# my bloodwork came back today....weird



## kimis (Jul 16, 2011)

TSH 0.01 RR 0.40-4.50
T4, FREE 0.3 RR 0.8-1.8
T3, FREE 3.0 RR 2.3-4.2
T3, TOTAL 104 RR 76-181
CORTISOL, AM 14.8 RR 4.0-22.0
This is my first time posting here. I was hoping for opinions and advice on why I still feel hypo but my blood work sayd hyper. I should probably mention that I take 25mcg synthroid and 80 mcg cytomel a day. This bloodwork is weird right?


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## lainey (Aug 26, 2010)

Did I read 80 mcg of cytomel? That is a very high dose of a T3 only medication.

T3 medications tend to suppress the TSH and free T4 (make them low). Your blood work matches the medications that you are taking.

I am, however, quite surprised that your free T3 is not higher on that dose of cytomel. Your T3 could be a little higher in the range than it is, which is probably why you think you have hypo symptoms.


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## hochelaga (Jul 10, 2011)

Best to listen to more experienced members here but right off the bat I see that your FT4 is too low. Are you taking 80mcg of cytomel or is that a typo?


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## Lovlkn (Dec 20, 2009)

kimis said:


> TSH 0.01 RR 0.40-4.50
> T4, FREE 0.3 RR 0.8-1.8
> T3, FREE 3.0 RR 2.3-4.2
> T3, TOTAL 104 RR 76-181
> ...


First off... never dose by TSH. Did you take your meds the before you had these labs done? It's a good idea to not take meds before you lab to set a baseline.

Your FT-4 is too low. You need to increase your synthroid which will most likely cause you to reduce your Cytomel.

Did you make a mistake on posting your Cytomel dose?


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## Andros (Aug 26, 2009)

kimis said:


> TSH 0.01 RR 0.40-4.50
> T4, FREE 0.3 RR 0.8-1.8
> T3, FREE 3.0 RR 2.3-4.2
> T3, TOTAL 104 RR 76-181
> ...


Are you serious that you take 80 mcg. of Cytomel per day? I think you need rT3 (reverse T3); there may be some sort of antibodies at work here.

The main symptom of RT3 issues is that of hypothyroidism that won't respond to treatment. If this sounds a bit like Chronic Fatigue Symptom then that's not unduely surprising.

rT3
http://thyroid-rt3.com/whatis.htm

And what is your doctor's comment on this? Also,are you taking brand name Cytomel or generic?

Welcome to the board!


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## kimis (Jul 16, 2011)

I take 80 mcg cytomel....this is not a typo. I did not take my meds before my blood test. Every time I tried to increase synthroid I would have very weird side effects (throat swelling, crying, joint pain...ect) But cytomel seems to agree with me very well. I have tried armour, nathure throid and canada's thyroid with no luck...even tried a combo of natural and cytomel. I don't understand what is going on inside my body...I really just want to feel well again so I will try anything. I have been to a few rheumatologist but they found no other conditions and I follow a strict gluten gree diet because I have celiac disease. I see my endo on wednesday and I know she will want to lower my dose. I am out of ideas....what the hell is wrong with me?


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## Andros (Aug 26, 2009)

kimis said:


> I take 80 mcg cytomel....this is not a typo. I did not take my meds before my blood test. Every time I tried to increase synthroid I would have very weird side effects (throat swelling, crying, joint pain...ect) But cytomel seems to agree with me very well. I have tried armour, nathure throid and canada's thyroid with no luck...even tried a combo of natural and cytomel. I don't understand what is going on inside my body...I really just want to feel well again so I will try anything. I have been to a few rheumatologist but they found no other conditions and I follow a strict gluten gree diet because I have celiac disease. I see my endo on wednesday and I know she will want to lower my dose. I am out of ideas....what the hell is wrong with me?


Please ask your doctor to run the rT3 and did you go to the link I provided?


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## kimis (Jul 16, 2011)

Thank you for the link. I suspected rt3 and when off t4 completely for a while and felt worse after a few weeks, when I added the t4 back I started to feel better again. Because I take a high amout of t3 and a low amount of t4....wouldn't that interfere with the rt3 test? I had a rt3 test a week or so after stopping the t4 treatment while I was only taking t3....the results

t3 reverse 4 RR 11-32

I understand that a ratio between RT3 and FT4 is a good way to tell if you have a reverse T3 issue (STTM site) but my other levels were not checked when I had this test done.


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## lainey (Aug 26, 2010)

The theory says, that the treatment for reverse T3 dominance is to take T3 only for a period of weeks.

You are practically doing that now, and in addition you say that when you did take T3 only, that did not help.

I think you can drop the rT3 theory in relation to your labs--you are not going to be able to do anything about T4/T3 ratios unless you take T4 itself.

Your TSH and free T4 are in the correct place, bloodwork-wise, for someone taking such a high amount of T3 hormone.

Has anyone looked at your pituitary function for central hypothryoidism?

Chronic fatigue is a diagnosis of exclusion. If more thyroid medication is not helping, perhaps it is something else.


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## kimis (Jul 16, 2011)

I have had my pitutary hormones checked as well. I have a tumor on my pituitary gland but I am told it is not a problem. It has grown to 7mm, but it is not pressing. I don't think I have chronic fatigue syndrome because I am not tired all the time. If I was hyper I would be able to tell right? I was checked for lupus and lyme and all kinds of rheumatological things.


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## lainey (Aug 26, 2010)

>>I don't think I have chronic fatigue syndrome because I am not tired all the time.<<

Okay, but you said in the first post you felt hypo. Ummm, other than tired, what other major symptoms of hypo do you have that are a problem then? Many of the symptoms of subclinical hyperthyroid are the same as hypo. You really can't go by symptoms alone in that area, as they cross-over.

If you have a pituitary tumor, it certainly can be a problem in the sense that, your TSH readings may become unreliable in general. In that case, dosing would be to correct the T4 and T3 so that they fall into range.


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## Andros (Aug 26, 2009)

kimis said:


> I have had my pitutary hormones checked as well. I have a tumor on my pituitary gland but I am told it is not a problem. It has grown to 7mm, but it is not pressing. I don't think I have chronic fatigue syndrome because I am not tired all the time. If I was hyper I would be able to tell right? I was checked for lupus and lyme and all kinds of rheumatological things.


It is my humble opinion that you need that rT3 test and I certainly agree w/Lainey about the pituitary. Since when is something that should not be there not a problem? I swear. It most certainly could be affecting what is going on with your thyroxine replacement and such.

Please inquire about what could interfere with the rT3 test. I am not sure. Because you are taking a lot of T3 and I do suspect that most of that is by-passing cellular uptake and going straight to rT3. To me, I would think that you should take your Cytomel and take the test. We need to find out where 80 mcgs. of Cytomel is going; you know?

Mind you I am not a chemist nor am I a doctor.


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## kimis (Jul 16, 2011)

Hi! I just wanted to let you all know how my appiontment went. My doc dropped my cytomel to 70mcg because my TSH was too low. She said I am defenetly over treated and I could end up with osteoporosis or some kind of heart condition even though my heart rate is normal now. She thinks this will bring my T4 level up. I really don't think I am going to feel better on less cytomel, but I am willing to give it a shot because I like her. She said she just wants to get my TSH to a measurable place. I don't feel over treated but I also don't feel 100% better either so I will listen and pray and hope for the best. Thank you all for your input....I really appreciate it


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## Andros (Aug 26, 2009)

kimis said:


> Hi! I just wanted to let you all know how my appiontment went. My doc dropped my cytomel to 70mcg because my TSH was too low. She said I am defenetly over treated and I could end up with osteoporosis or some kind of heart condition even though my heart rate is normal now. She thinks this will bring my T4 level up. I really don't think I am going to feel better on less cytomel, but I am willing to give it a shot because I like her. She said she just wants to get my TSH to a measurable place. I don't feel over treated but I also don't feel 100% better either so I will listen and pray and hope for the best. Thank you all for your input....I really appreciate it


You are welcome; we are here if you need us. I guess your doctor did not think rT3 test to be important?


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## Andros (Aug 26, 2009)

kimis said:


> TSH 0.01 RR 0.40-4.50
> T4, FREE 0.3 RR 0.8-1.8
> T3, FREE 3.0 RR 2.3-4.2
> T3, TOTAL 104 RR 76-181
> ...


I have gone through all your posts; I still think you need rT3 (reverse) test and I now wonder if you have absorption issues re the GI Tract.

Feel badly that I can't pinpoint what the cause of having to take so much T3 is. You are a very little person to boot!!


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## kimis (Jul 16, 2011)

Andros, I am getting my new bloodwork on Monday. I'll just check off that RT3 test and post the results when I get them. If I had absorption issues I think my TSH wouldn't be this low...or is that wrong? I do think my free T3 should be higher than mid range when taking 70mcg of Cytomel. I don't know how to get my doctor to use free t3 and t4 as a guide and not my TSH. I really appreciate you taking the time to try to help me figure this out. I am unsure at this point if my symptoms are hyper or hypo. Could the symptoms I experience be a clue to what is wrong?


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## bigfoot (May 13, 2011)

kimis said:


> I am unsure at this point if my symptoms are hyper or hypo. Could the symptoms I experience be a clue to what is wrong?


Hello from a fellow newbie! As far as signs & symptoms go, you could experience nearly any of them, regardless of whether actually hypo or hyper. I have been likely over-medicated lately and am exhausted, still have dry/cracking skin, and all the fun fatigue and mood issues. I think they can give clues that something is wrong or not at the right level, but beyond that you need a doc and good testing.

hugs3


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## kimis (Jul 16, 2011)

My doctor switched me to NP Thyroid 45mg, brought my cytomel down to 55mcg and eliminated the synthroid. She will check my RT3 level in 3 months. I will start my new replacement hormones in a week or so....I am sick right now and I want to wait till I am feeling better. Wish me luck


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## Andros (Aug 26, 2009)

kimis said:


> My doctor switched me to NP Thyroid 45mg, brought my cytomel down to 55mcg and eliminated the synthroid. She will check my RT3 level in 3 months. I will start my new replacement hormones in a week or so....I am sick right now and I want to wait till I am feeling better. Wish me luck


Well; for Pete's sakes! I hate to hear you are so sick. Do you have a cold or the flu?

Sure will be anxious to see your rT3 when you get it done and I hope your med adjustment suits you.

Hope you feel better real soon!


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