# So confused, I have no idea if I'm hypo or hyper or just nuts!



## SnoodMama (Jan 11, 2011)

Hi, y'all. I always pop in here when I get strange test results. I had my thyroid removed in 2009 for benign multinodular goiter. I was euthyroid at the time. I can't seem to get it right now. I just bounce between being hypo and hyper and it is driving me NUTS!!!!!!!!!!! My symptoms seem both hypo and hyper. I'm fatigued and depressed and sleeping all day. But that seems rather common! LOL. And I'm at a weight high point. My body temperature today was 94.6!!!!! And my most reliable indicator of thyroid status seems to be my bathroom activities which indicate MILD hypothyroidism. But I'm having heart palpitations. Pretty bad actually. That would be a hyper symptom, right??? Can you get palpitations with hypothyroid????

I recently upped my dose of Levothyroxine from 112.5 - 137 after these test results ---->

10/4/2014

TSH004264







5.76 0.450-4.500 uIU/mL

Triiodothyronine,Free,Serum010389 2.2 2.0-4.4 pg/mL

T4,Free(Direct)019745 1.63 0.82-1.77 ng/dL

Now about 4 months after the increase I get these test results ----->

TSH 0.3 - 4.7 mcIU/mL *8.0*

Free T4, Automated 0.8 - 1.6 ng/dL 1.6

Free T3, Automated 222 - 383 pg/dL *241*

T4,Total 4.9 - 11.4 mcg/dL 9.0

T3,Total 85 - 185 ng/dL *69*

Ok, so my TSH went up after increasing my dose. My Free T3 and T4 are normal, free T3 maybe a little low. But the Total T3 is low. If the unbound/free T3 is the gold standard for judging things then my results are good. Yay! All is well. Doctor (primary care physician not endo) says not to change anything. But if my Free T3 is so wonderful, then why is my TSH not going down??????

I feel hypo. And I feel more hypo since increasing my levothyroxine.

I think I'm broken!!!!!!!!!!!! Oh and let me add that I'd rather sleep all day and be depressed and gain weight than be thin and agitated with a pounding heart!!!!! Cuddling in bed with my cat is nicer than feeling like I'm plugged into the electric socket!

Lynn


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## Octavia (Aug 1, 2011)

Your Free T4 is borderline hyper.

Your Free T3 is hypo.

You did not need an increase in your levothyroxine. What you need is to add Cytomel to your Levo. Cytomel is a T3 drug. Levo is a T4 drug.

Many people successfully convert T4 to T3. You clearly do not. Please talk with your doctor about adding Cytomel. If you add Cytomel, you'll need a decrease in your Levo, though...keep that in mind. For Cytomel, you should likely start at 5 mcg, then increase to 10, then go from there based on labwork.

Let me know if this does or does not make sense. One of us can try to explain it better.


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## SnoodMama (Jan 11, 2011)

It makes total sense. Thank you. Time to find an endocrinologist! I moved and haven't found one yet. Oy.

Thank you!!!


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## Lovlkn (Dec 20, 2009)

You can get Cytomel from the doctor prescribing your current levothyroxine only medication.

I've never had any luck with endo's when it comes to supplementing Cytomel.


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## jenny v (May 6, 2012)

Also, you can get heart palps with both hyper or hypo (I do). But I'm betting yours are from your Free T4 being almost out of the top end of the range.


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## Lovlkn (Dec 20, 2009)

> Doctor (primary care physician not endo) says not to change anything.


Sorry - I missed this. You need to change doctors. Why not try another primary doctor?

You may have more luck. Go in and ask for what you want/need. If you are confident and ask - for a reduction of your levothyroxine and an addition of Cytomel - 5mcg to start. You certainly have a low enough FT-3 to prove you are not a good converter.

I felt horrible when my FT-4 was in high range and my FT-3 was in low range. Thyroid symptoms overlap.


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