Over medicated?????

[Warren184]

My endo appointment next week and my last two blood tests show the following:

July

Serum free T4 level (XaERr)

23.7 pm/L [12.0 - 22.0]

Serum TSH level (XaEKV)

<0.01 miu/L [0.35 - 5.5erum free T4 level (XaERr)

November

Serum free T4 level (XaERr)

25.0 pm/L [12.0 - 22.0]

Serum TSH level (XaEKV)

<0.01 miu/L [0.35 - 5.5erum free T4 level (XaERr)

Does this even begin to establish what is required to adequately medicate me? I feel tired, my hair is still falling out, I'm now wheat and lactose intolerant, my motions fluctuate from 1-5 on the Bedford scale and I'm so crabby I feel like I should be menstruating again! (I'm 61 so that's not happening). I sleep between 2-5 hours a night (no wonder I've no energy), my hips ache all the time, oh and I've put on over 7 stones in four years. Aside from that - libido - that's gone too with my svelt figure. Can anyone advise me?

[HarryE]

Without a free t3 result, you are stabbing in the dark. If you aren't converting the Levo to the active T3, it won't matter how much you take, it won't help

[Warren184 in reply to HarryE]

Thanks Harry Should I have to request they test my active T3?

[HarryE in reply to Warren184]

Absolutely - they won't like it & may refuse. But without they cannot tell if you are properly medicated

[Ruthi]

If you still feel rubbish then something is not right.

You need your T3, and reverse T3 (RT3) testing. You may not be converting your T4 to T3 (which needs special enzymes in the liver) or you could be converting your T4 t reverse T3 which, if you remember your school chemistry, is the optical isomer of the active T3 - it shows up in the tests but doesn't have the right effects.

Hyperthyroid symptoms aren't that dissimilar to hypo, but the weight gain would suggest that you aren't hyper.

Plus you need tests for Ferritin, and Vitamins B12 and D3. All will produce these symptoms if deficient.

If all of that is clear and OPTIMAL (ask here with help to interpret the results) then you could also consider whether your adrenals are functioning properly. Take the quiz at adrenalquiz.com and consider getting your saliva cortisol tested. And read up on Cushing's disease - it has a very recognisable weight gain pattern if you look at the diagrams.

More than you can possibly research and absorb in a week! I would concentrate on persuading the endo to test T3 and reverse T3. If he won't you can get it done privately but that is a whole different universe to explore!

Once you are over 60 they start to dismiss everything as 'your age'. Before 60 we are hysterical women! Don't accept any of it!

[Warren184 in reply to Ruthi]

Thanks so much for taking the time to provide such great advice. Really appreciate it

[shaws Administrator]

Did you leave 24 hours between your between your dose of levo and the blood test and fast? What dose and I assume you are on levo only.

[Warren184 in reply to shaws]

Yes. I take Levo b4 breakfast and had fasted from 7pm the previous evening. Tested at 8:40am.

[shaws Administrator in reply to Warren184]

Ask if he can add some T3 to a reduced T4 on a trial basis as you are feeling so unwell on the dose you are on and you know levothyroxine can cause weight gain in some people and that you feel you are getting absolutely nowhere on what you are taking at present and the fact that you now feel much worse.

[Warren184]

Well I've been given a lifeline. Changed my medication to liothyronine sodium X 10mcg night and morning with T3 blood tests each month for two months. Off the levothyroxibe completely to see if this helps my symptoms. Can anyone confirm that this seems favourable?