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Old 09-19-2012, 05:04 PM   #1
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What direction can I move with these new results please?

Am on 62.5 thyroxine (up from starter dose 50) T4 only meds.

TSH has gone down from 1.5 ((.04-4) to .4 (.2-4.0)
FT4 is still 17 (15-30). Previous 17 (10-20)
FT3 4.5 (2.8-6.8) was 4.8 previously

RT3 just in from same test batch is 406 (170-450)

It really doesn't help that the ranges have changed though it is same blood draw place I go to?

My Ft3/RT3 ratio is 11.8 and should be above 20 ideally 23/24

Does this mean I have probs converting?
How much room to move have I got on TSH if I get a T4 increase without risking hyper?
Do I need T3 meds and what if doc doesn't agree if I do? They rarely if ever prescribe T3 in oz
I am trying to learn as much as I can before I go back and tackle these results but can't find anything on TSH going lower but Frees staying the same with just a slight drop! (well a huge drop if you use the new range they gave!)
Symptoms have not really changed much since I increased

Would love some input if you have the time thanks!!

Last edited by Administrator; 02-02-2013 at 10:17 PM.

 
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Old 10-25-2012, 03:57 PM   #2
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Re: What direction can I move with these new results please?

Hi surfing4answers,
My TSh moves up and down depending whether I am on BCP pills to prep for what my RE wants me to do and my FTs don't move around too much. Since my TSH on Synthroid was going past 2.x even though my FTs never moved, I had to do something. I,like you, was on 50 Mcg (Synthroid though) and I found that when I moved to 62.5 mcg, my FT4 started dropping a bit and my FT3 creeped up slowly but TSH dropped a bit. Still felt horrible. Moved up to 75 mcg and felt a bit hyper the first week and then on week 5 was really tired. TSH did not move much but just a tad lower but my FT4 decreased and saw a bit of a jump in FT3. Titrated to 88 mcg. and it took a weeknbefore I started to feel a whole lot better. I have a high FSH and hoping my thyroid will kick start more follicles in ovaries. Being on 50 mcg for 4 years prob. didn't help me at all since I thought the TSH was fine. It was my FT3 that was in the basement that made me so hypo. So if your TSH looks hyper, look at your Frees AND symptoms to determine if you need a higher dosage. My FT3 used to be 2.3 while the lowest limit was 2.2 and I never thought I would see an increase due to possible conversion issue. Cytomel never worked for me and I felt worse on it. . I was so reluctant because my Free T4 did not look like it needd a boost but after increasing, it looks like my FTs are starting to go in the right direction and at the same pace. I think it is now FT4 at 48% of range and FT3 at 39% of range where it used to be 80% and 5% respectively.

Last edited by librarygirl2; 10-25-2012 at 04:00 PM.

 
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Old 10-25-2012, 09:57 PM   #3
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Re: What direction can I move with these new results please?

Surfer: I believe that you should not have increased your T4 meds from 50 to 62.5 because your lab readings were good at 50. I'm guessing that you have hypo symptoms and they have not improved and may have got worse on 62.5. The increased T4 has pushed your RT3 to 20-30% above normal (above median value) and RT3 is inhibiting the action of your T3 and makes you hypo. If you increase your T4 meds you will only make the problem worse. The solution is to go back to 50 T4 with some T3 meds. Look for a compounding pharmacy and ask the druggist for the names of docs who prescribe T3.
Please post again if you want further expalnation...

 
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Old 11-01-2012, 02:28 AM   #4
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Re: What direction can I move with these new results please?

Hi Librarygirl2, thank you for your response! It is good to know that you had a similar experience with the TSH moving but the frees staying in or around the same values. So if I get your comments right (brain fog is shocking right now so bare with me ) my tsh at .4 is more hyper than hypo but its the frees keeping my symptoms so hypo. The tsh started at 7 so has dropped dramatically it my frees really aren't moving and like you I thought it was an absorption issue (RT3 is higher than it should be) we only have synthetic T4 broadly used here and doc's just won't prescribe T3 but I think I have found someone who uses armour style combined desiccated treatments. I gather you are T4 only with synthroid? And you are guessing another increase might shift the frees for me, I am afraid it will push the tsh too low and I am not sure how that will affect me?! My energy levels are rock bottom but some symptoms did go like hair loss and skin falling off my arms pretty attractive, also, which might be of interest to you, I was originally diagnosed early meno (thank god my family is finished) and every blood test showed I was in it but after 6 mths on T4 my new hormonal tests show it to have reversed which was pretty amazing! My cycle regulated for a few mths but has gone to the pits again now so I had new female panel done last week and let you know if that is still the case but I won't know for a few weeks until next appt. so I hope you get the same response thanks again for your input!

 
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Old 11-01-2012, 02:44 AM   #5
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Thumbs up Re: What direction can I move with these new results please?

Quote:
Originally Posted by telus View Post
Surfer: I believe that you should not have increased your T4 meds from 50 to 62.5 because your lab readings were good at 50. I'm guessing that you have hypo symptoms and they have not improved and may have got worse on 62.5. The increased T4 has pushed your RT3 to 20-30% above normal (above median value) and RT3 is inhibiting the action of your T3 and makes you hypo. If you increase your T4 meds you will only make the problem worse. The solution is to go back to 50 T4 with some T3 meds. Look for a compounding pharmacy and ask the druggist for the names of docs who prescribe T3.
Please post again if you want further expalnation...
Hi Telus, thank you for your answer but I am a little confused now. My original TSH last march when hashi was diagnosed via auto antibody test was 7 and I was put on starter dose which brought it down nicely, they did not do frees until after that which were and always have been what is posted above (though I need to point out that they are always done at the same place which for some reason changed the range which makes my F4 look a lot worse but it has always been 17ish) my symptoms improved slightly but the extreme fatigue and brain fog never left and go from almost manageable to some days chronic, body of lead, can't stay awake and brain just doesn't function. I used to have high blood pressure but this keeps going lower and my bps tabs are being reduced by the month, I don't know if this means anything but I never have hyper symptoms, no fast heart beat or high bp and I always have a body temp of 36.5. The continuing symptoms and frees are why the doc allowed the increase but I still have the same symptoms and some old ones came back. Why go lower again? Or is it only go lower while introducing T3 ? If that is the case I am hoping that the new doc I see later this mth will prescribe T3 also though I am wary that will open a can of worms as I tend to respond quite dramatically to meds! Except for T4 obviously! Thank you for your advice

 
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