Getting worse - Should I try T3? Advice please

Hi there, I posted a little while back about worsening severe fatigue & dizziness amongst other symptoms and had tried increasing my dosage from 25mcgs to 50mcgs of levothyroxine.

I've hit a dead end with my GP who said I've done all I can (not that HE's done all he can) and that I'm just going to have to accept that maybe I'm just prone to being this ill.  He won't do any more tests and doesn't think I should be on 50mcgs of Levo.  I've been on this dosage now for 4 weeks and although I initially thought I was getting a tiny bit better, I've now got a lot worse and am struggling to get through each day even with nothing on my schedule.  I'm also now getting bad joint pain and losing a lot of hair.

I'm due to go back to college in a week - I'm in my final year and my course director wants to know whether I'll be able to finish the course.  The way I feel now I wouldn't be able to last more than two days (we do 70hour weeks) if even that.

I've read up about adrenal problems and am doing a 24hr saliva cortisol test next week.  I have also had other tests done privately but can't get the results for another few weeks.  I'm being very impatient but I'm steadily getting worse and don't want to have to pack in everything I've worked for .... is it worth trying T3 now?  If so, could anyone recommend a reliable source and some guidelines on dosages?  I appreciate any advice anyone could give me, I'm absolutely desperate at this stage.

Thanks

[liverish]

Hello lampie, getting your Cortisol checked is the right thing to do as it does sound like adrenal fatigue - it seems treating the thyroid before getting the adrenals up to snuff can cause people real problems so getting those checked before changing your thyroid meds is wise - some doctors actually recommend reducing or stopping Levo while you are treating the adrenals, but I'd recommend you talk to a doctor who knows about this, Doctor P is a good bet, I'll PM you if you don't know who that is.

[Hidden in reply to liverish]

Thanks for the quick reply! I haven't heard of Dr P so if you could PM me that would be great.  I'm seeing Dr M* in Dublin (I'm studying in Dublin but I'm from Northern Ireland so trying both avenues) but can't see him again for another 4 weeks and I'm not sure I can wait that long feeling the way I am...

*edited by admin re posting guideline #25

healthunlocked.com/thyroidu...

[Jazzw]

Lampie, I think your doctor is wrong - 50mcg of levo is only a starter dose, and if it made you a bit better for a while, then it seems clear to me that another raise to 75mcg would be in order.

But my other thought is about B12. Did you ever get that tested? Please don't disregard it - B12 deficiency is serious, is ridiculously under-diagnosed and missed by nearly all doctors in their rush to tell you your symptoms are all in your head. 

See here: pernicious-anaemia-society....

How many of those symptoms can you tick off?

If it was tested, do you have a result?

[Hidden in reply to Jazzw]

Thanks for the reply Jazzw, my doc only prescribed 25mcgs and I upped it myself when I became too ill to work.  I had all of my bloods done and was told that I'm deficient in Vit D which I'm taking supplements for, and that my B12 and Folate were a little too high but I don't have a level for these

[Clutter]

Lampie,

What are your thyroid results and ranges?

[Hidden in reply to Clutter]

Hi Clutter, the last results I got were:

Serum free T4 level 18.6 pmol/L (12.0 - 22.0)

Serum TSH 1.95 mU/L (0.3 - 4.5)

This was before the increased dose - I've had my bloods done again since (including T3) but won't get the results for another few weeks.

[Clutter in reply to Hidden]

Lampie,

Dose increase should raise FT4 close to top of range and lower TSH below 1.0.  I really don't advise increasing dose or adding T3 until you see the new results.  I assume, like me, you can't see your results until your endo tells you what they are

[Hidden in reply to Clutter]

I've never been referred to an endo and my doctor won't do the referral.  I've had bloods done by a private doc in Dublin but like I said he can't see me for another 4 weeks - it's the thought of not seeing any improvement for so long when I've already been out of action for a couple of months.  To be honest, if I don't get any improvement before I can see the private doc I'll be kicked out of my college course and I'm only a few months from finishing that's the only reason I'm seeking out alternatives and I read on here that if you didn't see improvement with T4 you should consider trying T3 with a reduced dose of T4

[Clutter in reply to Hidden]

Lampie,

Without seeing FT4 and FT3 results it's impossible to guess whether adding T3 will help or whether Levothyroxine dose needs reducing.  Even if you do add T3 it isn't going to be an instant fix as it will take time to metabolise.  Contact your student counsellor and ask what accommodations can be made due to your poor health.

Perhaps you could also contact the private dr's secretary and  explain the urgency and ask whether your appointment can be brought forward or whether you can have a telephone consultation, and whether your results can be emailed to you.

[Hidden in reply to Clutter]

Ok, thanks Clutter.  I can see your point, it's just not the answer I'd been hoping to hear.  But you're able to look at it more rationally than I am at the minute.

Unfortunately due to the nature of my course (practical & conservatoire style) if I'm not up to it then they really can't do anything to accommodate me.  Also with the private doc, he won't see me until all of my test results are back and one test I can't get for another week or two.  I've just been feeling like I've hit a dead end.

At least however I've slightly picked up in the last couple of days since crashing quite badly so hopefully things will continue to improve.

Thanks for the replies

[Clutter in reply to Hidden]

Lampie,

I hope you'll continue to pick up and will be able complete your course successfully.

[humanbean]

That rule is only used as a first approximation for dosing people who have just had a thyroidectomy. I don't think it has any relevance in other circumstances.

[Clutter]

Eljii,

If the weight/dose ratio was valid I would be taking 80mcg T4 whereas I'm prescribed the equivalent of 180mcg.