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Posted 4/20/2016 9:39 PM (GMT 0)
I have my thyroid test results from my endocrinologist but don't see her until next month and I am hoping you can help me sort out if anything needs tweeking. I have been on Levothyroxine 100 mcg for a few years and this is the first time I have had thorough testing. The results are:

Free T4....1.5 (0.8-1.8)
Free T3. 2.4 (2.3-4.2)
Total T3....82 (optimal 100-180)
Total T4....10.5 (optimal 5.4-11.5)
TSH....3.12 (optimal 1.8-2.5)

I have also been diagnosed with Hashimotos
Thyroglobulin antibodies....205
Thyroid peroxidase antibodies....52

I have called the office and the staff states they will have the doctor call me back but that hasn't occured.

Thanks a ton.

Patty
Posted 4/20/2016 9:54 PM (GMT 0)
Patty, I think cd will need to see what the test parameters are. If you could post those it would be helpful to her. All tests are different.
Posted 4/20/2016 11:12 PM (GMT 0)
I will do that, PeteZa. Thank you.
Posted 4/21/2016 1:00 AM (GMT 0)
Looks like another one who gets to join the T3 club.
Posted 4/21/2016 2:21 AM (GMT 0)
astroman is right, Patty. You need T3.

Please forgive me if I'm preaching to the choir with some of the stuff I share but I like to be thorough. Please ask any questions that come to mind.

OK...when evaluating thyroid labs, the only levels that matter are your Free T4 and Free T3.

The Free T4 level measures the amount of T4 storage hormone the body has available for use. The body converts that T4 storage hormone into T3, our active hormone....the measurement for that is the Free T3 level.

Everyone needs adequate amounts of both T4 and T3.

People taking T4 only meds like levothyroxine usually need top-of-the-range or slightly over-range Free T4 levels to feel well. And, their Free T3 level needs to be in the upper quarter of the range.

Based upon your lab's ranges, this means Free T4 at least 1.6 or higher......and Free T3 at least 3.8 or higher.

As you can see, your Free T4 level is just a little low - some people might be fine with that level. Others, such as myself, would have many, many symptoms of hypothyroidism.

Your Free T3 level is almost at the bottom of the range and this is not good at all - sorry.

Your body just isn't able to convert that T4 in your levothyroxine to T3, the active hormone. That's why your Free T3 level is so low.

Increasing your levothyroxine will help your Free T4 level but it will not be able to get that Free T3 level up to where it should be for good health.

You need T3. The easiest route would be to get a prescription for Cytomel from your doctor.

I'm glad you put in a call to your endo and I sure hope you hear back in a timely manner.

Good luck getting the hormone you obviously need!!!

Please let us know how things go.
Posted 4/21/2016 11:41 AM (GMT 0)
Astroman....LOL.

Cd, thank you so much. Do you think this could be contributing to the sob I've been experiencing for so long? I will put a call in to the endo this morning.

Patty
Posted 4/21/2016 12:46 PM (GMT 0)
Patty,

The list of possible symptoms from hypothyroidism is as long as the list of possible Lyme and Co. symptoms:

hypothyroidmom.com/300-hypothyroidism-symptoms-yes-really/

Optimizing your thyroid levels will help you know whether or not your thyroid is to blame. If it isn't, I'd be trialing Babesia treatment along with the Lyme treatment since both of these infections can cause sob/air hunger.
Posted 4/21/2016 9:38 PM (GMT 0)
Cd, that is a real long list! The endo doc did not return my call AGAIN. Unbelievable!
I am sure most of my symptoms are related to lyme and company but I am actually hoping some are related to thyroid problems.
Thanks again.

Patty
Posted 4/21/2016 10:44 PM (GMT 0)
I have some of those symptoms - it's a really,long list!!!


But, my T3 and T4, along with my TSH are good. (T3 and T4 high end of range, and TSH <1)

And, no fatigue or weight gain.

Because of my labs, I don't need to pursue this, do I?

the symptoms I have: lump in throat (about 80% better since treatment), lower body temperature, internal shivering, receding gums/gum disease (prelyme), change in hair texture (prelyme), eyelash loss (starting to come back now), ridged fingernails, premature birth(prelyme), joint pain, foot pain, tinnitus.
Posted 4/22/2016 3:41 AM (GMT 0)
summer16-

Endos...........what can I say?

Some T3 facts: The brand Cytomel of synthetic T3 comes in really small doses. Straight T3 itself goes into your cells and used much quicker than the unconverted T4, so many people take it twice a day. And unlike T4, T3 will not bind to protein; thus you dont have to take it on an empty stomach.

Some people use the desiccated natural thyroid (Armour, Nature Throid, NP Thyroid, ERFA Canadian) wich has both T4 and T3, some people like it better, but the individual T3 and T4 aren't adjustable.
Posted 4/22/2016 12:04 PM (GMT 0)

Girlie said...
I have some of those symptoms - it's a really,long list!!!


But, my T3 and T4, along with my TSH are good. (T3 and T4 high end of range, and TSH <1)

And, no fatigue or weight gain.

Because of my labs, I don't need to pursue this, do I?

the symptoms I have: lump in throat (about 80% better since treatment), lower body temperature, internal shivering, receding gums/gum disease (prelyme), change in hair texture (prelyme), eyelash loss (starting to come back now), ridged fingernails, premature birth(prelyme), joint pain, foot pain, tinnitus.

I remember your thyroid labs, Girlie, and they indicated VERY healthy thyroid function. I think you can scratch any thyroid concerns off your list.

And, yes, there is quite the overlap between thyroid symptoms and the symptoms of these infections. That's why those of us with thyroid disease need to be vigilant with thyroid labs/needed dose adjustments.
Posted 4/22/2016 12:09 PM (GMT 0)
After suffering needlessly under the care of a succession of 3 endos, I will never see an endo for thyroid care again.

I've been seeing an internist since 2009 for thyroid care and there have been a few times she wanted me to see an endo. I told her "no thanks", I prefer to continue working with her (I still have to suggest every needed dose adjustment and sometimes have had to convince her I needed it...but I still got it ;

I'm glad astroman mentioned desiccated thyroid - I was remiss in not including that originally. The reason I did so was because an endo is caring for you, Patty. Most endos seem to be against T3 and, desiccated thyroid even more so. I still should have mentioned that option.

No matter what, healthy thyroid levels are vital for healing.

Good luck getting the meds you need!!!
Posted 4/24/2016 12:41 AM (GMT 0)
Well, I finally received a call from the receptionist from the endo's office but I was taking a shower so I had to listen to the answering machine. Evidently, my labs are fine and I am to continue on my meds. My lyme rage overwhelmed me so thank goodness I did not answer the phone. I hate doctors!!!! I have a follow-up appt next month so I will see how it goes. I know my gp will follow my advice and I may need help from you guys before I see him if that is ok with you.

Patty
Posted 4/24/2016 4:27 AM (GMT 0)
Your endo says your labs are fine?

this part right here.......Free T3. 2.4 (2.3-4.2)....is not fine at all, if you included the right range. Anyone with free T3 at the bottom of the range will feel symptoms. I know this and felt the symptoms of low T3. Any thyroid forum will say the same.

Geeze......If the lab above is in fact what this endo say is fine, then this endo is close to cluless.

So before I rant, (trying to control myself here) the above part of the lab is OK per your Dr? Not some other lab report shes talking about? Ahhhhhhhhh...Rrrrrruuunnn!!!!

These ranges are somewhat flawed, some Drs know this, most do not.

That the equivalent of a car mechanic who never fill a radiator all the way up to the full level.

An experience Dr who has listen to/ learned from patients symptoms will know this, and would say, technically your just barely in range and probably will feel better with more T3.

I bet this Dr has no experience with T3 and only prescribes T4 meds. More T4 will not correct your problem, you need separate T3.

Find a new Dr.

I went through 3 PCP's and 3 endos till I found one who understood T3, and I still need to push him. Stubborn T4 Drs are responsible for countless continued thyroid symptoms. Total irresponsibility. And yet so common.

And this even though not used much anymore is obviously OFF the chart, Total T3....82 (optimal 100-180)

Post Edited (astroman) : 4/23/2016 10:33:30 PM (GMT-6)

Posted 4/24/2016 11:45 AM (GMT 0)
astroman read my mind....including the part of trying to control myself from a rant lol

Doctors that declare the patient "normal" because they have "normal" (aka in-range) thyroid labs are the ones that keep patients sick.

In the 7+ years I participated on multiple thyroid forums, there was *one* member who had a thyroid-savvy endo. Everyone else was either under-treated for their hypothyroidism....or overtreated for their hyperthyroidism.....and miserable not knowing why they felt horrible when their labs were "normal".

My current thyroid doctor (an internist and now my GP of 6+ years) offered T3 to me before I was ready to take it lol

Still, just as astroman deals with, I have to push my doctor for the doses I know I need (based upon my labs).

We are here for you whenever you are ready to talk to your GP. And, truly, once your get your GP on board, I'd be inclined to ditch the endo - you are certainly not getting the right service for your money.
Posted 4/24/2016 12:09 PM (GMT 0)
Astroman, those are the correct results of the labs and the only one she has for guidance.

I am so tired of battling doctors for myself and my husband.....so many stories.

If these were your values what would you suggest? You may e-mail me if you have time. Cd, I could also use your help.

I need some guidance for my gp.

Patty
Posted 4/24/2016 12:24 PM (GMT 0)
Patty

I think you might want to let your GP know ahead of time that you'd like to talk to him/her about your thyroid care.

It's appropriate to share the list of symptoms you have....and you could acknowledge the possibility that they are caused by something else....but you think your thyroid function shows room for improvement and you would like to see if changing things around a bit with your thyroid meds makes a difference.

You could then share a copy of your labs and point out that your Free T3 level is at the bottom end of the range....and your Total T3 is well below-range. (Total T3 doesn't matter for dosing purposes but you are clearly not producing T3).

It would then be appropriate to ask your GP to prescribe some T3 "just to see"....and assure him/her that you're not looking to become hyperthyroid but, instead, "try on" a higher Free T3 level within the normal range to see if you feel better

If you think you want to try Cytomel, I'd ask for a 5mcg prescription.

You'd divide that 5mcg Cytomel tab into an AM dose and an afternoon dose (no later than 2-3 pm unless you want to be up at night). You'll need a pill cutter to accomplish this.

If you think you want to try desiccated thyroid, 15mg is a reasonable start.

From what I understand, the T3 in desiccated thyroid acts more like a time-release med since desiccated thyroid also contains Thyroglobulin - the thyroid hormone transport protein. You could try taking it in the morning only but if you experience an afternoon crash, that's a sign you should divide the dose.

You will want to get labs no more than 4 wks. after starting T3 with the expectation of needing a dose increase.

Wash, rinse, repeat until your Free T4 and Free T3 levels are higher.

If your dose increases are adequate, your TSH should slowly DEcrease (which means your pituitary isn't having to scream at your thyroid as much to produce hormone).

Please know that there's a good chance your Free T4 level will also decrease after starting T3 - it all has to do with your pituitary that responds more to T3 than T4.

It will take awhile to optimize both the Free T4 and Free T3 levels but with regular labs and appropriate dose adjustments, it will happen.

Good luck!!!

Please let us know how things goe.
Posted 4/24/2016 5:12 PM (GMT 0)
Summer-16

It bothers me to see others wobbling down that same untreated thyroid path that so many have for years due to our unjust medical professionals. It so common. Just how many "fibro" people actually have under-treated thyroid issues is something I always wonder.

CD gave you the technical info, I'll tell you my story, which is similar to many others, I assume. Just to reassure you, the info you have from both of us is 100% correct.

You have to push for proper treatment. The sad fact, but its possible to do.

I've been treated for Hashimoto hypothyroid (with antibodies) almost two decades.

I was only tested for TSH and T4 years ago, and way undertreated. It was not till ten years ago that I began to learn about proper thyroid treatment with ZERO help from Drs. There is much more on the web now (overwhelming to newbies maybe), easier to learn, vs book stores and the library.

There are many different approaches to getting a good thyroid Dr. It took me a long time, so now I know from my experiences and others. I had many first time appts to find one.

Many naturopaths prescribe T3 in both forms, but these Drs are spendy like LLMDs are - no insurance. If you goggle thyroid treatment and your town, these Drs always come up.

It takes longer to find an insurance taking MD Dr, but they are out there - that's what I did. Funny thing is My Dr is an endo, but also was on "good" thyroid Dr lists. I mention what my "thyroid thoughts" are and he listens. That said, I am always the one with suggestions, not him.

Start with a Dr that seems to listen, you have to show that you've read up on T3 levels and understand that others feel better when not ignoring T3. You might be able to find a good thyroid Dr from asking on thyroid forums (like we do here). about Thyroid.com used to have a Dr list. Try asking local pharmacists for Drs who prescribe Cytomel or Armour.

Instead of trial Dr visits , you can also call the office and ask the Drs' nurse to call you back on weather or not they Rx T3 for patients there.

The worst part is if you move, this needs to be repeated again.

about T3 meds (I've used/tried all): I tried Cytomel (synthetic T3) first with several brands of Synthetic T4's, as this is fine with most people. However he energy deliver of synthetic T3 (you feel T3 after taking it) seemed a little to sudden for me. I had adrenal issues to, which makes the T3 "feel" more obvious, longer to get used too. So I switched to natural, which provides a smoother energy delivery, I still split my dose for AM and afternoon. . I have tried many (two stopped production), and now use NP thyroid.

Armour, NP Acella Thyroid, Nature Throid (they have two versions) and Canadian Erfa (order online) are pig thyroid hormone identical (made from same powder) besides the fillers used.

Synthetic T3 brands are limited. Cytomel is the most popular. There was a generic not to long ago- a pharmacist would know.

Post Edited (astroman) : 4/24/2016 11:16:24 AM (GMT-6)

Posted 4/25/2016 12:17 AM (GMT 0)
Astroman gave you a realistic explanation about what's involved with getting proper thyroid care.

His suggestion about calling pharmacists is a good one. I moved recently and did that exact same thing but discovered that my current doctor is closer to my new home than any other T3-prescribing doctors.

The site I'm linking below has a more recently compiled thyroid doctor recommendation list by state:

www.thyroidchange.org/patient-recommended-doctor-list-us.html

And, I'm sure you realize that astroman's relationship with his endo is very similar to my relationship with my thyroid doctor - we basically lead our treatment.

My thyroid doctor actually took note of my optimal Free T4 and Free T3 levels. Only thing, she seems to think that a slightly lower level is "close enough" that I should feel well. I have to remind her that asking me to "wear" a slightly lower thyroid level is like asking me to wear shoes that are a size smaller than what I usually wear.

Good luck and keep asking questions!!!
Posted 4/25/2016 12:25 AM (GMT 0)
Oh - forgot to mention.

My doctor didn't write "brand only DAW (dispense as written)" on my first Cytomel prescription and my insurance dictated that I get the generic - liothyronine.

Since I fared well with generic levothyroxine (always having my doctor write "Mylan only" on the Rx so I get the same brand each time), I tried the generic T3....and did well on it.

Paddock Labs was the manufacturer of my T3 and then their parent company took over. Thank goodness Perrigo's T3 is exactly the same (tab is stamped the same).

I know you mentioned taking levothyroxine.....do you get the same manufacturer's product each time you refill your prescription? That can make a difference in your levels....and how you feel - all because of the difference in the fillers each company uses.
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