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  • FT4 won't budge, FT3 keeps dropping - advice?

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    Old 03-28-2013, 07:00 PM   #1
    SickandTired31
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    FT4 won't budge, FT3 keeps dropping - advice?

    Hi all... you guys have been a wealth of information as I have been trying to get a diagnosis and then proper treatment of my hypo. I wanted your thoughts on my labs, if anyone is inclined to chime in.

    June 2010 (pre-sickness)
    TSH - 0.61 (0.4-4.5)
    FT4 and FT3 unavail.

    Feb. 2012 (just before starting meds)
    TSH - 2.25 (0.45-4.5)
    FT4 - 1.19 (0.82-1.77)
    FT3 - 2.7 (2.0-4.4)
    antibodies - negative
    AM cortisol - 46.6 (6.2-19.4)

    Latest labs (on 75 mcg T4 for about 7 mos.):
    TSH - .20 (0.4-4.5)
    FT4 - 1.2 (0.8-1.8)
    FT3 - 2.1 (2.3-4.2)

    Some of my symptoms have gotten better, others have definitely lingered. My TSH (largely irrelevant, I know) is back to normal for me, but my FT4 won't budge, and my FT3 keeps dropping! My other #s (cortisol, cholesterol, etc.) have gotten much much better.

    Advice? Should I push for a dose increase on the T4, ask for T3?

     
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    Old 03-28-2013, 08:52 PM   #2
    light472
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    Re: FT4 won't budge, FT3 keeps dropping - advice?

    All I can think of right now would be to get your Reverse T3 tested. Since you're being medicated on a rather "low" TSH, maybe your body is busy converting what it considers excess T4 into RT3, which could make your T4 stall and your T3 drop since more is actually being made into RT3.

    It's just something I read about and don't really know how to deal with though, just a hunch :/

    By the way, did your doctor decide to begin medication based solely on symptoms? I'm asking because your results were all in range and I have yet to meet a doctor who would remotely consider treatment in such a case. Not saying there's a problem with that, but I'm curious as to what brought to this decision.

    Also, lingering symptoms could very well due to an adrenal problem since there is a lot of overlap between thyroid and adrenals. My two cents ;D

     
    Old 03-28-2013, 09:07 PM   #3
    SickandTired31
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    Re: FT4 won't budge, FT3 keeps dropping - advice?

    The short version is, I was falling apart at the seams and felt like I had no control over my own body anymore. My fingertips were peeling like crazy, I had unexplained weight gain despite good diet/exercise (I am a gym rat - I was within the same 4 lb. weight range for 11 years before that), IBS issues, really bad edema in my legs, exhaustion, low body temp, low blood pressure, insomnia. I knew something was wrong, and so I started doing research and pressing the doctors for answers. I also cut out all the crap from my diet (no artificial sweeteners, little artificial preservatives) to rule out as much dietary factor as possible. My regular M.D. told me there was nothing wrong with me and tried to put me on lexapro. Went to an endo for a second opinion, who would not treat my thyroid issues because I was "in range," but ran a battery of tests for possible Cushing's disease because my cortisol was through the roof (I am guessing because of the stress on my body from the undiagnosed thyroid issue). I finally went to a D.O., who said he has patients like me who are "in range" but start on thyroid meds and feel better. He recognized that my TSH had quadrupled from my baseline, and agreed to give the meds a shot. I am on 75 mcg of the T4 now with no hyper symptoms, and a lot of my non-thyroid #s have normalized - cortisol back in normal range, dropped 60 points on my cholesterol, etc. So I certainly think I was hypo, even if my TSH said I was "normal." I certainly feel a lot better. I just can't get rid of some of the lingering hypo symptoms (fingertips are still peeling, fatigue, can't lose weight).

    Last edited by SickandTired31; 03-28-2013 at 09:32 PM.

     
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    light472 (03-29-2013)
    Old 03-29-2013, 08:03 AM   #4
    light472
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    Re: FT4 won't budge, FT3 keeps dropping - advice?

    Someone else should really confirm this, but my best guesses would be to check your Reverse T3 to make sure your liver isn't working against you, or to perhaps raise your meds since you are still having hypo symptoms and don't seem to have experienced any hyper symptoms. Plus your FT4 and FT3 are simply low, which would suggest raising your dosage (average is around 60-120mcg, with some going way beyond that)

    I believe most people end up with a TSH lower than their "baseline", and since yours was already pretty low, perhaps you'd feel better with a higher dose even if your TSH becomes suppressed (I don't think anything bad can come from a low TSH anyway).

    Not a professional and those are only my guesses. I haven't seen anyone with such a low "normal" TSH so I don't really know if this should affect your other results. Good luck getting to feel 100%

     
    Old 03-29-2013, 09:25 AM   #5
    SickandTired31
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    Re: FT4 won't budge, FT3 keeps dropping - advice?

    Thank you for the feedback! I agree, my normal TSH is very low, and I think I am very sensitive to TSH changes (my first symptoms appeared when my TSH went from 0.6 to 0.8). By the time I hit the 2.25 in Feb. 2012 (my highest ever), I felt horrible and was terrified that I would never get help. I realize I am incredibly lucky to have found someone that was willing to listen and try treatment in light of my "normal" mid-range TSH. I honestly don't know what I would have done without my D.O.

    Last edited by SickandTired31; 03-29-2013 at 09:30 AM.

     
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