my tsh is 4.6. my t4 is 14.6 and my t3 is 1.4 i still feel symptoms of severe fatigue.I am having trouble waking up need help urgently.

I am on 100mg of levothyroxine and 10mg of T3. I am battling with my doctors and endocrinologists as they do not want to increase this incase i become hyperthyroid. I have not had an increase in months and i have been complaining about my symptoms for a very long long time. i have been diagnosed with this since may 2012. I have gained a lot of weight. i am now 18 and a half stone. I have looked at my holiday photos and i look so different.I feel i have got more uglier and fatter because of this. CAN SOMEONE PLEASE HELP ME WHAT SHALL I DO??

[PinkNinja]

Can you convince your doctor to prescribe a very small increase of T3, perhaps 5mcg, and do tests again in a few weeks to check that you have not become hyper? Your TSH is at the very top of the range and is not going to come plummeting down with an increase of 5 or even 10mcg of T3.

Do you have a copy of the Pulse article for GPs where Dr Toft states that many people don't feel well until their TSH is in the lower part of the range (i.e below 0.5)? If not you could email Louise for a copy at [e-mail] and she could email it to you. It might help to show them this. It might be more out of concern and lack of knowledge that they are refusing to increase your dose. If they see this article they may be reassured a little. You may have to take it very slowly though.

There is also research to show that there is no risk attached to having a TSH below the reference range as long as it is not suppressed. That may also help them to worry less and give you the increase you clearly need.

endocrinology.org/press/pre...

I hope you manage to convince them.

Carolyn x

[Hidden]

In order to comment really accurately we need to see the reference ranges for these test results. Can you please post them on here, and we can can advise you better. However it looks very much as though you are undermedicated, but I'm sure you've already deduced as much from the symptoms you are experiencing.

I understand completely the frustration and desperation you are feeling. My daughter was informed she was seriously hyperthyroid on a low dose of levo. because her test results told the doctor this was the case. At that time in her life she could barely move from the settee!!! We decided it was time for more expert advice and took her to see a private doctor. From that point her health began to improve, but it had been allowed to deteriorate to a VERY low point, and it has taken a great deal of investigative work and a very long time.

Maybe you too need to take charge of your own health too as you don't seem to be getting help from your doctors. Check here for a list of TUK recommended doctors, and good luck:thyroiduk.org.uk/tuk/diagno...

Jane x

[nostoneunturned]

While it would help in assessment to have the ranges applicable to these results, nevertheless anyone (but not your endocrinologist) can see that the T3 is way down while your TSH is too high. What are they thinking of?

It will help to buy "Understanding thyroid disorders" by Dr Anthony Toft, BMA publication, £5 from amazon/chemists, plus he is past president of the BTA so one of their own authorities.

On P88 he writes:

"Judging the correct dose of thyroxine.

Your GP or thyroid specialist will usually prescribe a dose of thyroxine that raises the FT4 and TT4 to the upper

part of the normal range and reduces the TSH level in the blood to the lower part of the normal range.

Typical results would be a FT4 of 24pmol/l or TT4 of 140nmol/l, and a TSH of 0.2mU/l. In some patients a sens of well being is achieved only FT4 or TT4 is raised, for example 30pmol/lor 170nmol/land TSH low or undetectable. In this circumstance it is essential that the T3 level in the blood is unequivocally normal in order to avoid hyperthyroidism."

Do not be put off by the fact that he is writing of treatment by thyroxine, he could well be writing of combined T4/T3 treatment as it is the numbers that matter, also please note that the reference ranges applying to his quoted numbers are those he gives on P87.

It is important to know that hyperthyroidism is indicated by the T3 level in the blood. Yours must be low, even without the ranges this is evident, and it is no wonder that you are not feeling well at all.

Buy Dr T's book, I do not know what the reaction to it will be, but Dr Toft reached the very top of the endocrine tree so there should not be any argument over his words.

If you had given the ranges for each item (labs all differ) it would be easier to make the possible deduction that you are not converting T4 to T3 but lack of the ranges makes such surmise difficult. I am not a doctor, remember, but my feeling is that if anything is increased it should be the T3 not the thyroxine.

Please. always quote the ranges given on your copy of any blood test.

You might like to visit the main site of Thyroid UK, it is just full of information. For instance, T4 to T3 conversion is hampered by dearth of selenium, iron, etc., all info is on the site:

thyroiduk.org

[flatfeet1]

Perhaps this might help convince doc

rxabbvie.com/pdf/synthroid.pdf

DOSAGE AND ADMINISTRATION

General Principles

The goal of replacement therapy is to achieve and maintain a clinical and biochemical euthyroid state. The goal of suppressive therapy is to inhibit growth and/or function of abnormal thyroid tissue. The dose of SYNTHROID that is adequate to achieve these goals depends on a variety of factors including the patient's age, body weight, cardiovascular status, concomitant medical conditions, including pregnancy, concomitant medications, and the specific nature of the

condition being treated (see WARNINGS and PRECAUTIONS). Hence, the following recommendations serve only as dosing guidelines. Dosing must be individualized and adjustments made based on periodic assessment of the patient's clinical response and laboratory parameters (see PRECAUTIONS) Laboratory Tests

[Marz]

...you will only become HYPER when the TSH is very low and your FT3 over or high in the range. As you can see your FT3 is very low - based on ranges that I am familiar with. Do hope you soon feel stronger - hopefully with the advice given by others here you will soon be making a good start in taking control and making headway.....

[helvella Administrator in reply to Marz]

Marz,

I am guessing that is a Total T3 result. which is usually numerically around one third of the number a Free T3 result might be.

HypoHippo,

It is important to anyone trying to help to know if that was a Total T3 or a Free T3 test.

Rod

[Marz in reply to helvella]

Of course Rod - you are absolutely right. The very FEW times I have seen an TT3 result on this forum it has been accompanied by a FT3...even so both are like hens teeth ! I should have thought of that though when I was replying. Thank you for reminding me. Hopefully we will learn more from HypoHippo......

[shaws Administrator]

HypoHippo I am sorry that you are suffering so much and hope, for goodness sake, that the doctors can soon give you a dose which makes you feel better. Were you hyperthyroid at all before you became hypothyroid? Is that why they are concerned?

The Pulse Article from Louise is good and as well as hypothyroidism it covers other aspects of the thyroid gland's dysfunction which may help your GP. For hypothyroidism question 6 is the one your GP should look at, particularly adding some T3 if necessary.

Best wishes

[gemma2012]

Gemma2012

There are other indicators of thyroid function eg blood fats. Also Broda Barnes an American Doctor also says that some thyroid patients have a difficulty using thyroxine in the body ie they might have antibodies and as with diabetics who still produce insulin but can't use it due to insulin resistance, the same can apply in thyroid disease.