# synthroid switch/ new dr ??



## Tori64 (Mar 7, 2017)

HI

I am new hear and have spent a few years trying to feel well with NDT.

always with NDT my FT4 level is low low low. so i switched Dr.s and now going T4/T4 combo. the first month he had me take 100 levo and 10 t3, upon return with labs 21-feb and 22-feb he put me on 112 synthroid and told me to decrease to 5 t3.

he had me do labs 3 hours AFTER taking thyroid meds.. see 21-feb reading below. I had some old lab request so i decided to do a med fasting lab see 22- feb.

I have a couple concerns.

1. his request to drop the t3 from 10 down to 5 ? ( I am afraid of crashing and being worse off than i am.. even a intermittent slow 2mile walk can make my leg sore.)

2.

he has me follow up in 3 months but is not ordering labs.. is that strange?

also i need to learn to stand up for myself with these dr's and that isn't easy most of the time.. i forget and just get doe eyed with them and then later i think , why didnt I ask " " .

since i have been on the synthroid (only 7 days) i feel more tired i think, sometimes groggy shortly after I take it and the groggy may last a while.

I was hopeful to read of the person who feels better on the synthroid even without T3.

I know in my past i was not a good converter and had a high level of RT3 that was before cortef, and this dr will not test RT3 .

Open for suggestions and feedback.. thank you!

Oct and Jan labs are with NDT and are med fasted too.

Jan-17

21-Feb

22-Feb

16-Oct

2grans 18hr medfast

3HRS AFTER MEDS

26 HR MED FAST

3 grains 20hrfast

FREE T4

.80(.82-1.77)

1

0.92

0.85

t4 direct

6.1 (4.5-12.0)

FREE T3

3.6 (2-4.4)

2.4

2.8

REVERSE T3

TOTAL T3

t3

105(71-180)

TSH

.031L

.178L(.45-4.5)

0.278

0.006


----------



## Lovlkn (Dec 20, 2009)

> Jan-17 21-Feb 22-Feb 16-Oct 2grans 18hr medfast 3HRS AFTER MEDS 26 HR MED FAST 3 grains





> 20hrfast FREE T4 .80(.82-1.77) 1 0.92 0.85 t4 direct 6.1 (4.5-12.0) FREE T3 3.6 (2-4.4) 2.4 2.8 REVERSE T3 TOTAL T3 t3 105(71-180) TSH .031L .178L(.45-4.5) 0.278 0.006


Am I reading this correctly? Did you only post only the labs with the fast prior? These are labs while taking levothyroxine and T3 hormone?

All I can seem to make out is your FT-4 and FT-3. Your FT-3 should fall somewhere between 1/2-3/4 of range. Since I believe these are fasting your FT-3 actually looks like it is in a good place. Free T-4 is definitely low for someone on T4/T3 combo hormone replacement. The way to fix that is to raise Levothyroxine and lower T3 hormone - then the question to ask is "Does my body properly convert the T4 hormone?"

Waiting 3 months is too long, my doctor changed me from brand cytomel to generic and never had me come back except for my 6 month semi annual required visit so if your doc will not run the lab, you should run them yourself if possible after 4-6 weeks. Six will give you the most accurate result but no need to suffer - go in 4 if you do not feel well. Your body is adjusting to the dose change and that may be why you are tired. Are you in the USA? I run labs myself all the time and NO , my doc does not really care to ever see my results so I use them to tweak my dose.

The FT-4 and FT-3 will reflect the free and unbound thyroid hormone in your system at time of draw. Total 3 is not as accurate as you can see, I do not see the # for Reverse T3.

If you have refills of your med's make sure to refill them - pay cash if you have to but having plenty around during the time you dial in your dose is key.

I'm curious, did you feel poorly on the 100/10 combo?


----------



## Tori64 (Mar 7, 2017)

sorry the labs came out like that .. i will relist them seperately.

no meds before labs at 100 levo 10 t3

FT4 .92 (.82-1.77)

FT3 2.4 ( 2 -4.4)

tsh .278 ( .45-4.5)

Here are the labs the new endo requested 3 hours after taking meds

FT4 .92 (.82-1.77)

FT3 3.6 ( 2-4.4)

TSH .178 ( .45-4.5)

I haven't felt well for a long time.. i was starting to feel a bit better on the 100 t4 10 t3, I am not sure why he switched me to synthroid.

I was not freezing all the time, but i was starting to get a bit constipated.. while i was transitioning from NDT to t4/t3 i did have some diarrhea for a while. but now constipated again,... which is odd while i was on NDT everything was pretty normal.

I like you idea of doing labs again in 6 weeks.. i want to have a dr on board with this but maybe it is impossible to find someone that really knows what's going on.

he also suggested to decrease the cortef from 25 down to 20.

do you go by the med fasted labs or the labs taking thyroid meds first?

thanks for your reply!


----------



## Lovlkn (Dec 20, 2009)

Why do you take cortef? What is the diagnosis?



> no meds before labs at 100 levo 10 t3
> 
> FT4 .92 (.82-1.77)
> 
> ...


These labs are hypo.

I usually lab prior to taking med's - first thing in the morning. Having just made a change myself recently I did lab after my morning doses and was surprised they were similar to the no med's lab. My doctor ignored these results and told me to lab prior to med's so that's what I did and again... they were exact to when I took the med's. That is why it is important to have some history on doses before you change. I move slow when changing doses and lab every 6 weeks, paying out of pocket. I have 12 years of no med prior to labs and when I am at 3/4 of range I personally think I am running a bit on the hyper side, but not always which only further complicated the matter. I take 1500 mg of calcium daily over 3, 500mg doses so I have alot of calcium interaction with absorption. I definitely notice it when I skip a few calcium doses over a few days. Today was a perfect example - I forgot my morning dose and my my 2nd T3 dose I was feeling very agitated and hyper. Do you split your T3 dosing in 2 doses 6 hours apart?

With that said, your lab would likely be closer to the 1/2 range or above if you lab prior to med's. Definitely not below and not an issue if above, but not above 3/4 of range.


----------



## Tori64 (Mar 7, 2017)

My old endo said i had "secondary " adrenal insufficiency i believe? although i was already taking cortef before going to here and never flunked a stim test.. i do know that when i tried in the beginning a small dose of NDT i could not tolerate it, even 1/4 grain.

the cortef helped with that and some other things too.

the new endo told me to take the T3 in the am with the synthroid, and now he just wants me to take 1 (5mcg ) instead of 10mcg.

i have heard of splitting the dosage so was a bit surprised when he suggested taking both at the same time, that was the first visit.

I got a bit confused about your last paragaraph

"With that said, your lab would likely be closer to the 1/2 range or above if you lab prior to med's. Definitely not below and not an issue if above, but not above 3/4 of range."

and i am really confused on what to do.. lower the T3 like he said ? also dont understand why i am so wiped out switch changing to the synthroid.

thanks for your help.


----------



## Tori64 (Mar 7, 2017)

I think i understand your meaning

"With that said, your lab would likely be closer to the 1/2 range or above if you lab prior to med's. Definitely not below and not an issue if above, but not above 3/4 of range."

this is what my labs should look like at the 1/2 range or above, but not about 3/4 of the values-- and that is with doing labs before taking meds.

which is the opposite of what the dr wanted.

how do you get your dr to rx your meds so you can tweek them? I am glad you found a soultion.

thanks!


----------

