# Need your opinions



## buttonwood (May 4, 2014)

I have been hypothyroid since 1997. I was on 112 Synthroid until 2010. All of a sudden I went hyperthyroid in 2010 and was diagnosed as with Hashimotos. My Synthroid was lowered to 100 then 88. Since that time myTSH has been on the high side and every time I increase my dose to 100 I feel anxiety and insomnia after 6 - 7 weeks so I have been alternating between 88 and 100 .- one day 88 next day 100. In

Dec. my TSH was 23 (0.450-4.500),

June - 8.050 (0.450-4.500),

Sept.- 12.080 {0.450-4.500).

I can't stand how I feel when I raise my dose to 100. Ihave had 2 ultrasounds and no nodules.

Here are my lastest labs. I do not see my dr. until Dec. 17 but She is very cooperative and let's me adjust my Synthroid according to my symthoms. Right nowI am having difficulty sleeping, and my blood pressure has been high. I am very fatigued.

Lab Test Resultsthyroxine (t4) free, direct, s

Test

Low

Normal

High

Reference Range

Units

t4,free(direct)

1.55

0.82-1.77

ng/dL

Test

Low

Normal

High

Reference Range

Units

tsh

9.470

0.450-4.500

uIU/mL

triiodothyronine (t3)

Test

Low

Normal

High

Reference Range

Units

triiodothyronine (t3)

88

71-180

ng/dL

triiodothyronine,free,serum

Test

Low

Normal

High

Reference Range

Units

triiodothyronine,free,serum

2.5

2.0-4.4

pg/mL

reverse t3, serum

Test

Low

Normal

High

Reference Range

Units

reverse t3, serum

14.9

9.2-24.1

ng/dL

I would really like your opinions.
Thanks,
Pat


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## joplin1975 (Jul 21, 2011)

Have you had your antibodies tested? I would be curious about TSI, specifically.


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## Lovlkn (Dec 20, 2009)

> Test Low Normal High Reference Range Units triiodothyronine (t3) 88 71-180 ng/dL
> 
> triiodothyronine,free,serum
> 
> Test Low Normal High Reference Range Units triiodothyronine,free,serum 2.5 2.0-4.4 pg/mL


You are not converting your T-4 replacement medication properly to FT-3 which is confirmed by these labs.

Ask for a 5mcg trial of Cytomel which will likely require you to reduce your T-4 medication slightly. It may take awhile to dial in your dose but I feel that your FT-4 is likely going to or above top range and your FT-3 is staying low which is why you are not feeling well.

Insist they run FT-4 and FT-3 (triiodothyronine,free,serum) at every lab. Never dose by TSH

Patience pays off here.


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## buttonwood (May 4, 2014)

The only antibodytest that is out of rangewas Thyroid Peroxidase 68 H< 35 iu/ml

My internist has been puzzled by myformer tests and I told her that i should have these tests.--- Free T 3 and 4 etc. I was surprised and happy that she listened. My appt. is not until Dec. 17. I am going to call on Monday to see if I could see her next week.

Your information is very healthful and I can't wait to share it with her. My dr.listens and wants to do what is best forme.

THank you ,

Pat


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## Lovlkn (Dec 20, 2009)

Most on this board do NOT take our replacement medications before a lab draw. Consistency is key, and also try and have them drawn the same time of day each time.

I usually see my doctor and come back early the next day for labs.


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## buttonwood (May 4, 2014)

Lovlkn said:


> Most on this board do NOT take our replacement medications before a lab draw. Consistency is key, and also try and have them drawn the same time of day each time.
> 
> I usually see my doctor and come back early the next day for labs.


 I do not take my meds the morning of my blood tests. I wait until after the blood tests. My dr. usually has me have my blood tests a week or 2 before my appt . so we can discuss them at my appt.I go to Lab Corp. for my tests.

After reading the advise on these boards I take my synthroid in the middle of the night. Since I am 66 I often wake through the night. I keep my meds and water on my nightstand. This way I do not have to wait to eat when I wake up.

Just thought of another question before I see my dr. I know that a TSH test is useless after you are diagnosed but ... Why is both my TSH and Freet 4 high? Shouldn't my TSH be low because my Free T 4 is high?

Thanks for all the help,--I really, really appreciate it !

Pat


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## Lovlkn (Dec 20, 2009)

I'm not a doctor - but I believe your TSH is high because your FT-3 is low.

My TSH completely suppressed once I added Cytomel so yours will likely go down - not likely yours would fall as much as mine - I have suppressing antibodies due to my thyroid illness.


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## buttonwood (May 4, 2014)

Lovlkn said:


> I'm not a doctor - but I believe your TSH is high because your FT-3 is low.
> 
> My TSH completely suppressed once I added Cytomel so yours will likely go down - not likely yours would fall as much as mine - I have suppressing antibodies due to my thyroid


iAlthough you are not a dr. you seem very knowledgeable. i know that my dr. andI will make the final decision but I believe in having some knowledge before I go to the drs. i like to do some research before I go to the drs.

ex. Years ago my husband had a blood disorder. After doing some research I discovered that the dr was giving him too low of a dose of medication. I brought this to the attention of the dr. and I was right.He admitted it . He was a specialist . Needless to say we switched drs and all went well !

Thanks again.


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## buttonwood (May 4, 2014)

I went to my dr. and showed her all the research that I did. I even print out your response. She said that she would read what I gave her. Her receptionist just called to tell me to lower my Synthroid and that she called in a prescription for Cytomel. She said to start with a half dose and then gradually increase it and at the same time decrease my Synthroid. She gave me a script to have blood work done in 6 weeks. It includes Free T 3 & 4, Total T4 and 3, and Reverse T3.

Thanks again for your help.


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## buttonwood (May 4, 2014)

Here are my new lab test results after lowering my Synthroid to 88/100 and adding Cytomel 1.25 twice a day.

Feb.--- FreeT4 1.35 ( 0.82 -1.77) Dec. 1.55 (0.82-1.77)

TSH 13.770 H (0.45-4.500) 9.47 H (0.45-4.500)

Reverse T3 21.3 (9.2-24.1) 14.9 (9.2-24.1)

T 4 - 8.1 (4.5-12.0)

T3 - 77 (71-180)  88 (71-180)

FreeT3 - 2.4 (2.0-4.4) 2.5(2.0-4.4)

I have a Dr. appt. tomorrow morning and I was thinking of asking her to increase the Cytomel. What do you think?

Also, why would my Reverse T3 has such a great increase yet no increase in my T3 and FreeT3? Actually my Free T3 went down .1 and my T3 11.


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