# Still feel crappy



## Sandyz24

Labs are as follows: free t4. 1.81H. (0.93-1.71.)

Free t3 2.51. (2.02-4.43)
TSH 2.58. (0.49-4.67)

This was almost 2 weeks ago. I've been feeling sort of anxious, pain all over left arm and legs. . Previous TSH was .58 and free t4 was 1.91. .


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## Andros

peripheral neuropathy
http://www.ninds.nih.gov/disorders/peripheralneuropathy/detail_peripheralneuropathy.htm
(Copy and paste into your browser)

http://www.suite101.com/content/thyroid-disease-and-neuropathy-symptoms-a140669
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SUGGESTED TESTS
TPO (antimicrosomal antibodies) TBII (thyrotropin-binding inhibitory immunoglobulin), Thyroglobulin and Thyroglobulin Ab, ANA (antinuclear antibodies), (thyroid hormone panel) TSH, Free T3, Free T4.

You can look this stuff up here and more.........
http://www.labtestsonline.org/
(Copy and paste into your browser)

Trab
http://www.ncbi.nlm.nih.gov/pubmed/17684583
(Copy and paste into your browser)

Hmmmmmmmmm!!! And welcome! Are you currently on thyroid replacement meds? If not.....................

it would appear that antibodies are playing tricks on your body and your lab results. And it seems you are experiencing peripheral neuropathy as a result of all this confusion.

Listing some tests that would be most helpful and would also like to encourage you to request an ultra-sound of your thyroid if you have not had one here recently.


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## Sandyz24

Yes, I was on 88mcg but that was decreased to 75mcg and since then taken down to 1/2 tab q day. . I'm also a diabetic. So I don't know what's going on. I have an appointment with my internist on Wednesday and I'm hoping that he can help me.


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## Octavia

It seems to me that you need to talk with your doctor about decreasing your Synthroid/Levothyroxine and adding Cytomel. This would result in a decrease in your Free T4 labs and an increase in your Free T3 labs.


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## Sandyz24

Octavia said:


> It seems to me that you need to talk with your doctor about decreasing your Synthroid/Levothyroxine and adding Cytomel. This would result in a decrease in your Free T4 labs and an increase in your Free T3 labs.


i hope he will work with me.  I'm just so tired of feeling this way.


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## Sandyz24

Even with these lab results, would I still feel anxiety? Just wondering.


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## Lovlkn

I have horrible anxiety when my FT-4 is top or above range.

ALso, when I added Cytomel my TSH fell to below range - but because my Frees are both in mid to 3/4 range my doctor is cool with the lack of TSH - thank GOD for that!


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## Sandyz24

Lovlkn said:


> I have horrible anxiety when my FT-4 is top or above range.
> 
> ALso, when I added Cytomel my TSH fell to below range - but because my Frees are both in mid to 3/4 range my doctor is cool with the lack of TSH - thank GOD for that!


i hope that's what's wrong with me.


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## Octavia

Sandyz24 said:


> Even with these lab results, would I still feel anxiety? Just wondering.


Absolutely, yes. Because your Free T4 is high out of range. When my Free T4 gets close to top of range, my heart palpitations are overwhelming. You really need to get that Free T4 back into range, with a target of around 75% of range.


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## Andros

You are paying this guy; if he won't work w/you find a doctor who will! There are lots of good ones out there!

Hugs,


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## Sandyz24

Thanks. . I'm just so stressed out from both home and work. . My old dr wanted to put me in an antidepressant and I'm so against that.


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## Sandyz24

So what other tests should I ask my doctor for? Should I ask for cytomel? Should I ask for Armour thyroid instead? Sigh. I have a lot of questions.


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## Sandyz24

So I went to the Internist today found out I have a massive uti. They further decreased the synthroid to 50 mcg every other day. I started taking selenium about a week ago. I hope it helps.


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## Octavia

I'm puzzled about why your doctor is opposed to adding Cytomel (from your other thread). Did he/she give a reason? It just seems so obvious to me that this would be your next step.

When do you get labwork done again?

I hope your UTI clears quickly. Is it causing a lot of pain?


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## Sandyz24

Octavia said:


> I'm puzzled about why your doctor is opposed to adding Cytomel (from your other thread). Did he/she give a reason? It just seems so obvious to me that this would be your next step.
> 
> When do you get labwork done again?
> 
> I hope your UTI clears quickly. Is it causing a lot of pain?


she said that they would leave it for the endo to do. .

I'm having a terrible time with the uti.

Don't know when I need to get more labs done.


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## RGRN

So how does a UTI affect your thyroid symptoms? I have chronic interstitial cystitis and I get UTIs all the time. Are they connected some how?


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## Andros

They can be. The body cannot defend it's self nor can it heal if one does not have sufficient T3.

Hugs,


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## Sandyz24

Saw the TPO levels.. 43 (0-34). Hashimoto's right?


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## Sandyz24

Not only that, my lipase was high. 231 (25-200). 
And I may have gallstones. Oh fun.


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## Sandyz24

Can anybody help me?  since they further decreased the Synthroid to 25mcg a day, I've been feeling really sluggish. Was gonna ask the doc to see if they could increase to 50 a day.


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## kris90

I believe there is evidence that Selenium deficiency can negatively affect the iodothyronine 5'-deiodinase enzyme which converts T4 to T3. Maybe you should try a Selenium supplement.


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## Sandyz24

I've been on one for about 3 weeks.


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## Sandyz24

Got some wellness labs done. T3 uptake 35 (23-40). T4 total. 13.2 (4.7-13.3). T7 4.6 H (1.4-4.5)

TSH 3.80 (.49-4.67).

Iron is low. 31 (26-170). Ferritin is also low 28 (14.0-233.0). This is on 25mcg Synthroid. I'm Only able to tolerate 65 mg iron with vitamin c 1 tab a day.


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## Sandyz24

New labs.


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## buttonwood

Your tests are similar to mine. I was told that the high Free T 4 means that you are hyperthyroid. From the good advice on this board I went to my dr and she lowered my Synthroid and added a small dose of Cytomel. When I was hyperthyroid I felt worse than when I was hypo. --- Fatigue, insomnia, anxiety.... I am feeling much better and I will have my labs retested at the end of this month. My TSH has gone as high as 23 . I was told that when I add Cytomel it should lower my TSH.

This board is great and they gave me useful information to take to my dr .I am sure that some of the veterans will give you great advice on what you should do.


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## Andros

Wow! Clearly you are hypothyroid. And I do urge you to get an ultra-sound.

Has doc started you on thyroxine replacement?

And you do need to work on that Ferritin. Has doc suggested a supplement for that?

Hugs.


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## Sandyz24

Andros said:


> Wow! Clearly you are hypothyroid. And I do urge you to get an ultra-sound.
> 
> Has doc started you on thyroxine replacement?
> 
> And you do need to work on that Ferritin. Has doc suggested a supplement for that?
> 
> Hugs.


im on Synthroid 37.5 again after I compained of no energy. lol. I'm on iron bisglycinate for the ferritin. I guess it's time to cut down on the synthroid again. Had just started on the 37.5 about a week ago. .

I'm going to an endocrinologist next week. Hopefully he can help.


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## Sandyz24

buttonwood said:


> Your tests are similar to mine. I was told that the high Free T 4 means that you are hyperthyroid. From the good advice on this board I went to my dr and she lowered my Synthroid and added a small dose of Cytomel. When I was hyperthyroid I felt worse than when I was hypo. --- Fatigue, insomnia, anxiety.... I am feeling much better and I will have my labs retested at the end of this month. My TSH has gone as high as 23 . I was told that when I add Cytomel it should lower my TSH.
> 
> This board is great and they gave me useful information to take to my dr .I am sure that some of the veterans will give you great advice on what you should do.


thanks!


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## Sandyz24

Wonder if a long acting t3 would help.


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## joplin1975

Your free t3 is super low, so you are technically hypo (but because of the high free t4, you might have some hyPER symptoms mixed in -- fun, uh?!). I agree that you should drop your synthroid and add in a smidge of Cytomel.


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## Sandyz24

joplin1975 said:


> Your free t3 is super low, so you are technically hypo (but because of the high free t4, you might have some hyPER symptoms mixed in -- fun, uh?!). I agree that you should drop your synthroid and add in a smidge of Cytomel.


i will see what the Endo says next week.

I'm praying for the best.


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## Octavia

Wow. I still stand by my suggestion to add Cytomel to your lowered Synthroid dose. I believe one of your major issues is that you are not converting T4 to T3. While lowering your T4 (Synthroid) was the right thing to do based on your high Free T4, it means that your Free T3 will end up being lower than it already was. Your T3 really needs to be supplemented.

What are your most recent labs?

Is there any chance you can find a doctor who is more willing to add a T3 drug to your regimen?


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## Sandyz24

Octavia said:


> Wow. I still stand by my suggestion to add Cytomel to your lowered Synthroid dose. I believe one of your major issues is that you are not converting T4 to T3. While lowering your T4 (Synthroid) was the right thing to do based on your high Free T4, it means that your Free T3 will end up being lower than it already was. Your T3 really needs to be supplemented.
> 
> What are your most recent labs?
> 
> Is there any chance you can find a doctor who is more willing to add a T3 drug to your regimen?


the picture above was the most recent. I don't know of any doctor where I live that would prescribe cytomel or anything else. I'd have to go to Corpus Christi Tx for that.


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## Sandyz24

I wonder why I'm not converting. T4.


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## Octavia

Sandyz24 said:


> I wonder why I'm not converting. T4.


It's pretty common. That's why the Synthroid-Cytomel combo or Armour work for many people.

Maybe you need to educate your doctor. Can you do some research to find some studies/articles that support the Synthroid-Cytomel combination approach?


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## Sandyz24

Octavia said:


> It's pretty common. That's why the Synthroid-Cytomel combo or Armour work for many people.
> 
> Maybe you need to educate your doctor. Can you do some research to find some studies/articles that support the Synthroid-Cytomel combination approach?


i wouldn't even know where to start.


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## buttonwood

I go to an internist. My last appointment I went in with information about low Free T 3 and high FreeT4 and High TSH. I received helpful information from the Thyroid boards and the internet. At first she was hesitant to prescribe Cytomel. She told me that she would research it and then call me in a day or 2. A few hours later I received a call from the receptionist telling me that my dr. called in a prescription for Cytomel. If it wasn't for the people on these boards I would still be increasing my Synthroid and becoming more hyper. I am finally starting to feel better.


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## Sandyz24

buttonwood said:


> I go to an internist. My last appointment I went in with information about low Free T 3 and high FreeT4 and High TSH. I received helpful information from the Thyroid boards and the internet. At first she was hesitant to prescribe Cytomel. She told me that she would research it and then call me in a day or 2. A few hours later I received a call from the receptionist telling me that my dr. called in a prescription for Cytomel. If it wasn't for the people on these boards I would still be increasing my Synthroid and becoming more hyper. I am finally starting to feel better.


would u have that info handy?


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## Lovlkn

Sandyz24 said:


> New labs.


What dose were you on when these labs were drawn?

Do you take your replacement medication prior to your lab draw?

Do you have labs drawn around the same time during the day?

I've even considered how my monthly cycle affected my labs -

Have you had an ultrasound of your thyroid? Not all nodules are cancer and with your decreasing levothyroixne replacement and the continued high FT-4, something is amiss.


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## Sandyz24

Lovlkn said:


> What dose were you on when these labs were drawn?
> 
> Do you take your replacement medication prior to your lab draw?
> 
> Do you have labs drawn around the same time during the day?
> 
> I've even considered how my monthly cycle affected my labs -
> 
> Have you had an ultrasound of your thyroid? Not all nodules are cancer and with your decreasing levothyroixne replacement and the continued high FT-4, something is amiss.


i was at 37.5 mcg at this time for 3 days. I always get my labs done first thing in the am. But this time it was a different lab facility. No thyroid ultrasound yet, but I'm gonna beg for one.


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## Lovlkn

OK - So as I read this thread you continue to reduce your levothyroxine and your FT-4 stays high and your FT-3 stays low and your TSH stays high.

You definitely need more testing - I think an Ultrasound is absolutely necessary and also your doctor should be looking at your pituitary.

I get the feeling some posting on this thread feel that low FT-3 is enough to raise the TSH, rendering you hypo, but I'm not too sure about that.

If it does come back as "thyroid" then a high T-3 medication such as Armour is what you should consider.

Has your doctor suggested stopping the levothyroxine all together to see if the FT-4 comes down?

What supplements and other medications do you take?

How many labs have you taken your replacement prior to the draw?


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## Sandyz24

I take vitamin d3 5000 units, selenium 200mcg and I take iron bisglycinate once a day, but I think I'm gonna shoot for twice a day.

I've done blood draw 3 times since the decrease


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## Lovlkn

Your D is low for taking 5K IU daily. Did your doctor prescribe the 50K IU weekly for 12 weeks prior to you starting the 5K IU daily?

I did the prescription first and now take 5K IU daily to maintain top 3/4 range or higher.

What time do you take your levothyroxine and what time do you take your iron?

I would space at least 4 hours either side - just to be sure there is no interaction.


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## Sandyz24

Lovlkn said:


> Your D is low for taking 5K IU daily. Did your doctor prescribe the 50K IU weekly for 12 weeks prior to you starting the 5K IU daily?
> 
> I did the prescription first and now take 5K IU daily to maintain top 3/4 range or higher.
> 
> WHattime do you take your levothyroxine and what time do you take your iron?
> 
> I would space at least 4 hours either side - just to be sure there is no interaction.


yes D is low I tried to take 10000 a day but could not tolerate it. So 5000 it is. . I take my levo in the morning at 0600 and iron at noon.


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## Sandyz24

How would I know if it's a pituitary problem?


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## Sandyz24

So, I went to the endo today... He was no help. But at least he didn't increase the med. He did order an ultrasound and more labs so that's something.


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## Sandyz24

So the ultrasound on the thyroid was done. They found a 4mm nodule on the right side. TSH shot up To 11. F T4 remains at 1.46, free t3 went up a tile bit to 2.7
All the same reference numbers. Reverse t3 has
Not come in yet.


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## Sandyz24

Sooo..... I got an rx for armour. lol.


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## KeepOnGoing

Good luck with the armour! Wish we had it in the UK - I don't seem to respond well to any of the synthetic options at the moment...


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## Sandyz24

So.... It's my first two days of armour. I feel ok Just wondering when an increase might be due.


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## joplin1975

You'll have to wait a full six to eight weeks. That is the hard part about finding your sweet spot with regard to thyroid meds.


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## Sandyz24

joplin1975 said:


> You'll have to wait a full six to eight weeks. That is the hard part about finding your sweet spot with regard to thyroid meds.


i know. I hate how slow the process is.


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## Sandyz24

Soooo.... I got the results from the reverse t3. It's high 36.2. (9.2-24.1). Can anything be done?


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## jenny v

There are several schools of thought with high reverse T3, some believe lowering your Armour down to 90mg works and some believe switching to T3 only (Cytomel) works. High reverse T3 essentially means that the T3 is building up in your system instead of being used by your cells, so you never feel optimal. I would look at the Stop the Thyroid Madness site, they have a whole section on reverse T3.


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## Sandyz24

jenny v said:


> There are several schools of thought with high reverse T3, some believe lowering your Armour down to 90mg works and some believe switching to T3 only (Cytomel) works. High reverse T3 essentially means that the T3 is building up in your system instead of being used by your cells, so you never feel optimal. I would look at the Stop the Thyroid Madness site, they have a whole section on reverse T3.


thanks Jenny. Right now I'm only on 30mg of Armour


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## Lovlkn

> They found a 4mm nodule on the right side.


What did your doctor have to say about this? I don't have experience with nodules but did you think to ask for the actual report of the ultrasound?


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## Sandyz24

Lovlkn said:


> What did your doctor have to say about this? I don;pt have experience with nodules but did you think to ask for the actual report of the ultrasound?


he said they really can't do anything until it reaches 8mm. I gave the actual report to him.


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## Sandyz24

TSH is now down to 3.3.


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