# Normal results, but feeling terrible



## Endlessness

Hey guys!

So a little while ago, I asked you what you thought of Synthroid vs. generic, and thanks to your help, I decided to switch back to Synthroid after being rocky on generics for about 5 years. I honestly thought it would fix everything...

Well, the labs say it's fixed, but I've never felt this tired in a while. I'm losing so much hair, I've counted 200 hairs just taking a shower (from what just sticks to my hands while I shampoo) and from brushing afterwards, not even counting what falls throughout the rest of the day... My skin is dry, I have so much brain fog it's ridiculous. I also gained a bit of weight and can't seem to lose it.

I mean, I sleep 8-9 hours, and I still wake up super tired and could sleep another 2-3 hours easily (and sometimes I do)...

To me, this all screams hypo, but I went to see a real endocrinologist this time, and he did a bunch of tests that all came back normal (of course).

Here are the important ones:

T4, Free (Direct) 1.74 ng/dL [0.82 - 1.77]
TSH 0.820 uIU/mL [0.450 - 4.500]
Thyroid Stim Immunoglobulin 42% [0 - 139]
Sedimentation Rate-Westergren 3 mm/hr [0 - 32]

Vitamin D, 25-Hydroxy 32.4 ng/mL [30 - 100] (note: I take 2000IU of Vitamin D3 everyday, and I upped the dosage to 4000IU, but nothing changed)

Iron Bind. Cap. 285 ug/dL [250 - 450]
UIBC 188 ug/dL [150 - 375]

Iron, Serum 97 ug/dL [35 - 155]
Iron Saturation 34% [15-55]

He did a bunch of other stuff like CBC with Differential/Platelet, Complete Metabolic Panel, Basic Metabolic Panel, etc. Everything came back normal.

My new endo is really sweet and very nice. He assured me it's not caused by my thyroid. He thinks all of my symptoms aren't related to each other and he's trying really hard to figure each of them out, but somehow I just feel they're all caused by my thyroid... I just don't know what to do.

He's thinking I might have a sleeping disorder, but the home test came back borderline negative/positive for sleep apnea, so not super obviously the cause for now and it's ambiguous. He's also trying to see if I'm having some sinus problems that might be causing the slight sleep apnea, so he put me on a nasal steroid, mucinex and Allegra. So that's where I stand for now. I've been feeling awful for 3 months now...

So my question is (sorry for the long post) what is your opinion? What should I be asking? Have you ever had this problem, where your endo says everything is perfect, but you still feel awful?

Thank you for your help, I'm starting to feel really frustrated and scared it will never go away


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## JPGreco

Have him test your Free T3. You may have a problem converting the T4 to T3 in your body and may need a T3 medication. I've read the hair issue can be from getting used to the medication.


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## Endlessness

Thanks for your input JPGreco!

The last time they checked my T3 was 5 months ago, and it was normal. Here was the result, along with the other tests taken at the same time :

Free T3 3.04 pg/mL [2.3 - 4.2]
Free T4	1.33 ng/dL [0.59 - 1.61]
TSH 0.59	uIU/mL [0.34 - 4.82]

This was about 2 months after switching back to Synthroid from Levothyroxine.

Is it possible that I suddenly can't convert the T4? Or is it pretty much a given that if it was converting correctly 5 months ago, it should be ok now?

And how long does it take to get used to Synthroid and stop losing hair?  It's been 5 months... so I'm hoping it'll stop soon!


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## Octavia

Endlessness said:


> And how long does it take to get used to Synthroid and stop losing hair?  It's been 5 months... so I'm hoping it'll stop soon!


For me, it was probably about 6 months. Hopefully, you're at the tail end.


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## Endlessness

Octavia said:


> For me, it was probably about 6 months. Hopefully, you're at the tail end.


That would be good!

Were you losing that much hair too? It's really freaking me out... :sad0049:


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## Octavia

Yes, I did lose a TON of hair...but my hair is super-thick, so it was not the least bit noticeable to anyone but me.


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## Endlessness

It makes me feel better to know that it stopped for you and it did take a long time, so I'm still hoping it'll stop. If only I didn't have super thin hair T_T


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## Octavia

Yeah...if my hair was thin, the hair loss would have definitely concerned me - a lot! If your hair loss does last more than 6 months, that is cause for further exploration. I hope it stops tomorrow for you! :hugs:


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## joplin1975

Endlessness said:


> Is it possible that I suddenly can't convert the T4? Or is it pretty much a given that if it was converting correctly 5 months ago, it should be ok now?
> 
> And how long does it take to get used to Synthroid and stop losing hair?  It's been 5 months... so I'm hoping it'll stop soon!


I honestly don't know, but the biggest thing I've learned in this journey is to never assume. So if you a very symptomatic, I think it would be well worth it to get your free t3 tested again.

I went through a two month period of hair loss...it stopped eventually. A friend of mine who had Graves and who had her thyroid out a month after me was doing fine for about five months and then suddenly started losing her hair and is now in the whole titration process again.


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## Andros

Endlessness said:


> Hey guys!
> 
> So a little while ago, I asked you what you thought of Synthroid vs. generic, and thanks to your help, I decided to switch back to Synthroid after being rocky on generics for about 5 years. I honestly thought it would fix everything...
> 
> Well, the labs say it's fixed, but I've never felt this tired in a while. I'm losing so much hair, I've counted 200 hairs just taking a shower (from what just sticks to my hands while I shampoo) and from brushing afterwards, not even counting what falls throughout the rest of the day... My skin is dry, I have so much brain fog it's ridiculous. I also gained a bit of weight and can't seem to lose it.
> 
> I mean, I sleep 8-9 hours, and I still wake up super tired and could sleep another 2-3 hours easily (and sometimes I do)...
> 
> To me, this all screams hypo, but I went to see a real endocrinologist this time, and he did a bunch of tests that all came back normal (of course).
> 
> Here are the important ones:
> 
> T4, Free (Direct) 1.74 ng/dL [0.82 - 1.77]
> TSH 0.820 uIU/mL [0.450 - 4.500]
> Thyroid Stim Immunoglobulin 42% [0 - 139]
> Sedimentation Rate-Westergren 3 mm/hr [0 - 32]
> 
> Vitamin D, 25-Hydroxy 32.4 ng/mL [30 - 100] (note: I take 2000IU of Vitamin D3 everyday, and I upped the dosage to 4000IU, but nothing changed)
> 
> Iron Bind. Cap. 285 ug/dL [250 - 450]
> UIBC 188 ug/dL [150 - 375]
> 
> Iron, Serum 97 ug/dL [35 - 155]
> Iron Saturation 34% [15-55]
> 
> He did a bunch of other stuff like CBC with Differential/Platelet, Complete Metabolic Panel, Basic Metabolic Panel, etc. Everything came back normal.
> 
> My new endo is really sweet and very nice. He assured me it's not caused by my thyroid. He thinks all of my symptoms aren't related to each other and he's trying really hard to figure each of them out, but somehow I just feel they're all caused by my thyroid... I just don't know what to do.
> 
> He's thinking I might have a sleeping disorder, but the home test came back borderline negative/positive for sleep apnea, so not super obviously the cause for now and it's ambiguous. He's also trying to see if I'm having some sinus problems that might be causing the slight sleep apnea, so he put me on a nasal steroid, mucinex and Allegra. So that's where I stand for now. I've been feeling awful for 3 months now...
> 
> So my question is (sorry for the long post) what is your opinion? What should I be asking? Have you ever had this problem, where your endo says everything is perfect, but you still feel awful?
> 
> Thank you for your help, I'm starting to feel really frustrated and scared it will never go away


Okay; your FREE T4 is very high in the range and the TSH is very low in the range and that is probably all okay if the FREE T3 is where it is supposed to be but your doc did not run that. FREE T3 is critically important as this is your active hormone. If you are indeed hyper, that would cause hair loss, weight gain and a whole host of problems.

Also, has your doc commented on the TIBC and UIBC? They seem kind of low to me. Even though they are within the range, that does not necessarily mean that is a good place for you.

Are you taking iron or eating foods high in iron?

And.........................what about the TSI? This is present in patients w/hyperthyroid.

TSI
Normally, there is no TSI in the blood. If TSI is found in the blood, this indicates that the thyroid stimulating immunoglobulin is the cause of the of a person's hyperthyroidism. 
http://www.medicineonline.com/topics/t/2/Thyroid-Stimulating-Immunoglobulin/TSI.html


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## Endlessness

Thank you so much Andros!

I don't understand why he didn't do the T3 test... I was assuming that since he's an endo he would know what to do (it's the first endo I see in the last 10 years). I guess like joplin1975 said, never assume, and that goes for your doctor as well ;P

And no, he did not comment on the iron at all.

Here are some older results for iron (taken at a different lab):

*January 2011*
IRON	101 ug/dL [52 - 150]	
TIBC	292 UG/DL [240 - 400]
SATURATION 35% [15 - 50]

*August 2009*
IRON	62 ug/dL [52 - 150]	
TIBC	319 UG/DL [240 - 400]
SATURATION 19% [15 - 50]

I'll try to eat more food with iron or take supplement and see if it helps!

So it sounds like next time I see him, I should ask him to redo the thyroid function tests and to include TSH, T3 and T4 this time! And then maybe we'll get a better overview of what's going on.

I don't get why he didn't even say anything about the TSI! But if it's bad to even have it in your blood, why is the "normal" range 0-139%? I'm confused!


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## Andros

Endlessness said:


> Thank you so much Andros!
> 
> I don't understand why he didn't do the T3 test... I was assuming that since he's an endo he would know what to do (it's the first endo I see in the last 10 years). I guess like joplin1975 said, never assume, and that goes for your doctor as well ;P
> 
> And no, he did not comment on the iron at all.
> 
> Here are some older results for iron (taken at a different lab):
> 
> *January 2011*
> IRON	101 ug/dL [52 - 150]
> TIBC	292 UG/DL [240 - 400]
> SATURATION 35% [15 - 50]
> 
> *August 2009*
> IRON	62 ug/dL [52 - 150]
> TIBC	319 UG/DL [240 - 400]
> SATURATION 19% [15 - 50]
> 
> I'll try to eat more food with iron or take supplement and see if it helps!
> 
> So it sounds like next time I see him, I should ask him to redo the thyroid function tests and to include TSH, T3 and T4 this time! And then maybe we'll get a better overview of what's going on.
> 
> I don't get why he didn't even say anything about the TSI! But if it's bad to even have it in your blood, why is the "normal" range 0-139%? I'm confused!


They need a range to assess the seriousness of the TSI and to be able to detect movement either up or down. That's the scoop on that. Sadly, even most doctors don't "get this." Wah!

If you take iron, make sure you take it 4 to 5 hours away from your thyroxine replacement.

Make sure you say FREE T3 and FREE T4; not T3 and T4 which are totals of bound and unbound hormone.

Dr. Mercola (FREES)
http://www.mercola.com/Article/hypot...nosis_comp.htm

Your doc did do the FREE T4 which was good but in this instance means little w/o the FREE T3. As another poster pointed out, you may not be converting which is another possible scenario.

Keep us posted.


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## Endlessness

Awesome, thank you ALL for your valuable input! I don't know what I'd do without you guys <3

I'll update as soon as I see him again (2 weeks!)


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## Endlessness

Alright, I FINALLY got my results back... It took so long to get them, for some reason I did not receive them by mail like I usually do, so I had to call my doctor after waiting for 3+ weeks, and he snailed mailed them to me.

So I asked for another full check on my thyroid, and he very reluctantly checked the T3 box because I asked, but when I specified FREE T3, he said it was pretty much useless unless I was pregnant... So I didn't insist. I'm weak like that... I'm frustrated at myself, but I didn't want to annoy him. Sigh...

I'm still losing a LOT of hair. Went to a dermatologist who said all the test she would have done (thyroid, iron) had been done and were normal, so there was nothing more she could do. She told me to use Rogaine (no thanks), and to try taking biotin and B complex vitamins. I tried the B complex but it really messed me up. I could not sleep until 6 am the 3 nights I took them and I felt awful, even if I took them in the morning. I stopped them when I realized they were the cause of my insomnia.

My endo still thinks my fatigue comes from low quality sleep so he told me to take a Benadryl caplet before going to sleep. I tried that for a week, but that messed me up too. I lost 6 pounds in 4 days, I had NO appetite and felt queasy all the time, on top of feeling super groggy in the morning and having to take a nap 2 hours after waking up. I just stopped taking them and I'm hoping my appetite will come back, unless it was coincidental and is just a new symptom of whatever is happening.

Anyway, that's where I'm at. Now here are my results. The blood test were taken on June 27th, so a month ago:

Free T4 : 1.72 (0.82 - 1.77)
TSH : 1.560 (0.450 - 4.500)
Vitamin D : 42.1 (30 - 100)
C-Reactive Protein, Cardiac : 0.26 (0.00 - 3.00) **I didn't even know he ordered that, and I have no idea why he did it... I'll ask him when I see him next week**
T3 (not free) : 98 (71 -180)
Sedimentation Rate-Westergren : 5 (0 - 32)

What do you guys think?


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## Andros

Endlessness said:


> Alright, I FINALLY got my results back... It took so long to get them, for some reason I did not receive them by mail like I usually do, so I had to call my doctor after waiting for 3+ weeks, and he snailed mailed them to me.
> 
> So I asked for another full check on my thyroid, and he very reluctantly checked the T3 box because I asked, but when I specified FREE T3, he said it was pretty much useless unless I was pregnant... So I didn't insist. I'm weak like that... I'm frustrated at myself, but I didn't want to annoy him. Sigh...
> 
> I'm still losing a LOT of hair. Went to a dermatologist who said all the test she would have done (thyroid, iron) had been done and were normal, so there was nothing more she could do. She told me to use Rogaine (no thanks), and to try taking biotin and B complex vitamins. I tried the B complex but it really messed me up. I could not sleep until 6 am the 3 nights I took them and I felt awful, even if I took them in the morning. I stopped them when I realized they were the cause of my insomnia.
> 
> My endo still thinks my fatigue comes from low quality sleep so he told me to take a Benadryl caplet before going to sleep. I tried that for a week, but that messed me up too. I lost 6 pounds in 4 days, I had NO appetite and felt queasy all the time, on top of feeling super groggy in the morning and having to take a nap 2 hours after waking up. I just stopped taking them and I'm hoping my appetite will come back, unless it was coincidental and is just a new symptom of whatever is happening.
> 
> Anyway, that's where I'm at. Now here are my results. The blood test were taken on June 27th, so a month ago:
> 
> Free T4 : 1.72 (0.82 - 1.77)
> TSH : 1.560 (0.450 - 4.500)
> Vitamin D : 42.1 (30 - 100)
> C-Reactive Protein, Cardiac : 0.26 (0.00 - 3.00) **I didn't even know he ordered that, and I have no idea why he did it... I'll ask him when I see him next week**
> T3 (not free) : 98 (71 -180)
> Sedimentation Rate-Westergren : 5 (0 - 32)
> 
> What do you guys think?


Don't believe you are converting. Total 3 is in the basement and this is not good because the Total 3 is bound, unbound (FT3) and rT3 (reverse.)

So, you do have a situation and I urge you to find a doctor who will run the FREE T3 just to verify and put you on T3. You need it badly. You must be feeling awful.

Humble opinion.

Dr. Mercola (FREES)
http://www.mercola.com/article/hypothyroid/diagnosis_comp.htm
FREE T3 explained by Woliner
http://thyroid.about.com/cs/testsforthyroid/a/freet3.htm


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## adenure

Hi There 

I have Kaiser Permanente and they don't run free T-3 tests - stinkers. So, I'm going to pay for it myself and have it done. If your doctor won't run the test (I'd ask him again. But, I'm like you, I have a hard time ruffling feathers and tend to back down. I'm trying not to do this anymore as I figure, hey, it's MY life, my family, my health & I want to feel good dang it!) So, yeah, be a thorn in his side and ask again. Here's the website to get your own lab ordered though. I'm heading in tomorrow or in another day or 2 to get it done.

http://www.healthcheckusa.com/Thyroid-Panel-II-T4-Free-T3-Free-with-TSH/46938/

I too am on 100 mcg Synthroid (brand) after a total thyroidectomy 6 weeks ago because of Graves (methimazole did great for my thyroid, not so great for my liver.) It'll be interesting to see where I'm at. I'm not sleeping great, headaches, anxiety on occasion, hair definitely falling out, diarrhea (sorry); I just feel like a mess of symptoms. Let's hang in there! We can do it! hugs1


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## Endlessness

Andros, once again, thank you so much for your help. What would we do without you? 

You say that my total T3 is in the basement, but where should it be? It's so confusing because with the range, it makes you think that all is well and it's all in your head (they love saying that don't they?). When I called to get the results, his secretary told me that he said everything was perfectly in range and I had nothing to worry about. Gnnn...

Adenure, I'm thinking of ordering it myself too, or maybe going on a hunt for yet another doctor who will do it. I'll definitely try to muster the courage to insist when I see him next Wednesday, or maybe ask my husband to come and insist for me hahaha 

I hope you can figure out the right dosage quickly! Those symptoms are not fun at all... hugs1 Thanks for the encouragements!


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## webster2

Endlessness said:


> Andros, once again, thank you so much for your help. What would we do without you?
> 
> You say that my total T3 is in the basement, but where should it be? It's so confusing because with the range, it makes you think that all is well and it's all in your head (they love saying that don't they?). When I called to get the results, his secretary told me that he said everything was perfectly in range and I had nothing to worry about. Gnnn...
> 
> Adenure, I'm thinking of ordering it myself too, or maybe going on a hunt for yet another doctor who will do it. I'll definitely try to muster the courage to insist when I see him next Wednesday, or maybe ask my husband to come and insist for me hahaha
> 
> I hope you can figure out the right dosage quickly! Those symptoms are not fun at all... hugs1 Thanks for the encouragements!


Your labs are almost identical to where mine were. Endo said they were in range but I felt terrible. I was cold all of the time. Tired but in the afternoons exhausted.

I think Free T's should be in mid to 75% of the range to feel best but it seems to be subjective. I have found it is a fine balance and sometimes takes a little tweaking to get where one feels human or normal again.

Remember you live in your body and know it best, don't be afraid to speak up with your doctor.


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## I DClaire

My numbers were O.K. with Synthroid but I felt like I was caught in a perpetual panic attack - I stayed "off". My hand/eye coordination was off, my balance seemed off, I felt weird mentally and emotionally and I honestly thought I might lose all my hair. My hair is thin naturally, and baby fine. For awhile, it got to where it felt like dry straw and it was even falling out at night. I'd wake-up and there would be hair on my pillow.

Everytime I've ever had surgery I've experienced temporary hair loss so I didn't know if that was the explanation or not. I changed to Armour last December and the hair loss stopped but, again, I don't know whether it was the change in medication or not.

Thankfully, my hair has pretty much gone back to it's normal state.


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## Endlessness

Alright, I finally had the courage to insist on a Free T3. I didn't have to insist too much, which was very nice. He said he would test it so that I can feel better about it and clear the doubts. He also sent me to an infectious disease specialist, which told me I most likely have Chronic Fatigue Syndrome T_T

I got my results back. The interesting thing is that my endo also did a few adrenal tests.

Here are the thyroid results:

Free T3: 2.8 [2.3 - 4.2]
TSH: 0.72 [0.4 - 4.5]
Free T4: 1.4 [0.8 - 1.8]

Here are the abnormal adrenal results:

Cortisol Total Serum: 20.8 [4.6 - 20.6]
ACTH Plasma : 79 [6 - 50]
(Note: The two tests say to do them between 7am - 10am, and I didn't know. I took it at 11:23am, fasting. Does it matter?)

Other abnormal tests:

Creatine Kinase: 21 [29 - 143]
ANA (IFA) : Speckled, Titer 1:80
(I've had the ANA done before with the same results and was told it was false positive)

So of course I read about the adrenal tests and it seems to lead to Cushing's, but I have none of the obvious physical signs (weight gain in the torso, hump on the back, purple marks, etc.). Just to remind you, my main concern is extreme fatigue and hair loss. I do bruise easily, my heart rate is always pretty high, and I just generally feel bad. I feel like something is really wrong. I constantly feel under the weather, and I have major brain fog/poor memory.

So do you guys have any idea if this could be Cushing's anyway? I'm seeing my endo next week, but it's hard to wait that long without letting your mind wander, so I thought I'd ask you guys for your opinion until then  The problem is, I have no idea how bad my results are. I mean, my cortisol is only 0.2 higher than the range... I'm lost in this area! Help!


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## Andros

Endlessness said:


> Alright, I finally had the courage to insist on a Free T3. I didn't have to insist too much, which was very nice. He said he would test it so that I can feel better about it and clear the doubts. He also sent me to an infectious disease specialist, which told me I most likely have Chronic Fatigue Syndrome T_T
> 
> I got my results back. The interesting thing is that my endo also did a few adrenal tests.
> 
> Here are the thyroid results:
> 
> Free T3: 2.8 [2.3 - 4.2]
> TSH: 0.72 [0.4 - 4.5]
> Free T4: 1.4 [0.8 - 1.8]
> 
> Here are the abnormal adrenal results:
> 
> Cortisol Total Serum: 20.8 [4.6 - 20.6]
> ACTH Plasma : 79 [6 - 50]
> (Note: The two tests say to do them between 7am - 10am, and I didn't know. I took it at 11:23am, fasting. Does it matter?)
> 
> Other abnormal tests:
> 
> Creatine Kinase: 21 [29 - 143]
> ANA (IFA) : Speckled, Titer 1:80
> (I've had the ANA done before with the same results and was told it was false positive)
> 
> So of course I read about the adrenal tests and it seems to lead to Cushing's, but I have none of the obvious physical signs (weight gain in the torso, hump on the back, purple marks, etc.). Just to remind you, my main concern is extreme fatigue and hair loss. I do bruise easily, my heart rate is always pretty high, and I just generally feel bad. I feel like something is really wrong. I constantly feel under the weather, and I have major brain fog/poor memory.
> 
> So do you guys have any idea if this could be Cushing's anyway? I'm seeing my endo next week, but it's hard to wait that long without letting your mind wander, so I thought I'd ask you guys for your opinion until then  The problem is, I have no idea how bad my results are. I mean, my cortisol is only 0.2 higher than the range... I'm lost in this area! Help!


3.2 is about the mid-range of the range given by your lab for FREE T3. I am so glad you got this test!!

You are way low. Most of us require our FREE T3 to be at about 75% of the range given by the lab.

It does not sound like you have Cushings but I am no expert on that one! What does your doctor have to say about that?

What thyroid med are you on and how much? Some of your test results would improve simply by getting that FREE T3 up there.


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## Endlessness

Oh really?! I didn't realize my free T3 was that low (thanks to the range confusing everyone haha). I'm on synthroid 100. Does that mean I would require an extra dose of T3 with my Synthroid, or should I just get a higher dose of Synthroid?

The other thing is, I read that Cushing's can interfere with the conversion from T4 to T3. I'm wondering if it might all be from that. I haven't seen my doctor yet about it, I have to wait until my next appointment next Tuesday. Booo!

Thanks for your input!


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## HotGrandma

Endless:

Sorry, but I am completely new here. Have you checked into Vitamin B deficiencies? I cannot find it right now, I'll keep looking, but hair loss was a big thing, and your other symptoms fit . http://www.mayoclinic.com/health/vitamin-deficiency-anemia/DS00325/DSECTION=symptoms

Please check it out, it can't make things any worse. HUGS


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## Endlessness

Hi HotGrandma!

Yes, we have checked the vitamin B, and they were all in perfect range  I also tried to take a B-complex vitamin just in case, and it made me feel terrible! I'm not sure why...

Thanks for the suggestion!


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## Andros

Endlessness said:


> Oh really?! I didn't realize my free T3 was that low (thanks to the range confusing everyone haha). I'm on synthroid 100. Does that mean I would require an extra dose of T3 with my Synthroid, or should I just get a higher dose of Synthroid?
> 
> The other thing is, I read that Cushing's can interfere with the conversion from T4 to T3. I'm wondering if it might all be from that. I haven't seen my doctor yet about it, I have to wait until my next appointment next Tuesday. Booo!
> 
> Thanks for your input!


If you are on 100 mcg. of Synthroid, you might want ask the doc about putting you on 5 mcg. of Cytomel to see how that works because to keep on increasing your Synthroid past a certain point with no appreciable results is not at all productive.

Free T3 and Free T4 are the only accurate measurement of the actual active thyroid hormone levels in the body. This is the hormone that is actually free and exerting effect on the cells. These are the thyroid hormones that count.
Dr. Mercola (FREES)
http://www.mercola.com/Article/hypothyroid/diagnosis_comp.htm


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## Endlessness

Hi everyone,

So I finally convinced the endo to try giving me Cytomel (after he made me take a million other tests and try other stuff).

He decreased my Synthroid to 88 and then added 5 mcg of Cytomel. I've only been on it for 3 weeks, but I feel worse than before. I've gained 8 pounds a week after switching the doses and I can't lose any weight, even though I've limited my calorie intake to 1300 per day, and I've been exercising a lot more (and it's not related to the holidays, as I've spent it with friends and cooked healthy meals, almost no desserts!).

I'm also even more tired, very cranky and depressed.

Can a dosage switch affect me this quickly? Is it unrelated?

The doc told me to wait 6 weeks before testing, but I'm going to go next week at the 4 weeks mark. I don't want to wait that much longer, honestly. I checked the test sheet he gave me and noticed he didn't mark the Free T3, only Total T3. GRRR.

I called today and asked his secretary if we could add it. She asked him and called me back... Nope. He says it's not needed. WTF. I'm so angry right now... But I was so shocked that he refused that I didn't know what to say and just said "thank you" and hung up.

I figure if I'm really hypo (which I feel like I am), it'll show up in his dear TSH, and we'll try to add more Cytomel or Synthroid. I don't feel like searching for a new endo for now, I just want to reach a "seemingly" correct dosage, and then I'll go see someone else for a free T3 test. Or pay for it myself.

This is all so frustrating. I feel like I've wasted a year of my life jumping through hoops while my endo tried to pin my obviously hypo symptoms to some other diseases.

I'm ready for this to be settled now!

So yeah, sorry for the rant, thanks for listening  And my main question would be: can a dosage change affect you so much only after a week?


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## Endlessness

Well, I got the test results and everything "looks" good, even though I feel hypo... Frustrating and so confusing. Not sure what to do now, although Free T3 wasn't tested. Maybe I'll wait another month and test again, I guess.

Results when I was taking Synthroid 100 only

Free T3: 2.8 (2.3 - 4.2)
Free T4: 1.4 (0.8 - 1.8)
TSH: 0.72 (0.40 - 4.50)

Results now, after a month of Synthroid 88 and Cytomel 5

Total T3: 91 (76 - 181)
Free T4: 1.0 (0.8 - 1.8)
TSH: 0.76 (0.40 - 4.50)


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## Andros

Endlessness said:


> Well, I got the test results and everything "looks" good, even though I feel hypo... Frustrating and so confusing. Not sure what to do now, although Free T3 wasn't tested. Maybe I'll wait another month and test again, I guess.
> 
> Results when I was taking Synthroid 100 only
> 
> Free T3: 2.8 (2.3 - 4.2)
> Free T4: 1.4 (0.8 - 1.8)
> TSH: 0.72 (0.40 - 4.50)
> 
> Results now, after a month of Synthroid 88 and Cytomel 5
> 
> Total T3: 91 (76 - 181)
> Free T4: 1.0 (0.8 - 1.8)
> TSH: 0.76 (0.40 - 4.50)


Your labs don't look good to me. While that is Total 3, it is revealing. Total 3 consists of bound, unbound and rT3 (reverse T3) hormone and the one that counts is the unbound which is called FREE T3.

Since this Total 3 is in the basement and we don't know which is what here, it is cause for concern.

Go get your FREE T3 run @

HealthCheckUSA
http://www.healthcheckusa.com/

No wonder you feel so bad. But, one has to be careful w/ the Cytomel and it has to be titrated in small doses such as 2.5 or 5 mcg. every 6 to 8 weeks using labs and clinical evaluation as a guide each and every time.

And by the way, taking exogenous T3 does lower the FREE T4. This is a normal and natural event.

Read this please.

Free T3 and Free T4 are the only accurate measurement of the actual active thyroid hormone levels in the body. This is the hormone that is actually free and exerting effect on the cells. These are the thyroid hormones that count.
Dr. Mercola (FREES)
http://www.mercola.com/Article/hypothyroid/diagnosis_comp.htm


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## Sandbar

Endlessness, sounds like your endo and my endo trained at the same place! I too have an FT4 at 1.0 and feel like complete crap. I called and said so and I just got back that my test results were perfect and no dosage changes allowed. I'm considering my options...hope you do too!


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## Endlessness

Well, the saga continues!

So my endo ended up refusing to renew my meds when I needed a refill because I hadn't seen him in a month, so I decided to "let him go" and go see my normal doctor. I was going to ask for a referral to another endo, but we ended talking and he said he would work with me to try to find the correct dosage, and he was more than happy to test for Free T3 (he didn't understand why my endo was refusing to do it). So I decided to give it a try!

So the first thing we did is test everything to see where I was. For comparison, I'll put what my results were BEFORE the Cytomel combo, and the results I got when I saw my family doctor:

BEFORE CYTOMEL
Free T3: 2.8 (2.3 - 4.2)
Free T4: 1.4 (0.8 - 1.8)
TSH: 0.72 (0.40 - 4.50)

AFTER 2-3 MONTHS
Free T3: 2.43 (2.3 - 4.2)
Free T4: 1.09 (0.59 - 1.61)
TSH:	0.42	(0.34 - 4.82)

Sooo... My T3 is LOWER with the Cytomel? So confusing T_T

I did feel a bit better on that combo though, not AS tired, but still very brain foggy and meh. He wasn't so keen on upping the Cytomel because my heart rate was 120-130 when he took it that day (going to the doctor makes me very nervous, it's not always that high), and I kind of agreed. I had some palpitations on Cytomel, so I wasn't sure how safe it would really be to up it. So I suggested that we try to go back to my original Synthroid dose of 112, the one I was on for 5 years before moving to the US and getting switched to generic (which messed everything up).

So we did. And I just did the 6 weeks later test, here are the results:

ON 112 SYNTHROID ONLY
Free T3: 3.25 (2.3 - 4.2)
Free T4: 1.41 (0.59 - 1.61)
TSH: 0.02 (0.34 - 4.82)

So yeah, now my TSH says I'm hyper, but my Free T3 and T4 are high-normal (which is supposed to be good, right?). Except I feel like I went back to being super tired, like I was before the Cytomel. I need to take naps at least once a day, sometimes twice. I don't get it, this is all so frustrating.

Anyone has any idea what my next step should be?

My doc still wants to try other things, like cutting out dairy (I tried the gluten-free diet by myself and nothing changed), and checking for intestinal problems, in case this is what is causing the fatigue and fog.

Sigh. I'm tired of being tired!  Sorry I'm being so negative, I'm just getting a bit discouraged...


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## jenny v

I would suggest a few more tests (if you haven't already):
1.Vitamin D
2. Vitamin B12
3. Ferritin

Being low in any of the above can cause tiredness and a whole host of other problems that can mimic thyroid issues.


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## Endlessness

jenny v said:


> I would suggest a few more tests (if you haven't already):
> 1.Vitamin D
> 2. Vitamin B12
> 3. Ferritin
> 
> Being low in any of the above can cause tiredness and a whole host of other problems that can mimic thyroid issues.


Thank you so much for your input!

Unfortunately, I did test all of those and they were all well in range (I take 2000 IU of Vitamin D, so I would hope it's well in range haha).


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## thumper54

Just my two cents worth, but Vit D needs to be much higher than the 32 you were at when you posted your level. It too needs to be in the 75% range to feel like you have any in your body. I fight this too. For some reason even though I take 5000 units daily I am always very low. Hope your are feeling better.


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