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  • Normal TSH/Borderline Low FT4

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    Old 12-02-2014, 06:37 PM   #1
    ktmac430's Avatar
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    ktmac430 HB User
    Normal TSH/Borderline Low FT4

    Hi y'all! So I was diagnosed 3 months ago with hypothyroidism. [[FT4: .74 (normal: .78-2.19) TSH: 1.41 (normal: .465-4.680)]]

    My symptoms included afternoon exhaustion, low energy, moodiness, weight gain/swelling, pain in my bones, and my feet staying so cold that they ached. I am only 27, work out, average/petite body size, and I was always energized so this has been a HUGE change in my life. I gained 19 pounds in 1 month while working out and eating very small portions due to my awareness of this quick weight gain.

    My Dr put me on generic synthroid. I was okay at first. A week in I began getting cystic acne breakouts all over my temples and down my cheeks to the point that they lasted a few weeks, scarred my face, and before I knew it, a new round of acne had begun to surface. (I had hormonal acne and it wasn't bad; this was totally new to me). A few weeks after that, I noticed depression, and zoning out while people were talking to me. I literally would stare a hole in the floor for hours. Fast forward to a week ago, one night I couldn't sleep, I had been worrying about things that I had never worried about before and began feeling paranoid.... So the next morning, I threw the prescription away!

    I feel back to myself mentally, and emotionally but i am starting to feel exhausted again, noticing the puffy face coming back, being hungry more, etc. I know my labs weren't normal but they weren't extremely off balance either. Has anyone had these side effects and tried to treat this alternatively without medication, or changed something and had better results. I just don't know what to do and my Dr is set on only treating with levothyroxine/synthroid 25mg.

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    Old 12-02-2014, 10:29 PM   #2
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    Re: Normal TSH/Borderline Low FT4

    Yes, your FT4 is "extremely off balance". It's below range, and that's completely insufficient. Healthy people have FT4 (and FT3) above lab median, which in this case is 1.5. Your body is screaming for the supplemental hormone. With the help of a cooperative and knowledgeable doctor, you can figure out a way to find something that works.

    OTC potions and herbal remedies won't do the job for hypothyroidism. The gland isn't making enough hormone, usually due to physical damage from thyroid antibodies. A damaged gland can't make enough hormone for the body's needs, so a prescription must take the place of that missing hormone.

    A 25 mcg dose is only a starting dose. It's not a true, therapeutic one. It actually can have the effect of worsening the hypoT, because it lowers TSH without raising FT4. The lowered TSH often will reduce the FT4 level even below what it was unmedicated. This should be corrected by raising the dose to 50 mcgs no longer than 6 weeks after treatment begins.

    Once treatment is started, it's extremely common to have a worsening of symptoms or the onset of new ones. The body has been short of sufficient hormone for a long time, usually. It's a sort of shock to the system when it finally gets some of the hormone it's been lacking for so long. It takes patience to weather this period. I've been through it. And in the time I've been a member here, I've seen it happen to at least a hundred others. Seriously.

    The acne could be related to what I said above... A new symptom related to the onset of treatment. But it would be smart and simple to just switch brands of levothyroxine to see if that might be causing it. Or... Also as I said above, it might have to be a matter of waiting it out.

    Successful thyroid treatment takes the help of a thyroid-smart MD. Too often, they're not. Generally speaking, your MD should have raised your dose to 50 mcgs after the first 6 weeks. He should be testing your TSH, FT4, and FT3 every 6 - 8 weeks and adjusting your dose until the FTs reach the upper part of their ranges. Any other approach - such as dosing according to TSH only, or providing only enough hormone so the FTs stay stuck in the lower ranges, or refusing to change brands or types of prescription hormones - is unlikely to restore your health.

    My advice is to educate yourself on all aspects of treatment. The more you know, the more likely you are to get what you really need. I can tell you now, though, you really do need the treatment. No one feels completely well with their FT4 below range.
    "We can complain because rose bushes have thorns, or rejoice because thorn bushes have roses." Abraham Lincoln

    Old 12-07-2014, 01:07 PM   #3
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    Re: Normal TSH/Borderline Low FT4

    I had the same T4 result you did (.74) when I was tested last month. It had been sliding from 1.10 back in 2003 to .90 in 2012. Back about 4 years ago, I started pushing my doctor for medication because my symptoms were bothering me and I have a family history of hypothyroidism--mother and five of her seven kids diagnosed so far, plus mother's two brothers--but my doctor was a numbers-only guy and the reference range for T4 at that lab is 0.54-1.17. My TSH had been bobbing up and down between 4.3 and 3.6 for at least the past 15 years. It was 3.7 last month (reference range is 0.340-4.820).

    I changed doctors just before I had my last test and kept my fingers crossed that the new doctor (a younger one) would look beyond the numbers. She did and I've been on 50 mcg levothyroxine since November 19. My next appointment is January 5th for a blood test to see how it is working. At first, I spent about a week scratching my very itchy skin, but no breakouts. Now that has gone away, my energy is slowly coming back, and it looks like my hair is getting better. It was falling out at an alarming rate over the past two years. So hang in there and get another prescription for the one you threw out. It takes time for the drug to build up in our starved systems. I wish you the best of luck.

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