# Does it take long to feel better once labs are 'normal'?



## chasing_angels (Jun 28, 2016)

My history of Hashimoto's/hypo is in my signature and my initial post is here.

I recently had more labs run and these are the results (meds last taken 24 hours prior to blood draw):
Free T4: 14.3 (9.0-19.0)
Free T3: 5.4 (2.6-6.0)
TSH: 0.17 (0.3-3.5)
TPO: >1000 (<6)
TPAb: 236 (<4)

I still feel really crap, but I still have the same symptoms as when I was hypo? (and a few more). Granted, some of these are probably from Zoloft... I've listed them all below anyway.

I'm going to reduce my dose from 150mcg to 137mcg on the advice of an endo. They said my thyroid is dead and would not be contributing to my levels, but I just don't know.

Once I do find the 'right' dose, might I feel better within a few months or does it generally take longer?

Current symptoms:

Anxiety/Depression
Clenching/grinding teeth
Night sweats
Unwell for a few hours after driving in the morning
Very tired in the morning, less so in the afternoon, less so again at night
'Wired' at night, difficult to sleep
Foggy thinking, poor memory and concentration
Hair going straight/falling out/dry
Weight gain
Sensitive to both hot and cold
Headaches, joint pain, face and muscle pains
Back twitching/spasms when lying down (recent)
Shooting pain from thyroid up to the front of my chin (recent)


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## Lovlkn (Dec 20, 2009)

Were med's taken 24 hrs prior to your last 2 draws?

My impression - I am testing this theory as I type ( I had private labs done this AM)

If there has been a long period between last med and lab, maybe we shoot for the 1/2 range.



> (meds last taken 24 hours prior to blood draw):
> 
> Free T4: 14.3 (9.0-19.0) *((14-16.5))*
> Free T3: 5.4 (2.6-6.0) *((4.3-5.15))*
> ...


(( )) indicates the 1/2 - 3/4 of your ranges.

Your FT-3 is over the 3/4 of range and may be your issue causing your symptoms.

FT-3 in my opinion will be a lab you will need to insist on as you seem to be a fantastic converter.


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## Octavia (Aug 1, 2011)

Your antibodies appear to be "off the charts" so to speak.

I don't have any personal experience with antibodies, but others here have said that antibodies can make it harder to "level off" on a correct dose of meds. (By that, I mean find one dose that works for you for a long time.) I've also read input from others here who have shared that antibodies may keep you feeling not so great.

Curious to see input from people with experience fighting antibodies.


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## chasing_angels (Jun 28, 2016)

Pamzilla13 said:


> How long have you been on 150mcg? (when did you start 150mcg?)
> 
> I must say that I have experienced the clenching and grinding, headaches, joint pain face and muscle pain and over all crappy feeling when I tried Zoloft. I didn't make it 2 days on that stuff. The side effects made me feel worse.


I started on 150mcg around August 17, so a little over 8 weeks prior to my most recent labs.

I'm using Zoloft as a mood stabiliser, I tried Lexapro first which immediately caused intense anxiety and panic attacks for 6 days (I wished I would die it was so horrible)... so Zoloft seemed tame to me in comparison, but it is probably causing those side effects.



Lovlkn said:


> Were med's taken 24 hrs prior to your last 2 draws?
> 
> My impression - I am testing this theory as I type ( I had private labs done this AM)
> 
> ...


Yep I've gone without meds for 24 hours prior to all of my labs. I also don't eat or drink anything for 2 hours after my meds each morning, which I assume helps with conversion. I've definitely felt a bit more hyper than normal over the past few weeks, will be interesting to know my levels once I do feel better - 1/2 range is probably the winner.

The pathology unit only tests FT3 if TSH is low - so I'll ask for it to always be tested from now on.



Octavia said:


> Your antibodies appear to be "off the charts" so to speak.
> 
> I don't have any personal experience with antibodies, but others here have said that antibodies can make it harder to "level off" on a correct dose of meds. (By that, I mean find one dose that works for you for a long time.) I've also read input from others here who have shared that antibodies may keep you feeling not so great.
> 
> Curious to see input from people with experience fighting antibodies.


That's what I've heard too. I asked the endo if I'd be better off with having my thyroid removed to get rid of the antibodies and possibly help to maintain a stable dose - but she said it wouldn't make a difference. Although I'm thinking of getting a second opinion about everything anyway, so this is something that I'll ask again.

My Mum got severe rheumatoid arthritis in her early 40's so I'd rather not have any naughty antibodies floating around...


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## Octavia (Aug 1, 2011)

I would get that second opinion. Good idea.


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## chasing_angels (Jun 28, 2016)

Update... latest results are in, as with all my labs I did not have meds for 24 hours prior to draw. Usual dose is 137mcg/day for the past 3 months, I was at 150mcg prior to that.

Labs are pretty much perfect, which I was surprised about because I 'felt' low.

Free T4: 13.3 (9.0-19.0)
Free T3: 4.1 (2.6-6.0)
TSH: 0.3 (0.3-3.5)

I still have all of the other symptoms, which suggests that they aren't thyroid related after all. Time to stop hoping for a miracle in that space...


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## Lovlkn (Dec 20, 2009)

> Labs are pretty much perfect, which I was surprised about because I 'felt' low.
> 
> Free T4: 13.3 (9.0-19.0) *((14-16.5))*
> Free T3: 4.1 (2.6-6.0) *((4.3-5.15))*
> TSH: 0.3 (0.3-3.5)


I've edited in the 1/2-3/4 ranges beside your actual lab range above.

Were these labs drawn the same time - 24 hours after your last dose? Being at 1/2 range with no med's for 24 hours , one would expect to be close to 1/2 range, which is about where you fall.

One thing I can say about thyroid med's - it can and does take time for symptoms to completely resolve once they are added. You have changed doses quite alot in a short period of time which causes it's own issues with symptoms. Adjusting replacement doses can take awhile to dial into optimal doses.

Have you ever had an ultrasound of your thyroid?

Other lab's to consider asking for which can mimic low thyroid, Vitamin D, Ferritin ( note when in cycle the lab draw is) and B-12 all of which if low can mirror low thyroid symptoms.


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## chasing_angels (Jun 28, 2016)

All blood tests were ~8am and 24 hours after last dose.

I had an ultrasound last year which I think was fine:

"Marked heterogeneity of thyroid echo pattern with diffuse increase in vascularity through both lobes. Correlation with thyroid blood test would be indicated. Findings may be in keeping with some active thyroiditis. There is no goitre and no focal thyroid lesion otherwise identified."

My B12 was tested last week too, and was normal.

Vitamin B12: 300 (>150)

Active B12: 73 (>35)

I'll see how I go with the stable dose of 137mcg, and will ask for Vitamin D and Ferritin next time.


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## ssMarilyn (Nov 15, 2013)

chasing_angels said:


> My history of Hashimoto's/hypo is in my signature and my initial post is here.
> 
> I recently had more labs run and these are the results (meds last taken 24 hours prior to blood draw):
> Free T4: 14.3 (9.0-19.0)
> ...


*Many of your symptoms listed are indicative of being hyper now rather than hypo. Your numbers are in the upper ranges and for some, like me.. that will make you hyper. I have to keep my numbers in the lower ranges or else I have insomnia, anxiety, depression, restlessness when trying to sleep, etc.. Don't go by the numbers. Do what most wise doctors do, and go by how you feel. I think your thyroid med dosage is a tad too high for you. I had horrible insomnia til I cut my thyroid dosage down on my own... experimenting. It worked! My MD said I did good! Your B12 level is a tad too low. As is typical, that lab is not using current acceptable ranges.
http://www.mthfrsupport.com.au/vitamin-b12-reference-range-level-set-low/*


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## BurntMarshmallow (Feb 26, 2016)

Your hair symptoms make me think of zinc and b6. You can ask to have your levels checked. Low zinc and b6 will cause depression and anxiety as well as skin and hair symptoms. Low potassium can also effect the skin and hair, and give you nasty headaches.

When thyroid hormones are too low or too high, you can become low in many nutrients, and then it takes a while to feel better even after you've found the right thyroid dosage.

When you started feeling depressed, your doctor prescribed an SSRI- zoloft which affects serotonin receptors in the brain. But serotonin is only one neurotransmitter involved in mood. Serotonin gets all of the publicity but other neurotransmitters are even more important for mood - like dopamine.

I actually don't think serotonin is the issue for you. It's more likely it is low dopamine, which zoloft can't help you with. Dopamine is both a calming and stimulating neurotransmitter. Dopamine makes you feel focused, motivated, happy and calm. Dopamine is made from the same protein needed to make thyroid hormone - tyrosine. Low dopamine and thyroid problems go hand in hand. AND dopamine production is affected by smoking because cigarettes contain compounds which imitate dopamine. In fact, quitting smoking can suddenly increase the requirements for dopamine, making you feel depressed and anxious, and interfering with thyroid hormone production.

From dopamine we make other hormones like epinephrine, and things we need to handle stress. When you say you have trouble getting going in the morning, and you are anxious and depressed even though you're on zoloft, it is a dopamine pathway issue. Taking thyroid hormone will help free up the tyrosine in your diet to be used for dopamine - BUT you need other nutrients too, including vitamin D, B6 and iron, to make dopamine.

Now that your TSH is down and you are taking supplemental thyroid hormones, the tyrosine and other nutrients in your diet can be used for other things. Eventually you'll feel better. Maybe it will help understanding why this is happening, and why you feel this way. Hopefully it gives you confidence that it won't always be like this - you will get better.


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