# Thyroid Removed 6 Months Ago .... T-4 T-3 ????



## tbudke (Dec 30, 2009)

I had been battleing Graves for several years and because of nodule changes and symptoms I had it removed in May this year. A small spot of Cancer was found and Endo put me on 0.15MG of Levothyroxin after surgery. I have many Hypo symton still, the worst, being a woman is I am losing my hair and have small bald spots on my head now. 
I had Horrible hemorraging in August and large cysts were removed from my Uterus and now I have a large Cyst in one of my breast, both fibercystic.
I have beeen researching on the Internet and found Fibercystic Disease and many Thyroid like symptoms can also be Adrienal Gland deficiencies, mainly a Iodine deficieny.

I have come to find that my endo is a big T-4 believer and if you fall with in the range, all is good and no other methods or changes needed, retest in 6 months. This doesnt work for me and I decided I need a more hands on doc who looks at symptoms. 
This week I went back to my Family Doc loaded with info and asked him to look at other therapies. He reduced my T-4 and added 25MCG of Liothyron.
He agreed to run lab work on my T-3, Adrienal Glands, Sex Hormones among many other tests. Today I go back and do another round for some that were 2 day tests. 
I am very excited that he was open to adding T-3 and willing to look into Adrienal gland deficienies and Iodine defiecienies. I can't wait to get these tests back to see if there is any links to my symptoms.
When I went to the lab yesterday for testing I asked for copies of my last several blood tests.

Thyoglobulin Auto Antibody <20 IU/ml. 0.0-40.0
Thyroglobulin Level 20.59 ng/ml. 1.2-35.0

Free T-4 1.27 ng/dL 0.71-1.85 
TSH-hs 0.41 ulU/mL 0.39-4.67

I will post my T-3 when I get it back.

I am rather upset with myself that I went 3 or 4 years with Graves and I didnt take the time to research my treatment, I just did what my Endo said. I am a avid Facebook user and I came upon a page http://www.facebook.com/#/pages/Save...d/121680434089 . While the site is about natural thyroid therapies alot of the content is about all thyriod sufferers no matter what your drug of choice is. I am thankful there is so much out there if you know where to look for you answers.

Does anyone have any insite to my situation that I might take to my doc when I get my results?
Thank you
Theresa


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## Andros (Aug 26, 2009)

tbudke said:


> I had been battleing Graves for several years and because of nodule changes and symptoms I had it removed in May this year. A small spot of Cancer was found and Endo put me on 0.15MG of Levothyroxin after surgery. I have many Hypo symton still, the worst, being a woman is I am losing my hair and have small bald spots on my head now.
> I had Horrible hemorraging in August and large cysts were removed from my Uterus and now I have a large Cyst in one of my breast, both fibercystic.
> I have beeen researching on the Internet and found Fibercystic Disease and many Thyroid like symptoms can also be Adrienal Gland deficiencies, mainly a Iodine deficieny.
> 
> ...


Theresa, welcome to the board. I must say that having been on that very low dose of T4 since May has not done you any good. Talk about undermedicated and yes, I am glad your new doc added T3. That is awesome.

Tell me; did you have your entire thyroid surgically removed? And this lab result (Thyroglobulin Level 20.59 ng/ml. 1.2-35.0) is from before or after surgery?

Having a history of thyroid cancer makes it very very important that the doctor keep your TSH suppressed. If the TSH posted is current, that is good.


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## tbudke (Dec 30, 2009)

I was on T-4 and doc added T-3 this week.
I had my entire Thyroid removed.
Thyroglobulin test is from this month 6 months post surgery.


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## Andros (Aug 26, 2009)

tbudke said:


> I was on T-4 and doc added T-3 this week.
> I had my entire Thyroid removed.
> Thyroglobulin test is from this month 6 months post surgery.


Hah!! I made a typo. Yes, I am glad you are on T3 and you should actually start to feel better in 24 to 72 hours. What is the dose of T3 and is it Cytomel or something else?

And I urge you to talk to your doc as to why your Thyroglobulin is so high; that is a concern It is a "marker" for cancer.

Here is the information on that. "If" you had this test before surgery and you have a "baseline" and it is down from the original "baseline"; that is good. Let me know.

Here is information on all that..........

http://www.labtestsonline.org/understanding/analytes/thyroglobulin/test.html

And remember, it is important to keep your TSH suppressed.


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## tbudke (Dec 30, 2009)

Yes Cytomel 25 mcg
Do you think that is to much to start? I do not feel so well so far with it. 
I forgot to ask and doc didnt tell me, Is it ok to take both, levothyroxin and Cytomel at the same time? Or, should there be a few hours between both? I am trying Cytomel first this morning, waiting a hour and then take the levotyroxin to see if I feel a little better today. 
Since I began taking Cytomel this week, I have not felt so well, lots of hot flashes, little hypo feeling and upset stomach.


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## Andros (Aug 26, 2009)

tbudke said:


> Yes Cytomel 25 mcg
> Do you think that is to much to start? I do not feel so well so far with it.
> I forgot to ask and doc didnt tell me, Is it ok to take both, levothyroxin and Cytomel at the same time? Or, should there be a few hours between both? I am trying Cytomel first this morning, waiting a hour and then take the levotyroxin to see if I feel a little better today.
> Since I began taking Cytomel this week, I have not felt so well, lots of hot flashes, little hypo feeling and upset stomach.


THAT is a very very hefty dose and I would conjecture that you could become overmedicated very very quickly. This would not be a good thing.

Most patients are started on 5 mcg. Lab every 8 weeks and Cytomel titrated upward by "tiny" incrments as indicated by labs. I have been around a very long time and most, if not all patients do well on anywhere from 5 mcg. to 10 mcg. per day and rarely do I run across an individual on 25 mcgs. on up.

Here is where you can read the prescribing info. http://www.kingpharm.com/Products/Alphabetic_Listing_of_Pharmaceutical_Products.cfm

You could take them both at the same time, most people do. However, you will be interested to note that King Pharm says that patient should discontinue current thyroxine replacement and take cytomel only. That makes a lot of sense since T3 is your active hormone.

Bear in mind, I am not a doctor and if you have issues w/ your med, please call your doctor.


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## tbudke (Dec 30, 2009)

You are the 2nd person to say that is a high dose. This morning I cut it in half and do feel better today, so I will continue to do so for now. Is my understanding correct in that my T4 wont need to convert to T3 since I am now taking a T3? Doc felt by cutting back my T4 by 25% and adding 25% that would be the ratio, but from what I am hearing it must not take much T3 to get good levels?
Thank you so much for that input.


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## Andros (Aug 26, 2009)

tbudke said:


> You are the 2nd person to say that is a high dose. This morning I cut it in half and do feel better today, so I will continue to do so for now. Is my understanding correct in that my T4 wont need to convert to T3 since I am now taking a T3? Doc felt by cutting back my T4 by 25% and adding 25% that would be the ratio, but from what I am hearing it must not take much T3 to get good levels?
> Thank you so much for that input.


It will suppress the T4 and in actuality, you do not need the T4 if you are on sufficient amount of T3; T3 being the active hormone. This all depends on if you are converting well or not, your life-style re physical activity and a whole lot of other things may or may not affect the dose that is right for you.


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## tbudke (Dec 30, 2009)

OK, I got all my labs back. Adding some T-3 to my regimen has not been a peice of cake. Heart pounding, sweating, Hot flashes and lots of ups and downs emotionally.

I was on .15mg Levothyroxin until 2 weeks ago and Doc dropped dosage and added .25mcg Liothron. I felt really awful on that dose and started cutting the Liothron in half.
I am on .15MG of Levothyroxin, 1 whole every other day and a 1/2 everyother day, as perscribed by doc and then the 1/2 pill of Liothron, 12.5mcg (Cytomel).
I am not feeling so great since change in meds, I cry easy, I have horrible hotflashes, break out in sweats, overall feeling of unwellnes, quezzy, nauseas and much to my husbands dismay aboslutley no Libido. I try to eating small meals more often, adding protien seems to help some.
I am 52, overwieght 220 lbs. left handed, completely gray haired.
From my tests, what can I do to improve my health?

Thyoglobulin Auto Antibody <20 IU/ml. 0.0-40.0
Thyroglobulin Level 20.59 ng/ml. 1.2-35.0

Free T-4 1.27 ng/dL 0.71-1.85 
TSH-hs 0.41 ulU/mL 0.39-4.67
Free T-3 3.3 pg/ml 2.5 - 3.9

Cortisol 
13:09 .6.70 ug / dl 12/30/2009
Cortisol 
13:27 .70 ug / dl 12/31/2009

Specimen collected at 0800 hours: 5.0 - 23.0 ug/dk
Specimen collected at 1600 hours: 3.0 - 16.0 ug/dl
Specimen collected at 2000 hours: <50% of the 0800 value
Post ACTH Stimulation: >2 times the 0800 value
Post Suppression: <5ug/dl

FHS 76.20 
FSH Reference rang2
Mid-Cycle Peak: Referenced to WHO 2nd for HFSH 75/549
Menestrating Females 3.8 - 8.8 mIU /ml
Mid Cycle Peak 4.5 - 22.5
Mid - Luteal 1.9 - 5.1
Post Menopausal-Females 16.7 - 113.6

Luteinizing Hormone (LH) 61.6 
Luteninzing Hormoen Referenced to who 2nd IRP for hLH 80/55
Menstrating Females
Mid Follicular: 2.1 - 10.9
Mid Cycl Peak 19.2 - 102
Mid-Luteal 1.2 - 12.9

Estadiol (Code:EST) <20
Estradiol Reference Ranceg
Menistruating Females:
Mid-Follicular: 28 - 114
Periovulatory: 62 - 534
Mid-Luteal: 48 - 309
Post Menopausal Females <20-88

BASIC METABOLIC CHEM
Sodium 140 136-145
Potassium 4.2 3.5-5.1
Chloride 109 97 - 112
Total CO2 22.0 21.0 - 31.0
Glucose 108 70 -110
BUN 19.0 7.0 -20.1
Creatinine 0.7 0.6-1.1
Calcium 9.5 8.4 - 10.2

LIPIDS
Cholestorol 240 <200
Triglycerides 139 <150
HDL 59 49-59
LDL Direct 155 <130
LDL/HDL Ratio 2.63 0.00 - 3.23
Cholesterol/HDL Ratio 4.07 0.00 - 4.45


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## Andros (Aug 26, 2009)

tbudke said:


> OK, I got all my labs back. Adding some T-3 to my regimen has not been a peice of cake. Heart pounding, sweating, Hot flashes and lots of ups and downs emotionally.
> 
> I was on .15mg Levothyroxin until 2 weeks ago and Doc dropped dosage and added .25mcg Liothron. I felt really awful on that dose and started cutting the Liothron in half.
> I am on .15MG of Levothyroxin, 1 whole every other day and a 1/2 everyother day, as perscribed by doc and then the 1/2 pill of Liothron, 12.5mcg (Cytomel).
> ...


Are you saying you are on 12.5 mcgs. of Liothron (Lyothyroxine T3) and 12.5 mcgs. of Cytomel (more T3?) What is the thinking behind that?

That is one hefty dose of T3; I gotta' tell you. The "usual" starting dose of any T3 is 5 mcgs. and many cut that pill in half and take 1/2 in the morning and 1/2 late afternoon and "some" just start out on 2.5 mcgs. for the first week or so; that is how strong it is.

It is so rare for someone to require 25 mcgs. of T3; especially if they are not going to the gym, lifting heavy, doing 6 miles of cardio every day in addition to regular daily activities.

I would question that dose; I truly would.

I am not good w/ the other hormones so I hope someone else comes along to help you out there.

Your glucose is borderline diabetic which makes me suspect that you are insulin resistant and "may have PCOS?" Do you? Do you know what insulin resistance is? If you have IR, it is impossible to lose weight.

I am worried about you being on that much T3; I truly am. Even 12.5 mcgs. would be a lot.


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## tbudke (Dec 30, 2009)

I am just on the one T-3 12.5 mcgs of Liothron and the levothyroxin.
I found a MD that Specializes in a Holistic approach 35 miles away that. I have an appointment with her next Tuesday.
I also have a appointment with my GP tomorrow, I think the T3 has got to go... I felt better on T4 only.... and that wasnt so great... if what you say that the T3 is a high dose to start out.... I don think my GP has a clue .


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## Andros (Aug 26, 2009)

tbudke said:


> I am just on the one T-3 12.5 mcgs of Liothron and the levothyroxin.
> I found a MD that Specializes in a Holistic approach 35 miles away that. I have an appointment with her next Tuesday.
> I also have a appointment with my GP tomorrow, I think the T3 has got to go... I felt better on T4 only.... and that wasnt so great... if what you say that the T3 is a high dose to start out.... I don think my GP has a clue .


Well, the prescribing info says 25 mcgs. per day but it also says if the patient has myxedema to start out on 5 mcgs. Like I say, I have been around a long time and I don't know anyone first-hand who could tolerater 25 mcgs. or even 12.5 mcgs. as a starting dose.

Cytomel is very powerful; it is like taking speed. It is frequently misused, misprescibed and abused. So take care of yourself here.

I will be starting on Cytomel my self as soon as I turn in the Rx. (Can't get my Armour) I am going to start on only 2.5 mcgs. per day. Why? Because as I say, I have been around and I know better. Many have landed in the hospital from over dose. Worse, most cannot ever take T3 again as their system will no longer tolerate even a tiny bit after an incident such as I describe.

With my Armour, I was getting 33 mcgs. of T3 on 3 3/4 grains per day so that should give you clue as to what I know about Cytomel. It is a whole different ball game; trust me. And incidently, I do work out. Hard. I lift weights and do at least 6 miles cardio 6 days a week.


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## tbudke (Dec 30, 2009)

I thank you so much for your advice. From your previous posts I had already cut my Cytomel in half to 12.5 . Last night I had a horrible episode and almost went to the hospital. My heart was pounding and pulse racing, sweating and chills, nausousness. I did not take it this morning. 
I had an appointment with my General Doctor this morning, the one that prescribed it and He admitted he made a mistake in administering it. He wrote a new Prescription for .5mcg and lowered my Levothyroxin in half from .15MG., I do not think I am going to make the change
I asked him if there was any supplements I could take to improve my adrienal health and he said no. What is that all about? I though Vitamin D, B complex and Iron were good for adrienal health? I also asked him about Hormonal treatments with Bioenticals and he didn't know anything about it.
I got him to run Ferrin, D, B-12, Progesteron, Testostoron labs and I should get them back by the end of the week.  I found a MD in Bend Oregon named Mary Ellen Coulter , she is a MD but specializes in Homeopath. I have an appointment with her next Tuesday. She told me to bring in all my new labs when I go. She prescribes Armour for her treatments. I wonder if she agrees with compounding and bio-denticals. I am hoping she is my new answer to a healthier life.
Thank you for saving me from taking 25mcg of Cytomel, It might have been much worse for me.


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## Andros (Aug 26, 2009)

tbudke said:


> I thank you so much for your advice. From your previous posts I had already cut my Cytomel in half to 12.5 . Last night I had a horrible episode and almost went to the hospital. My heart was pounding and pulse racing, sweating and chills, nausousness. I did not take it this morning.
> I had an appointment with my General Doctor this morning, the one that prescribed it and He admitted he made a mistake in administering it. He wrote a new Prescription for .5mcg and lowered my Levothyroxin in half from .15MG., I do not think I am going to make the change
> I asked him if there was any supplements I could take to improve my adrienal health and he said no. What is that all about? I though Vitamin D, B complex and Iron were good for adrienal health? I also asked him about Hormonal treatments with Bioenticals and he didn't know anything about it.
> I got him to run Ferrin, D, B-12, Progesteron, Testostoron labs and I should get them back by the end of the week. I found a MD in Bend Oregon named Mary Ellen Coulter , she is a MD but specializes in Homeopath. I have an appointment with her next Tuesday. She told me to bring in all my new labs when I go. She prescribes Armour for her treatments. I wonder if she agrees with compounding and bio-denticals. I am hoping she is my new answer to a healthier life.
> Thank you for saving me from taking 25mcg of Cytomel, It might have been much worse for me.


Armour is the best but it is not available right now. That is why on Sunday I am starting on 2.5 mcgs. of Cytomel.

Boy, am I sorry this is happening to you.

If I may make another suggestion based on years of observation and experience; please wait 3 to 4 days before taking any more Cytomel. The biological halflife is 2.5 days. {{{{ Cytomel is then stopped for ten days (five half lives}}}} So, I do suggest you wait. A whole week would be good but do take your T4 in the meantime. I am not a doctor, just sharing my experience and observation. It is better to be safe than sorry in my humble opinion.

We will be anxious to see your labs and the ranges when they come in if you care to share.

Be careful w/ the Cytomel; it is very very powerful.

You are welcome for any help I may have been. We may have staved off a disaster.

What you listed is good for adrenal health and here are some more tips..
http://naturalmedicine.suite101.com/article.cfm/adrenal_exhaustion


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## tbudke (Dec 30, 2009)

My appointment with new doc is next Tuesday. Here are my labs I picked up to take, some I had posted and added the Ferriton, Folate, B12, D, Testosterone.
I did not start the T-3. I thought I would wait until new doc and I had a chance to see what we would like to change.

Thyoglobulin Auto Antibody <20 IU/ml. 0.0-40.0
Thyroglobulin Level 20.59 ng/ml. 1.2-35.0

Free T-4 1.27 ng/dL 0.71-1.85 
TSH-hs 0.41 ulU/mL 0.39-4.67
Free T-3 3.3 pg/ml 2.5 - 3.9

Cortisol 
13:09 .6.70 ug / dl 12/30/2009

Specimen collected at 0800 hours: 5.0 - 23.0 ug/dk
Specimen collected at 1600 hours: 3.0 - 16.0 ug/dl
Specimen collected at 2000 hours: <50% of the 0800 value
Post ACTH Stimulation: >2 times the 0800 value
Post Suppression: <5ug/dl

FHS 76.20 
FSH Reference rang2
Post Menopausal-Females 16.7 - 113.6

Luteinizing Hormone (LH) 61.6 
Luteninzing Hormoen Referenced to who 2nd IRP for hLH 80/55
Mid-Luteal 1.2 - 12.9

Estadiol (Code:EST) <20 Post Menopausal Females <20-88

Testosterone, Bioavalable 5.2 1.5 - 9.4 Range
Testosterone, Free 1.9 0.6 - 3.8 Range
Testoserone, Total 15 9 - 55 Range
Progesterone 0.1 <0.8 -- 0.78 Post Menopausal Range

Vitamin D 22 30 - 150 Range
Vitamin B!2 341 180 - 914 Range
Folate 17.3 3.1 - 14.2 Range
Ferritin 12.6 11.0 - 307.0 Range

BASIC METABOLIC CHEM
Sodium 140 136-145
Potassium 4.2 3.5-5.1
Chloride 109 97 - 112
Total CO2 22.0 21.0 - 31.0
Glucose 108 70 -110
BUN 19.0 7.0 -20.1
Creatinine 0.7 0.6-1.1
Calcium 9.5 8.4 - 10.2

LIPIDS
Cholestorol 240 <200
Triglycerides 139 <150
HDL 59 49-59
LDL Direct 155 <130
LDL/HDL Ratio 2.63 0.00 - 3.23
Cholesterol/HDL Ratio 4.07 0.00 - 4.45


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## Andros (Aug 26, 2009)

tbudke said:


> My appointment with new doc is next Tuesday. Here are my labs I picked up to take, some I had posted and added the Ferriton, Folate, B12, D, Testosterone.
> I did not start the T-3. I thought I would wait until new doc and I had a chance to see what we would like to change.
> 
> Thyoglobulin Auto Antibody <20 IU/ml. 0.0-40.0
> ...


I am so glad you had the Ferritin test. Very very low. Should be 50 to 100 and the closer to 100, the better.

A lot of these tests that are on the high side can be attributable and are probably directly or indirectly related to your current thyroid status. That would be your cholesterol, glucose and other hormones. I always advise getting on track w/ the thyroid and then reassessing these other things at a future time.

I am so glad to hear you held off on the Cytomel. I started mine Sunday @ 2.5 mcgs. per day and am doing wonderful thus far. This Sunday, I will titrate to 5 mcgs. and stay on that until labs in another 3 weeks.

Try and get a little sun on a daily basis.


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## tbudke (Dec 30, 2009)

It has been a couple months since my last post, I am getting my first blood test this week since I started with my new MD/ND. I think we are a good fit. I switched to Compounded Dessicated Porcine, Compounded Estrogene/Progesterone, several vitamin and herbal supplements for Adrienal Fatigue, Iron, D*3, Evening Primrose and a few things I have picked up on the way.
I am excited to see her, I feel pretty good, My hair seems to have stopped falling out so much and I am optimistic which is a switch.
Cant wait to share my results.
Theresa


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## Andros (Aug 26, 2009)

tbudke said:


> It has been a couple months since my last post, I am getting my first blood test this week since I started with my new MD/ND. I think we are a good fit. I switched to Compounded Dessicated Porcine, Compounded Estrogene/Progesterone, several vitamin and herbal supplements for Adrienal Fatigue, Iron, D*3, Evening Primrose and a few things I have picked up on the way.
> I am excited to see her, I feel pretty good, My hair seems to have stopped falling out so much and I am optimistic which is a switch.
> Cant wait to share my results.
> Theresa


Theresa.............you truly sound great and thank you for checking in with us. We will be very happy to look at your results and I have a funny feeling they are going to be very good.


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