Discussions that mention synthroid

Thyroid Disorders board

I can't answer all your questions - but I can answer the cortisol test question - my cortisol from the blood tests ranges from 15-29 or 30 with a range similar to yours - from what I understand cortisol varies a great deal from morning to night so that may be part of the blood test variability. I had the dex suppression test too where you take the pill the night before - my result was 1 as well....the pill is supposed to suppress the production of cortisol by the adrenals. As I understand it, when the result is suppressed (like 1) as ours was, that supports the idea that the adrenal glands are functioning okay because they responded to the suppression. I also had a 24 hour urine test for cortisol which came back high so my doc attributed my rises in cortisol to stress and not to a adrenal gland malfunction. Some of this could be a little off - but that's what I understood from my experience.

Interestingly my blood test results look a lot like yours...my freet3 is low, but my freet4 is in the upper 1/2 of the range, and my TSH is completely suppressed <0.03 by my synthroid dose of 150 mcg (was undetectable when I took 112 mcg too). I don't quite know how to interpret this either....

I too have a multinodular goiter....

sorry I couldn't be more help....
hope you feel better and get more answers soon....
best wishes,
Thanks Kathy, does this mean I don't have an adrenal problem?

Your numbers, with the T4 being high and the T3 being lo, is a very common problems on this board isn't it? But isn't mine, being the reverse, very uncommon. Maybe we need to swap meds!!!ha

I would guess that I need more Levothyroid added to mine to balance T3 & T4. But what I don't understand...................the worse symptoms I ever had was when I was on 1 gr. of straight Synthroid.

Does the thyroid produce T4 AND T3, OR just T4, and the way you get the T3 you need is strickly from conversion?
Good for you for finding that! - so 1 gr = .1 mg of synthroid? Do I have that right? I think that would be 100 mcg - I understand not tolerating more than that - I had trouble I think when I got over 100 mcg with my heart rate getting high....also my BP was getting high (don't know if that was from gaining weight or the synthroid). I am now on a beta-blocker (atenolol) and that has brought my heart rate down to normal and my BP too and now I can tolerate 150 mcg without any problems. I too have some trouble with cytomel - I got really anxious - but I haven't tried it since I've been on the beta-blocker - probably should since I have low t3.

You might direct a thread to midwest about the low freet4 - she knows so much....I'm not sure what to make of it...my endo only does totals except for one time (in Dec) when I specifically requested the frees....my totals were always above the top of the range but my frees were different. That surprised me because I thought I was on a pretty high dose. It seems to take 150 mcgs to suppress my nodules. otherwise I can get pretty uncomfortable with choking sensations. Last summer they shrunk and he lowered my dose to 112 mcgs and a couple of months later it swelled up again, so I'm back on 150 mcg.

you gave me the idea so I checked the archive about t3 - I found the following:
A healthy thyroid gland makes BOTH T4 and T3 among other things (see the reference I linked to below for more information). T4 is converted by various tissues including the liver into T3. Most doctors assume that this conversion process is enough T3 for the body and that no more is needed. The problem is that for many of us, the conversion is not as efficient, and we need some additional T3. This could be due to liver problems, selenium deficiency, extreme low-carb dieting or many other things.
Also I found this which could explain partly why we couldn't tolerate cytomel, although my doc started me on 5 and worked up to 15....
It only takes a small amount of T3 to be beneficial in most cases, and many doctors overprescribe the amount. Start by lowering your dose of T4 slightly and then adding only 5mcg of Cytomel a day for a few weeks, adjusting from there.
T3 is used by the body faster and because of this, it works better if dosed two to three times a day for many people, though some do just fine on once a day.