# UPDATE: Doc says Thyroid numbers great, but I feel horrible. Help!



## aspaige79 (Jan 4, 2017)

I had labs run back in November (6-month check-up coming soon) and my doctor said everything looks great. I take 75mg of Synthroid and have been on this regimen for over a year. I had a partial-thyroidectomy in 2017. It was a roller-coaster to steady at feeling ok. But since I have never felt the same and have gained 25 pounds.

Lab results:

TSH: 1.41 (0.34-5.66)

FT4: 1.01 (0.52-1.21)

T3: 2.81 (2.20-3.80)

Antibodies: negative

No inflammation markers and no sign of rheumatoid factor.

Ferritin was 31 (30-200) and I have been taking iron (Ferritin currently 49) and have been told to continue taking iron.

I have had extreme fatigue- to the point of exhaustion. Overall I just don't feel well. Almost like I am constantly on the verge of the flu. My doctor has run so many tests: metabolic, thyroid, etc. and everything comes up great.

What are your thoughts on these numbers? I'm hoping some seasoned pros can shed some light. Maybe Cytomel would help? Or maybe I need to up/reduce my Synthroid??

Any help would be great. I'm at my wits end and need some input.


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## Lovlkn (Dec 20, 2009)

First things first -

You really need to get your Ferritin levels up. Low ferritin makes fatigue unreal - been there, done that. Try Floridex which is liquid , easily absorbed and easy on your system. I ended up opting for ablation as the perimenopausal/post thyridectomy hit to my bods as making Ferritin bounce up and down due to heavy monthly cycles. Now I am approaching over top range - with no additional iron supplements, other than what's in my food.

Your labs

FT-4 mid to 3/4 range (( .865-1.03)), your level is 1.10 which in my opinion is slightly high and a dose reduction of levothyroxine is what I would do.

T-3 , if this is a "total 3", your range numbers are very odd. Mid to 3/4 range would be ((3-3.4)) your result is 2.81 which would point to a poor conversion of your levothyroxine. Have you considered adding some Cytomel?. Free T-3 reveals the free and unbound thyroid where the total is usually a larger range and in my experiences harder to pinpoint a "good #"

Have they tested your Vitamin D levels? If so what are your results and ranges?

Have they tested B-12 levels? If so what are your results and ranges?

I have totally been where you are right now - {{hugs}}


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## aspaige79 (Jan 4, 2017)

Lovlkn said:


> First things first -
> 
> You really need to get your Ferritin levels up. Low ferritin makes fatigue unreal - been there, done that. Try Floridex which is liquid , easily absorbed and easy on your system. I ended up opting for ablation as the perimenopausal/post thyridectomy hit to my bods as making Ferritin bounce up and down due to heavy monthly cycles. Now I am approaching over top range - with no additional iron supplements, other than what's in my food.
> 
> ...


@Lovlkn thank you so much for responding!! Your input and kind words are much appreciated I find so much comfort in this board, even if it's just knowing that there are so many people out there feeling the same way.

My vitamin D was tested in November, too, and it was: 48 (range 30-100)

I've not had my B12 tested in years, so I will request that next month, too.

My T3 test is the T3 Free. Is that different from a total T3?

Thank you for the iron supplement suggestion, too. Low iron runs in our family, so I do really need to work on that.


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## Lovlkn (Dec 20, 2009)

> My vitamin D was tested in November, too, and it was: 48 (range 30-100)


Not horrible but could stand to be a bit higher - goal should be 75. I struggle to stay near 75 taking 5K IU daily. My Vit D levels seem to change alot which is odd to me. How much do you currently take?



> My T3 test is the T3 Free. Is that different from a total T3?


In that case - definitely give the Cytomel or lilothyronine (T3) a try. You will need to reduce your levothyroxine. Since you are taking 75mcg and the next step down is 50mcg - I would probably try reducing to 50mcg 2x a week ( like Monday and Friday) and see how it goes as far as labs. If you can - it would be good to test yourself 6 weeks, both FT-4 ad FT-3 into your new dose. Start with 5mcg of Cytomel or generic split in 1/2 - take 1/2 dose with your levothyroxine and 1/2 dose 6 hours later. Don't split a bunch of pills but rather just the 1 you will take for the day as splits are often not exactly 50/50. Find a small case to hold the extra 1/2 for when you will need it mid day.

Here's your goal -mid to 3/4 range would be ((3-3.4)) your result is 2.81

Also - don't forget that iron interacts with your thyroid hormone so be sure to space iron intake at least 4 hours from your thyroid pills.


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## aspaige79 (Jan 4, 2017)

Lovlkn said:


> Not horrible but could stand to be a bit higher - goal should be 75. I struggle to stay near 75 taking 5K IU daily. My Vit D levels seem to change alot which is odd to me. How much do you currently take?
> 
> In that case - definitely give the Cytomel or lilothyronine (T3) a try. You will need to reduce your levothyroxine. Since you are taking 75mcg and the next step down is 50mcg - I would probably try reducing to 50mcg 2x a week ( like Monday and Friday) and see how it goes as far as labs. If you can - it would be good to test yourself 6 weeks, both FT-4 ad FT-3 into your new dose. Start with 5mcg of Cytomel or generic split in 1/2 - take 1/2 dose with your levothyroxine and 1/2 dose 6 hours later. Don't split a bunch of pills but rather just the 1 you will take for the day as splits are often not exactly 50/50. Find a small case to hold the extra 1/2 for when you will need it mid day.
> 
> ...


I take 5000 iu daily of D3 and my current GP suggested that I cut back to 1000. I, too, thought my vitamin D was a bit low.

I will talk with my endo about reducing my Synthroid 2 days a week and trying Cytomel. You pose so many great suggestions! Thank you so much for taking the time to respond!!


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## GOLGO13 (Jun 13, 2018)

If you get a lot of sun in the summer, you may want to get tested for your Vitamin D levels more often. But really, over 100 is when it's an issue.

I also may need to try Cytomel, but not sure how easy it will be to find a doctor willing to do it. I have a new endo appointment coming up in a month.

Some things that helped me are 1) making sure I get enough calories each day 2) taking a good multivitamin (I take a whole foods 40+ mens) 3) Getting some regular exercise (at the least walking each day for 30 min) 4) managing stress...stress I think affects me more than anything. I like to do meditation and breathing exercises. https://www.tarabrach.com/is a good meditation site.

Ultimately I need to get my thyroid optimized though to truly be better.

Good luck! and stay positive.


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## aspaige79 (Jan 4, 2017)

Update:

Newest labs in:

T3 Free: 4.19 (2.20-3.80)

TSH: 1.51 (0.34-5.66)

Free T4: 1.14 (0.52-1.21)

I've been taking iron supplements for the past week and taking 5000 i.u of Vit. D3. Since increasing supplements I am starting to feel a bit better, but my body still feels out of wack.


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## Lovlkn (Dec 20, 2009)

> T3 Free: 4.19 (2.20-3.80) *((3-3.4)) goal*
> 
> TSH: 1.51 (0.34-5.66)
> 
> Free T4: 1.14 (0.52-1.21) *((.865-1,0375)) goal*


What meds were you taking prior to this draw? Did you take your meds prior to the draw? Is this draw time the same as previous times?

Goal's for lab results - between 1/2-3/4 of range which I edited in bold into your quote.

Your levels for both FT-4 and FT-3 are higher than they should be.

Taken from your initial post on this thread..



> I take 75mg of Synthroid and have been on this regimen for over a year. I had a partial-thyroidectomy in 2017. It was a roller-coaster to steady at feeling ok. But since I have never felt the same and have gained 25 pounds.
> 
> Lab results:
> 
> ...


How do you feel with the change in your lab's?

Were your meds changed from the 75mcg for this most recent lab?


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## aspaige79 (Jan 4, 2017)

Lovlkn said:


> What meds were you taking prior to this draw? Did you take your meds prior to the draw? Is this draw time the same as previous times?
> 
> Goal's for lab results - between 1/2-3/4 of range which I edited in bold into your quote.
> 
> ...


These labs were taken in the afternoon, which is not my normal time, but I had yet to take my Synthroid for the day. I did, however, ask my doctor if I could try taking 75 mg 6 days a week and skip 1 day to see if any improvement came about. Started doing this last week, so I'm only 1 week into the regimen. But it seems like I am currently overmedicated. What do you think?


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## Lovlkn (Dec 20, 2009)

> Goal's for lab results - between 1/2-3/4 of range which I edited in bold into your quote.
> 
> Your levels for both FT-4 and FT-3 are higher than they should be.





> T3 Free: 4.19 (2.20-3.80) *((3-3.4)) goal*
> 
> TSH: 1.51 (0.34-5.66)
> 
> Free T4: 1.14 (0.52-1.21) *((.865-1.0375)) goal*


Your FT-3 is crazy high for your FT-4 if you are taking T4 hormone only.

What supplements do you take and do you consume any large quantities of any certain food?


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## GOLGO13 (Jun 13, 2018)

I personally would have all of that tested again....to see if it was just an anomaly that your FT3 is strange looking.

Otherwise your numbers look good.


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## Lovlkn (Dec 20, 2009)

GOLGO13 said:


> I personally would have all of that tested again....to see if it was just an anomaly that your FT3 is strange looking.
> 
> Otherwise your numbers look good.


.

Going to have to disagree with you on the FT-4 results. Being above 3/4 of range is pushing it.



> Free T4: 1.14 (0.52-1.21) *((.865-1.0375)) goal*


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## aspaige79 (Jan 4, 2017)

I have an appointment with my end early May, so I think I will ask for a retest and see if there is a change. I did go to a different lab and my blood was drawn in the afternoon; I normally have blood taken first thing in the morning.

I don't consume large quantities of any specific food. I do take supplements, but not massive doses or anything out of the ordinary.


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## GOLGO13 (Jun 13, 2018)

Ahh...didn't notice that it looked that high. Although I understand FT4 can look high if you took synthroid before the test. Best to test and take your pills afterwards. So that could be providing a false high result.

EDIT...I see above you said you didn't take it yet. Interesting. Not sure I've seen a pattern like that before with T4 meds.


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## GOLGO13 (Jun 13, 2018)

It's possible your fatigue is from something else also. Maybe want to get some other things checked also...like a full Iron panel and ferritin. B12, etc.

Also consider getting your RT3 (Reverse) checked.


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