# More than Thyroid?



## casstastrophe (Dec 29, 2016)

I had to have a total thyroidectomy in 2012 due to Hashi's complications, I was diagnosed with Hashi's in 2009. Since then, I rarely have felt "good" or "normal." I've been on generic levothyroxine, Armour, and am currently on Synthroid. I had my best days on Armour, but my numbers were never good, and I still never felt overall like I was healthy. My main symptoms are: extreme fatigue (I sleep a lot during the day), inability to stay asleep overnight, brain fog, memory loss, orthostatic hypotension, and difficulty concentrating. I also have difficulty recalling words in conversation that I want to use and joint pain. The slightest exertion makes me exhausted beyond anything the next day. Work is incredibly difficult for me. In fact, I'm on the verge of leaving my job because, even though I'm only part time, the shifts I work leave me exhausted, which has led to my home life suffering and my home not getting cleaned. My dogs are still being taken care of but I can no longer walk them. On the rare occasion I have the energy to walk them (I don't even take them at the same time, I take each for a very short walk), I am exhausted for 2-3 days afterward. My husband helps where he can but he works long hours so the main chores get done (dishes, laundry, etc), but my house is messy and things that aren't immediately needed get put on the backburner for months.

I've moved around a bunch since my diagnosis so have seen quite a few doctors. Every single one has brushed off my concerns as my hypothroidism. I have another appointment on Wednesday and plan to be adamant about my symptoms because I am not okay. Am I right in thinking I could have something more or is this really just likely my hypothyroidism never fully being regulated? Sorry if this post is all over the place, this took me awhile to write, like I said, I cannot concentrate well at all.


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## joplin1975 (Jul 21, 2011)

Well, if your numbers were never good, you'll never feel well. What do your latest labs look like and what meds are you on now?


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## casstastrophe (Dec 29, 2016)

March 2016: on Armour 2gr

TSH: 0.12

Free T4: 0.91

On Armour 2gr

So I was increased to Armour 3gr and here were my numbers: April 2016

TSH: 1.5

So he switched me back to Armour 2gr and these were my results Nov 2016:

Free T4: 0.76

TSH: 19.350

T3: 4.1

The endocrinologist that had me on that retired so when I went back for my recheck to get this bloodwork done the new endo switched me to Synthroid 125mcg. I get bloodwork at the beginning of February.


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## joplin1975 (Jul 21, 2011)

Do you have the reference ranges? Is that free t3 or total?


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## casstastrophe (Dec 29, 2016)

Free T4 range: 0.82-1.77

TSH: 0.450-4.500

Free T3: 2.0-4.4


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## joplin1975 (Jul 21, 2011)

It's hard to tell with the earlier labs since there's no free t4 and tsh and free t4 are basically useless with Armour, but with the latest labs, you appear to be creep towards being over medicated.

You don't really want to be above 3.8.

Make sure you always wait 12 hours between taking your meds and getting labs. Try for the same time of day. If you can track your free t3 numbers over a period of months, it would help sort out whether this is a thyroid issue or something else.


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## casstastrophe (Dec 29, 2016)

Okay, So my endo started me on Synthroid mcg when I originally posted this. Due to the way I was feeling and my labs (I don't have those results), she bumped me up to 150mcg. My numbers on 150mcg were:

Free T4: 1.61 (0.82- 1.77)

TSH: 4.52 (0.450-4.500)

Free T3: 2.9 ( 2.0-4.4)

On this dose I was having terrible hyper symptoms: heart palpitations/racing, breaking out into random sweats with the slightest exertion, and dizziness. So she decreased me to 137mcg. While I feel better on this dose (I am actually able to get things done around the house, take my dogs for walks, and do small exercises at home), I am having bad hypo symptoms (weight gain, hair loss, trouble concentrating). I go see the endocrinologist Monday but want to be a little more informed when I go in about potential options or if I should be having her look down another route. I've had cortisol tested in the recent past and it was normal. I'm also on birth control, cymbalta, and claritin. Here are my numbers on 137mcg:

Free T4: 1.23 (0.82-1.77)

TSH: 11.320 (0.450-4.500)


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## joplin1975 (Jul 21, 2011)

It's clear from those numbers that you need t3 meds, either via Armour or Cytomel.

I would ask to start Cytomel in addition to your Synthroid.


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## casstastrophe (Dec 29, 2016)

Thank you for letting me know. I'll ask about Cytomel since I was on Armour before and we could never get a good balance.


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## jenny v (May 6, 2012)

Have you ever had thyroid antibodies run? If you've got any TSI at all, it can make taking meds more difficult. You definitely need a T3 med though, I agree on that.


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