Blood results fine - still very hypo

[YulianaRossenova]

I just got my results and they made me nervous аs I might have some sort of resistance.

I am taking 62 T4 and 18 T3 in the morning in one dose. Got down from 200 T4 +18 T3 due to fear of rT3 building up. I was feeling hypo as well.

On the reduced dose I feel the same - skipped beats all day long, slow heart rate, terrible bone and muscle pain, brain fog, fatigue, horrible constipation, brittle nails.

I am trying to up my T3 but cannot tolerate it, elevates my heart rate a bit.

My results 22 hours after previous dose:

TSH 0.005

FT4 19.25 (12-24)

FT3 6.85 (3.95 - 7.80) Some labs here give 8.80 as an upper range in the same measurement units.

When I was healthy I had seen the following results:

TSH 0.8

FT4 24 something

FT3 7.40 +

When I was becoming hypothyroid, I was very ill, symptomatic, having the following results:

TSH 3.35

FT4 20.10

FT3 5.93

After giving birth when I was not taking any thyroid medication, I was euthyroid at FT3 6.60 and FT4 18.75. However that was a natural rise in FT3, not a medically-induced one and only 10 days after the blood was drawn I began experiencing hypo symptoms.

That is why I assumed that my hypothyroidism begins when my FT3 level falls down below 6.60.

Now it is 6.85 and I am still hypo.

Question is : Do I need just a higher level of FT3 to feel fine when on medication? Paul Robinson says that he has seen a level of 8.5 even 9+ on his blood tests and he attributes that to his body having something broken at a cellular level and requiring higher blood levels of FT3 to feel fine.

Does T3 pool in my blood? And I have hormone resistance?

Is it possible that I have a rT3 problem?

Thank you,

Yuliana

P.S. Going by symptoms I expected something like a 5ish FT3.

I feel the same with this FT3 of 6.85 as compared with an FT3 of 4.99 when I was on T4 only. The same!

Does my T3 pool in blood and show a higher but not realistic FT3 level while I still get my cellular FT3 level from FT4 converting? Is that why I feel real bad when stopping T4?

[Clutter]

YuliannaRossenova,

How many weeks have you been taking 62 T4 and 18 T3?

[YulianaRossenova in reply to Clutter]

2 weeks on +/-188 T4 and 18 T3

almost one week on 62 T4 18 T3

I am very hypo. I think I am either pooling or resistant.

In either case I don't know what to do.

[humanbean in reply to YulianaRossenova]

2 weeks on +/-188 T4 and 18 T3

almost one week on 62 T4 18 T3

Have you really dropped your dose of T4 by 126mcg per day? That is a massive, MASSIVE drop. No wonder you feel hypo. Or have I misunderstood?

[YulianaRossenova in reply to humanbean]

Yes I have, actually I stopped T4 for 3 days and restarted it on 50/75.

And I don't feel any different. I feel as hypo on 62 T4 and 18 T3 as I did on +/-188 T4 and 18 T3. Maybe a tiny bit more now, but the difference is not big at all.

[Clutter in reply to YulianaRossenova]

YuliannaRossenova,

I imagine you are hypo after dropping 126mcg Levothyroxine!

Dose adjustments should be in 25mcg increments every 6-8 weeks. I would resume taking 188mcg T4 + 18mcg T3 for 6 weeks and then retest. You are destabilising your metabolism by making large and rapid dose adjustments.

[YulianaRossenova in reply to Clutter]

You are right. But I was hypo on 188 T4 as well... So I acted on the assumption I am building up rT3 that is why I dropped my T4 dose.

[Clutter in reply to YulianaRossenova]

YuliannaRossenova,

Why don't you get a rT3 test rather than assuming, perhaps incorrectly, that high rT3 is why you remain hypo?

[YulianaRossenova in reply to Clutter]

I did. The results will be ready in 2 weeks.

I may have absorption issues or just require higher levels оf FT3 to feel well. I don't know, but on this level, I am completely hypothyroid.

[Clutter in reply to YulianaRossenova]

YulianaRossenova,

If you feel hypo on 188mcg + 18mcg T3 you are going to feel more hypo after reducing dose so much because FT4 and FT3 will plummet.

[YulianaRossenova]

One thing sprang to my mind just now.

During my second pregnancy I was hypothyroid, I was fine during the first one.

When I compare my results from the 3 trimesters of the 2 pregnancies, I can see that during my second one while on T4 I felt euthyroid on FT4 and FT3 levels that were 1-1.5+ higher than my FT4 and FT3 levels during my first pregnancy when I still had a normal thyroid function.

Is it really possible that I need a higher FT3 level now that I am on medication? Oh...