# More Labs and at Standstill



## haimia (May 9, 2012)

*I had TT in August 2012 due to possible hashi's and nodules causing swallowing issues. I was put on synthroid 150 in September 2012 and saw endo in November (labs still very low normal range) and was told by endo "see ya in March 2013". I was still feeling lousy in January and had family doctor run labs. Hypo! So, synthroid was increased to 175. I had labs done 3-13-13:
TSH 3.4 (.4 - 4.2)
FT4 1.28 (.89 - 1.76)
FT3 2.59 (2.2 - 4.0)

I was still feeling crummy! I asked to have a note to doctor asking to lower my TSH and to get my FT4 and FT3 into the 75% of range area. Is this correct?

I do have to admit that I had surgery on 3-6-13 to remove prior metal works, remove a disc and add metal work in my neck. Yup, that is three surgeries in the neck area in the span of less than two years!!!! Incisions for all three surgeries in the same spot. My neck looks like Frankenstein's doctor got a hold of it! However, labs are still not up to snuff!

Well, doctor had me increase synthroid by adding 150 more on Sundays and 175 on everyday. Ugh. Retest, again, in six to eight weeks.

May 15 labs were:
TSH 0.0065 (.4 - 4.2)
FT4 1.25 (.89 - 1.76)
FT3 3.01 (2.2 - 4.0)

I have discussed adding a T3 med with my family doctor and she seemed favorable to doing something, but that was back in January. Now, she will not change my meds because if she does at my current TSH level, I will go hyper. TSH is not a thyroid hormone, correct? My FT3 and FT4 are below the 2/3 or 3/4 range that most say they feel best, correct? I am still tired, hair falling out and cannot lose any weight (tried for three weeks, counted every calorie that went in mouth and walked and lost nada!)

So, at this point I am stuck. Will more time on current meds help with the symptoms. Only family doc was willing to consider other options. Endo in area is TSH based and it looks like family doc is really TSH based also. Help!*


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## Andros (Aug 26, 2009)

haimia said:


> *I had TT in August 2012 due to possible hashi's and nodules causing swallowing issues. I was put on synthroid 150 in September 2012 and saw endo in November (labs still very low normal range) and was told by endo "see ya in March 2013". I was still feeling lousy in January and had family doctor run labs. Hypo! So, synthroid was increased to 175. I had labs done 3-13-13:
> TSH 3.4 (.4 - 4.2)
> FT4 1.28 (.89 - 1.76)
> FT3 2.59 (2.2 - 4.0)
> ...


TSH is a hormone BUT...................at this point it should not be used to determine what you need. You do need T3 supplement. You cannot heal w/o it and you have had several surgeries so this is critically important.

If it were me, I would find a doc who agrees to try you on T3. You will get better so much faster. It makes little sense to keep on raising your Synthroid w/little results.

Here is some information to help you advocate for your self.

Understanding the Thyroid: Why You Should Check Your Free T3
http://breakingmuscle.com/

Dr. Mercola (FREES)
http://www.mercola.com/article/hypothyroid/diagnosis_comp.htm

Free T3 and Free T4 are the only accurate measurement of the actual active thyroid hormone levels in the body. This is the hormone that is actually free and exerting effect on the cells. These are the thyroid hormones that count.


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## haimia (May 9, 2012)

*I have appointment with rhuematologist tomorrow. I will discuss with her and see what I can do. *


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## haimia (May 9, 2012)

*Well, rhuematologist told me to check with local endos. Been there, done that!! So I checked with the pharmacist and she told me of one DO in the area that prescribes T3 meds. Only one in area that does!! So, maybe going to see him and, lucky me, he is on our insurance!

Also, had some tests last week on my throat. Swallowing difficulty, SOB, feeling a lump, etc. and I know so far that I have a hemorraged vocal cord, a vocal polyp, weak muscles in the voice box and a larengeal reflux burn. More results to follow and a doctor appointment on Tuesday to learn all of the good, bad and ugly. Doctor listed one of the diagnosis as conversion disorder-hysteria, which upset me a bit. I guess I was not as hysterical as he thought!*


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## HotGrandma (Sep 21, 2012)

haimia said:


> *Well, rhuematologist told me to check with local endos. Been there, done that!! So I checked with the pharmacist and she told me of one DO in the area that prescribes T3 meds. Only one in area that does!! So, maybe going to see him and, lucky me, he is on our insurance!
> 
> Also, had some tests last week on my throat. Swallowing difficulty, SOB, feeling a lump, etc. and I know so far that I have a hemorraged vocal cord, a vocal polyp, weak muscles in the voice box and a larengeal reflux burn. More results to follow and a doctor appointment on Tuesday to learn all of the good, bad and ugly. Doctor listed one of the diagnosis as conversion disorder-hysteria, which upset me a bit. I guess I was not as hysterical as he thought!*


You are Lucky. DO's think outta the box, so to say. They concentrate on the whole picture of the body not just the thyroid. They deal with nutrition and deficiencies as disease causing issues. More apt to prescribe vitamins or lifestyle changes before pharmacuticals. My whole thyroid journey was been with a DO. Best to you.


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## haimia (May 9, 2012)

*Well, saw the DO last week. Talked to me about 10 minutes and suggested Cytomel (T3). I have been given the generic (is this okay?) and at 5 mg in the morning and 5 mg about 2 in the afternoon. I am hopeful that it helps. Was practically on a cloud all the way to the pharmacy!

It has been a week. I think it is helping, but maybe not quite enough? I seem to have a bit more get up and go. I just hope this works. Thankfully, the DO had his thyroid removed and had similar symptoms and told the endo where to go! Nice to know a doctor that has been there and through that fun!

Also, I questioned DO about future labs. He did not seem concerned about doing them, only about how I felt. I return to see him in early July.*


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## webster2 (May 19, 2011)

Wow, a DO that has personal thyroid experience, good deal! I hope things will improve.


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## bigfoot (May 13, 2011)

Sounds like you are on the right track, and very luck to have found this DO. Awesome!

Glad you are finally on some Cytomel. Something to think about is switching to a natural, desiccated product such as Armour, Nature-Throid, or even consider going with a compounded T3/T4 from a compounding pharmacy. Personally, I would try the Armour or Nature-Throid if taking Synthroid and Cytomel don't get you where you want to be.


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## Andros (Aug 26, 2009)

haimia said:


> *I had TT in August 2012 due to possible hashi's and nodules causing swallowing issues. I was put on synthroid 150 in September 2012 and saw endo in November (labs still very low normal range) and was told by endo "see ya in March 2013". I was still feeling lousy in January and had family doctor run labs. Hypo! So, synthroid was increased to 175. I had labs done 3-13-13:
> TSH 3.4 (.4 - 4.2)
> FT4 1.28 (.89 - 1.76)
> FT3 2.59 (2.2 - 4.0)
> ...


TSH is thyroid stimulating hormone.

You may have to find a doc that is amenable. You are on a high dose Synthroid and getting nowhere slowly and agonally.

Please read below and pursue it.

Understanding the Thyroid: Why You Should Check Your Free T3
http://breakingmuscle.com/

Dr. Mercola (FREES)
http://www.mercola.com/article/hypothyroid/diagnosis_comp.htm

Free T3 and Free T4 are the only accurate measurement of the actual active thyroid hormone levels in the body. This is the hormone that is actually free and exerting effect on the cells. These are the thyroid hormones that count.


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## haimia (May 9, 2012)

*Okay, so it has been about a week and a half on 5 mg cytomel (generic) in the morning and 5 mg in the afternoon. I have noticed one BIG thing. I am tired and nearly falling asleep doing stuff before the afternoon dose. Is this not enough or what! Am really getting fed up with trying to get back to a semblance of normal!*


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## Andros (Aug 26, 2009)

haimia said:


> *Well, rhuematologist told me to check with local endos. Been there, done that!! So I checked with the pharmacist and she told me of one DO in the area that prescribes T3 meds. Only one in area that does!! So, maybe going to see him and, lucky me, he is on our insurance!
> 
> Also, had some tests last week on my throat. Swallowing difficulty, SOB, feeling a lump, etc. and I know so far that I have a hemorraged vocal cord, a vocal polyp, weak muscles in the voice box and a larengeal reflux burn. More results to follow and a doctor appointment on Tuesday to learn all of the good, bad and ugly. Doctor listed one of the diagnosis as conversion disorder-hysteria, which upset me a bit. I guess I was not as hysterical as he thought!*


Get to the DO; I could not agree more. Hopefully Armour will be the choice.
Or NatureThyroid etc.. Cytomel would be in addition to your current Thyroxine.

Here is some info for you!

Armour thyroid
http://www.armourthyroid.com/

Cytomel
http://labeling.pfizer.com/ShowLabeling.aspx?id=703


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## haimia (May 9, 2012)

*Please read the entire thread, Andros. I have been to the DO and have a different post dated today (6/19/13).*


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## Andros (Aug 26, 2009)

haimia said:


> *Well, saw the DO last week. Talked to me about 10 minutes and suggested Cytomel (T3). I have been given the generic (is this okay?) and at 5 mg in the morning and 5 mg about 2 in the afternoon. I am hopeful that it helps. Was practically on a cloud all the way to the pharmacy!
> 
> It has been a week. I think it is helping, but maybe not quite enough? I seem to have a bit more get up and go. I just hope this works. Thankfully, the DO had his thyroid removed and had similar symptoms and told the endo where to go! Nice to know a doctor that has been there and through that fun!
> 
> Also, I questioned DO about future labs. He did not seem concerned about doing them, only about how I felt. I return to see him in early July.*


You're good; it takes a few weeks for things to settle and by the time you see him in July you "both" will know more........................much more!

How fortunate for you that your rheumatologist suggested this. You have every reason to be hopefully now and I hope you share your journey to wellness w/us!!


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## haimia (May 9, 2012)

*Andros, PLEASE read post #10. I have been really, really tired and now I am having a period after 1 1/2 years without (1 1/4 years after stopping birth control because of deep vein thrombosis).*


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## Andros (Aug 26, 2009)

haimia said:


> *Okay, so it has been about a week and a half on 5 mg cytomel (generic) in the morning and 5 mg in the afternoon. I have noticed one BIG thing. I am tired and nearly falling asleep doing stuff before the afternoon dose. Is this not enough or what! Am really getting fed up with trying to get back to a semblance of normal!*


This sort of thing takes time; especially if you are in dire need of T3. You body is sucking it up and you are burning it up fast.

Give your body a chance to re-set it's self and heal.


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## haimia (May 9, 2012)

*Okay, really had not thought about that as DO said I should notice a change pretty much right away. And, only thing I was noticing was getting more tired!! Ugh. But, the return of my period could have some to do with that also. Will just try to hold out a while longer. Boy, is this process slow!!*


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## haimia (May 9, 2012)

*It has been about 2+ months since my last post. I was on 175 mg of Synthroid and 5 mg generic Cytomel in the morning and 5 mg generic Cytomel in mid-afternoon. I saw DO on 8-19-13 after bloodwork (see below for listing) and DO changed to - NO Synthroid for one month with 10 mg generic Cytomel in the morning and 10 mg generic Cytomel in mid-afternoon. DO wants to "unplug" T3 receptors as my RT3 was at the very top of the range and I am not utilizing the T3 meds correctly.

I read something about this on a link from this site (I believe Andros posted it). I am hoping for a good outcome, but not sure what to expect. Still have some hypo symptoms, but basically body is just falling apart! Currently in PT for bad knees (osteo and rheumatoid arthritis - knees are "severe"). Some days I want to curl up and . . .; well you get the picture! Any input??*

* 5-15-13 8-6-13 Range
TSH 0.065 0.057 (0.4 - 4.2)
FT4 1.25 1.49 (.89 - 1.76) 
FT3 3.01 2.75 (2.2 - 4.0)
TT3 -- 98 (60 - 181) 
T4 -- 10.8 (4.5 - 10.9) 
RT3 -- 26.9 (9.0 - 27.0)*


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## NeedhlpNow (Sep 9, 2013)

I had a complete thyroidectomy in 2000 and NOW it's driving me crazy w/my meds all off - I have an appt. tomorrow hopefully doc. (endo) can shed some light - said my T3's were off the charts - Free T3 highest range was 17? mine was at 276 and the Overall T3 highest is 420 mine is at 726 - Now wonder I can't sleep at night and my heart feels like it's going to pop out of my chest - BUT, I still feel tired - it's a crazy ride that's for sure!
NeedhlpNow


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## Andros (Aug 26, 2009)

NeedhlpNow said:


> I had a complete thyroidectomy in 2000 and NOW it's driving me crazy w/my meds all off - I have an appt. tomorrow hopefully doc. (endo) can shed some light - said my T3's were off the charts - Free T3 highest range was 17? mine was at 276 and the Overall T3 highest is 420 mine is at 726 - Now wonder I can't sleep at night and my heart feels like it's going to pop out of my chest - BUT, I still feel tired - it's a crazy ride that's for sure!
> NeedhlpNow


What thyroxine replacement are you taking and how much? Are the lab results you posted above recent?

If they are, you may need to get RAIU to see if thyroid tissue has grown back. Why did you have TT?

If your metabolism is at high speed from hyperthyroid or over medication, you can and will be exhausted.


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## Andros (Aug 26, 2009)

haimia said:


> *It has been about 2+ months since my last post. I was on 175 mg of Synthroid and 5 mg generic Cytomel in the morning and 5 mg generic Cytomel in mid-afternoon. I saw DO on 8-19-13 after bloodwork (see below for listing) and DO changed to - NO Synthroid for one month with 10 mg generic Cytomel in the morning and 10 mg generic Cytomel in mid-afternoon. DO wants to "unplug" T3 receptors as my RT3 was at the very top of the range and I am not utilizing the T3 meds correctly.
> 
> I read something about this on a link from this site (I believe Andros posted it). I am hoping for a good outcome, but not sure what to expect. Still have some hypo symptoms, but basically body is just falling apart! Currently in PT for bad knees (osteo and rheumatoid arthritis - knees are "severe"). Some days I want to curl up and . . .; well you get the picture! Any input??*
> 
> ...


The only problem I have been seeing is that you have not been getting enough T3 and your rT3 is up there but bearing in mind we all should have some rT3, it should not be worrisome.

What could be a concern for the future is taking too much T4 (which you are not taking now) because that T4 will in fact convert to rT3 if the person is taking exogenous T3

4 (T4) to 1 (T3) is the perfect ratio.

Now please tell me that is a typo re the dosage amounts? You should be on 20 mcg. (micrograms) total for the day, NOT mg. (milligrams.)



And......................you will definitely feel better on 20 mcgs. of Cytomel per day! Let us know!


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## haimia (May 9, 2012)

*Oops, my bad. It is 20 mcg (not mg) of Generic Cytomel a day. Didn't look at bottle, just assumed! And, you know what assume means!! *


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## Andros (Aug 26, 2009)

haimia said:


> *Oops, my bad. It is 20 mcg (not mg) of Generic Cytomel a day. Didn't look at bottle, just assumed! And, you know what assume means!! *


ROLF!!! Naw; I have no idea of what it means!

So, how long have you been taking the 10 mcg. of Cytomel twice a day? Truly; you needed more T3. Part and parcel of the problem.


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## haimia (May 9, 2012)

*Since 8-20-13. Have been having more hot flashes (whenever I exert myself a bit too much) and more shortness of breath. Asked DO about the hot flashes and he thinks it is thyroid related even though I am trying to climb out of hypo- he**!*


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## Andros (Aug 26, 2009)

haimia said:


> *Since 8-20-13. Have been having more hot flashes (whenever I exert myself a bit too much) and more shortness of breath. Asked DO about the hot flashes and he thinks it is thyroid related even though I am trying to climb out of hypo- he**!*


When are you to go in to have labs for FT3? To see where you are at w/this!

Do you know that low ferritin can cause shortness of breath?

Are you able to take daily walks; like mini-fast walks? You have to burn up that T3 and get your system in sync w/what is going on with the addition of Cytomel.


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## haimia (May 9, 2012)

*No labs scheduled at this point, last was prior to upping generic Cytomel and stopping Synthroid. I am to restart Synthroid about 9-20-13 and see the DO 9-30-13.

I will check on ferritin with DO on the 30th. I did not know low could cause SOB!

I started PT on 9-3-13 and water PT on 9-4-13 and have water PT on 9-11-13 and 9-13-13. I will consider adding short walks soon to my PT work. I am suppose to do PT slowly, building gradually to avoid the sharp, stabbing pain in my knees that I had been having. I can walk (and it is part of my water PT) relatively pain free in the water and am working on a doctor's note to do water PT on my own at a local hotel for $1 per visit. Only drawback is the travel to get to hotel (about 20 miles one way). Boy, it is so much fun getting old (er)!*


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