help reading results please.....

[zebady]

hi.... I am male, 36, and I had a total thyroidectomy due to cancer..... and when I was on t4 and t3 treatment I scored ft4 17.4pmol/L and TSH 12.8mtU/L ( on 200mg thyroxine 10mg liothyronine) so DR Gilbert has put me on thyroxine monotherapy (300mg), this was 3 months ago and I feel awful.... could you please tell me if you believe she made a good call? I am at the end of my rope ... I simply can not think my way out of a paper bag I have no idea what a normal range is and I can not understand how ft4 and TSH are related, even though I've tried to look on here, could you also tell me please what a good score for them both and how one should affect the other. As I say I cant grasp anything at the mo. Thanks guys xx

[radd]

Hi Mike,

Good to hear from you again and sorry to hear things are still not good.

Yes, the brain fog is simply awful when meds aren't working. How did you feel medicating the T3 ? . 10mcg probably wasn't quite enough considering you were also medicating 200mcg Levothyroxine. A dose of 20-30 mcg T3 with a further big reduction in Levo would have been more realistic.

Unfortunately it is controversial to prescribe T3 but many of us need it and considering your history, it is a great shame that Dr G has stopped yours completely.

You have had thyCa and I thought TSH was to be kept suppressed but yours is high. Many would feel very unwell with a TSH so high whilst medicating. Did you leave a significant gap between taking thyroid meds and having blood drawn ?

Your results are unusual because usually as T4 goes up, TSH goes down. TSH (thyroid stimulating hormone) is secreted from the pituitary gland in response to low thyroid hormone. Also T4 usually drops when medicating T3 but as you were on a small dose//ratio maybe this accounts for your more "normal" T4 levels. T3 should be tested when you are medicating it.

Did you ever have Vit B12, Vit D, folate and ferritin tested ? ? ...

[radd]

RFU,

Covertion happens in several organs, gut and peripheral tissue regardless of the presence of a working//defunct thyroid gland ( or not).

Many Hashi sufferers don't have a thyroid gland either after it has been attacked and shrivelled to the size of a dried pea.

I think RAI damages a whole lot of things ! ! ....

[Cmorales]

I too am of the understanding that the t4 combination medications should be lowereed and the t3 increased. Some times if your getting too much t4 medication a phenomenon called reversee t3 can happen. It is like your cells are rejecting the t3 conversion if I understand it correctly. Also certain nsaids except ibuprofen interfere with thyroid hormone transport and benzos do as well. All of this information is on NIH in studies in USA Where. I am. There is a great website called STOPTHETHYROIDMADNESS.COM You will get alot of answers there avout medicating and its querks. Dont feel alone. I kmow 2 other men who have thyroid problems since your age or younger.

How is your diet? are there other health issues?

[Hoxo]

After thyroid cancer your replacement thyroxine hormone dosage should be high enough to cause the TSH result to become suppressed and should give a 'less than' result eg <0.05 or whatever is the lowest level your labs report to. This is to stop the TSH or Thyroid Stimulating Hormone that your Pituitary produces stimulating any thyroid cells left in the body which in theory could cause any remaining thyroid cancer cells to regrow - so it's important that your TSH is suppressed by an adequate dosage of either T4 alone if that works for you OR IF NOT a combination of T4 and T3 ot T3 alone. Your TSH result is very high and I'm not surprised you are feeling unwell at that level. Your body is saying I don't have enough thyroid hormone and many of the symptoms you have will be a result of this. Discuss this with your cancer doctor or the endocrinologist and ask them what their treatment plan is for you and ask them to fully explain it. It all seems a bit complex at first but the more you read up the more it will sink in about how it all works.

Also have you had your B12 checked? Low B12 can cause a lot of the psychological issues you've described in previous posts.

Keep asking questions! This forum is brill! All the best.

[Hidden]

Do you have any more recent blood tests. 300 levo is a very high dose and could make you feel very ill if too much. You also probably needed a higher dose of T3 before you doctor changed you onto mono therepy, seems like you didnt have a fair trial of it. Maybe you need to pay to see a doctor with some expertise in thyroid issues, This website has a list somewhere. You own doctor doesnt know much I think.

[greygoose]

Plainly put : no, your doctor was wrong.

It looks like you are not converting your T4 (levo) into T3, the active hormone - the one most likely to suppress your TSH - which is what you need.

TSH rises as thyroid hormone levels go down. The TSH stimulates the thyroid gland to produce more hormone.

You don't have a gland to stimulate, so your dose of T3 should be increased to lower the TSH.

Before stopping the T3, your doctor should have tested the FT3 - labs don't like doing it but doctors can insist - to see if you were converting well. She didn't do that. So, in reality, she has no idea what is happening in your body, and she is just grasping blindly at straws!

If you take too much T4 when you can't convert it, that will make you ill. And that is what would appear to be happing to you.

Tell your doctor you want a full thyroid panel :

TSH

FT4

FT3

vit D

vit B12

folate

ferritin

If she won't do it, get it done privately. Then you will know where you are and what you need to do next.

[Clutter]

RFU,

ThyCa patients may be treated with T3 until after RAI when they are switched to T4.

[Clutter]

Mikepassword,

Have you had thyroid blood tests since you were switched to 300mcg Levothyroxine?

[shaws Administrator]

I understand how unwell you feel at present. I didn't have my thyroid gland removed and levothyroxine did me a great disservice. Thankfully, I am now back to good health on T3 only.

How they can prescribe on levothyroxine alone for someone without a gland, I just don't understand.

Levothyroxine has to convert to T3. T3 is the active hormone required in the billions of receptor cells in our bodies, the brain contains the most. Without T3 we cannot function. Some people have a genetic defect that they cannot convert T4 (levo) to sufficient T3.

If your doctor wont add T3 to your T4, you can purchase it yourself and members will help.

We depend on our doctors to make us well and it comes as a surprise to find out that they know very little of how to make us better, except precribe other medications rather than a decent hormone which our body desperately requires.

hormonerestoration.com/Thyr...

When you go for a blood test for thyroid hormones it should be the earliest possible and fast. Allow 24 hours approx between your last dose of hormones and the test.

This allows the TSH to be at its highest as it drops throughout the 24 hours and may mean unnecessary adjustments.

I hope you feel better soon

[Eddie83]

300mcg thyroxine is INSANE! Are you aware that Abbott advertises that the T4-only full replacement value is 1.7mcg/kg body weight? Your TSH of 12.8 while on T3+T4 was too high because you were not getting enough T3. I would find another doctor, pronto, this one does not know what she is doing. If you had the full thyroid panel (TSH,FT3,FT4,rT3,TPOantibodies,TGantibodies) recommended by thyroid advocates, I suspect it would show low FT3 and a high rT3 because your body is being asked to handle far more T4 than it can.

[helvella Administrator in reply to Eddie83]

There can be cases in which high doses are required - one clear example:

healthunlocked.com/thyroidu...

So I would be cautious of taking the typical dosing advertised by Abbott and applying it in every case. It is a good level to ask the question, "Is this too high a dose?", but not to jump to a conclusion.

In this particular case, I suspect that the ideas posted by others above make a lot of sense.