change, even though FT3 was higher, probably because I had my levels checked when my estrogen was low- so lower total T3 and higher FT3. I am sure that if I had checked it later on in the cycle, FT3 would have been lower and T3 total higher.
I think it's one more variable that could make a difference. I don't know that I would attribute further destruction of the thyroid as the cause, since the tests were so close together.
Bee - are you basing this solely on your own experience comparing 2 lab tests? I do believe our cycles have an effect as when I am hypo normally those few days before I start my period are the worst. I've just never heard any professionals recommend testing the same time each month. Guess I would have been really confused years ago when I was hypo and skipped a few periods.
I believe my results indicate further destruction of my thyroid because this will be my 7th increase in meds in the past 18 months and my free t's are at 50% and below and I definitely have hypo symptoms (even at the beginning of my cycle).
I found a helpful article from the Nat'l Acadamy of Hypothyroidism about transport. It talks about reasons for cellular resistance to transport of hormone. Very interesting what conditions are proven to slow down transport.
Rhaquel - I read the article and it was kind of hard for my hypo brain to keep up. The article seems to back up much of what I have already experienced; stress having negative impact, T3 supplementation being beneficial. However the article discussed having hypo symptoms with good labs but my labs are not at their optimal point. And my reverse T3 has been elevated.
The article did mention something about high reverse T3 being associated with hyperthyroidism. And I wonder if that has any explanation to my issues of heat intolerance this past year. I don't remember ever having issues with that before, even when previously hypo, but I guess my previous episodes of being hyper were normally fall/winter. And I've seen this listed as a hypo symptom before, but I always thought it was more of a hyper symptom.
Last edited by Heckofagal; 06-04-2012 at 08:06 AM.
I'm sorry I don't have enough knowledge under my belt to know, only recently started trying to understand when a psychiatrist brought it to my attention that I wasn't being adequately treated.
Now I've researched and gone to a doctor recommended on a site.
My TPO rose from 1000 to 1700 in a month, and she has put me on a supplement called THYTROPIN PMG. I have posted a question about it a few days back on another thread and got a very positive response. It's a bovine thyroid extract, and the purpose is to trick the antibodies into attacking it instead of me. Hope the theory works.
I'm sorry, I know it's awful when people don't understand, and want to make us feel like hypochondriacs, because we got dealt a tough hand. Why can't we make them feel it for 3 weeks when they backslide on compassion? Now that would be a better world.
OK, asked my doc to raise my synthroid from 175 to 188. She does not want to do that since my reverse t3 is still too high, but offered to raise my cytomel (I assume from 15 to 20). This is soo not what I wanted to do but told them to call in the refill since I definitely need some sort of increase. Thoughts?..... Opinions?
Hi heckofagal. i just don't know enough about it. maybe someone will read that can understand what the ratios mean. I'm just relying on my doctor and hoping she gets it right. She does listen to my symptoms and base the decision of going up on thyroid on whether or not I'm tired. I've read in various places that that is the way to do it right.
I have fibromyalgia, and that is another condition with intolerance to temperature extremes. I am quite warm in the trunk of my body. I don't remember feeling that before, so it almost feels wrong. It is probably just that I'm getting it right for the first time in so long. having to pay for more air conditioning now, but that's good.
Labs 5/22/2012
TSH: <0.01 (.4-4.5) LOW - Out of Range
Free T4: 1.3 (.8-1.8) 50%
Free T3: 3.2 (2.3-4.2) 47.37%
Reverse T3: 39 (11-32) HIGH
I can understand your request to increase your Synthroid since your FreeT4 level *might* need a little help (most people need a higher FreeT4 level but, some would be fine with yours).
And, I'm guessing you're hoping that your body will be able to convert that extra T4 into the T3 you obviously need based upon your lowish FreeT3 level.
Obviously, the Cytomel increase will help your FreeT3 level.
Some people would be fine with a proportionately higher-in-the-range FreeT3 level compared to FreeT4 level (as in, most of the people taking Armour/desiccated thyroid).
I know you've had more than your fair share of struggles but, there's a chance the Cytomel dose increase will help you.
If you knew your optimal levels (and they haven't changed), that would help a lot. If my memory serves me correctly, you don't know them - please correct me if I'm wrong.
Hi Sammy - thanks for popping in. I thought it would be best to increase BOTH my freeT3 and freeT4, that is why I thought a synthroid increase would be best. The person that called me said the dr did not want to increase synthroid because my T3 was too high (pretty sure she meant reverse T3). But I guess the thought is that more T4 would only create more reverse T3.
And I'm not exactly sure of my optimal levels as i have not felt optimal is quite awhile. However, I do recall years ago when I felt really good right after the labs listed below (this was before I began testing at the same lab everytime before taking my meds so we are not exactly comparing apples to apples).
I recall that memorial weekend (may 31) I felt great. Cleaned the whole house and went on a bike ride where I outlasted both my kids. Right now cleaning the bathroom would wear me out and I would not dream of even trying to get on a bike with my dizziness issues. Plus stepping outside in the heat makes me feel really bad.
