I am cutting and pasting from the FB. FTPO T3 only page. I apologize if this is not ok.
Too unwell to redo. This gives some history and will post latest labs / meds at the end.
Thanks in advance for ANY feedback / encouragement.
I am 50 year old mother of three children. At age 32, I had an elevated prolactin level out of the blue. MRI negative, took bromocyptine, and was able to get pregnant with first child within 6 months. I gained 18 lbs with first pregnancy, and was thinner leaving hospital than before getting pregnant (thyroid storm?). One year later diagnosed hypothyroid and managed on Synthroid for 8 years. I did have depression and fatigue and was put on AD and stimulants- I'm guessing thyroid not optimized at the time?
In 2008, I had a tubal ligation & uterine ablation. I had never been put under anesthesia before....I woke up a totally different person. Since this time I have been treated for lyme, mold, gut, viruses,- you name it- with little improvement.
Since 2008, I have addressed thyroid with many meds and protocols. I will have relief initially- then crash.
Also, my prolactin levels have continued to elevate over the past 6 years. MRI is negative.
At the end of June , I went off of one grain of Armour. I honestly didn't get worse- if anything relief from not worrying if I was on the correct medicine and dose.
Labs were drawn 7/18/17:
TSH 4.87. (.45-4.5 uIU)
FT4. 0.74. (.82-1.77 ng/dl)
FT3. 2.4. (2.0-4.4 pg/ml).
RT3 13.4. (9.2-24.1 ng/dl)
Prolactin 83.8. (4.8-23.3 ng/mL)
*I do not have cycle because of the ablation.
DHEA- 136 ng/dl
Testosterone 15 ng/dl
LH 8.7 mIU/mL
FSH 6.7 mIU/mL
Estradiol 283.4. pg/mL
Progesterone. 0.2 ng/mL
Vit D 25 hydroxy 44. 30-100 ng/ml
Ferritin 34. 15-150 ng/mL
TIBC 370. 250-450 ug/dl
UIBC. 315. 131-425
Iron ser. 55. 27-159
Iron sat. 15. 15-55
My current meds and supplements:
Lexapro 20 mg ( several years)
Ativan 1mg bedtime (8 years)
Concerta 54 mg am
Vit D 5000
*started 7/19/17
Dostinex .5mg - 1/2 tablet twice a week-
My dr does not think the elevated prolactin is due to SSRI, nor does he think it is low thyroid. MRI negative. I have had mild side effects and no noticeable improvement for this med.
*started 8/18/17
T4 37mcg in the am
T3 5mcg around 11 am.
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Hi My cortisol results are back:
ZRT 9/15/17
morning 5.3 (3.7-9.5 ng/mL)
noon 7.1 H (1.2-3.0)
evening 2.5 H (.6-1.9)
night 1.0 (.4-1.0)
last Thyroid labs 9/8/17 ( I was on 37mcg of t4 and 10mcg of t3 in divided doses)
TSH 1.67 uIU/ML .45-4.5
FT4 .97 ng/dl 0.82-1.77
FT3 2.7 pg/ml 2.0-4.4
RT3 16.7 ng/dl 9.2-24.1
Prolactin 27.1
I am currently taking:
7am 1 grain armour
11;30 .5 grain armour
3;30 T3- 5mcg
It seemed like there was improvement when I substituted one of my t3 5mcg doses with .5 gr of Armour last Friday. Anxiety and crying seemed to ease a tinch. However, reflux , bloating, constipation quite uncomfortable. I am still resting most of the day. Depression and flat mood are still profound- not sure if this is from thyroid or being ill last 10 years. Still very unwell.
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New info as of today:
TSH .893 uIU/ML .45-4.5
FT4 .69 ng/dl 0.82-1.77
FT3 2.6 pg/ml 2.0-4.4
RT3 13.2 ng/dl 9.2-24.1
Prolactin 27.7
Estradiol. 396.7 pg/mL
Testosterone, serum 30ng/dL
progesterone 2.4 ng /mL
TPO. 12 IU/mL 0-34. (does this mean hashi)
TGAb <1
Sex Horm Binding Glob 192.3. mol/L. 17.3-125
Meds /supplements:
7am- 1/2 grain of Armour
10;00 Concerta 54 mg (stimulant)
Noon-Cortisol Health (photo)- 1 cap
2pm 1/2 grain armour
bedtime- lexapro 18mg (weaning from 20mg slowly), Ativan 1mg, Vit d 5000ie
I have discontinued the t3 and also lowered the armour as I was equally as unwell as I was trying to increase the dose. I have rashes, constipation, nausea, vertigo, fatigue, delirium, depression, anxiety, crying all the time- just VERY unwell
My dr suggested increasing armour ??? perhaps the ratio is not right for me? I have tried cytomel, naturthroid, synthroid / combos.
Is there a chance I am not hypothyroid?? Meds make me feel SO much worse.
Is there something I am missing? Thank you for taking the time to review.
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Kcdb
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Iron - Ferritin - VitD are all low in range and will make you feel awful.
Ferritin needs to be around mid-range and VitD at 100. Results for B12 & Folate also needed.
T3 would be better higher in the range. Feeling awful when trying to achieve the correct dose can be due to low nutrients. Sounds too simple but worth a try 😊
Oops - posting ranges would be helpful 😊 - and Welcome to the forum !
I can supplement with iron glycinate. I was able to bring my ferritin up from 19 in 3 weeks - which shocked my dr. Anyway, as more meds / supplemts were added, I stopped taking due to absorption issue w other meds and constipation . Easy enough to double my Vit d and take 10,000 iu.
My b12 has always been on high end . Folate not regularly checked. I do have c677t and b vitamins typically cause anxiety .
I started the stress b complex by Thorne 3 weeks ago.
Yes, very hard to believe that these elements could be preventing me from going in the right direction .
This time last year, I did t3 only and felt so much more like myself for 4 weeks ... and then crashed hard . I’m guessing it was bc of nil ft4. Idk. Dr thinks I didn’t go up in t3 enough . I was taking 35 mcg total in divided doses. When I titrated I really got super depressed and agitated . Also, gained 16 lbs in three weeks when taking t3 only . Perhaps it raised my cortisol ? All in mid section . While I didn’t care as long as I felt good , the extra weight is a problem . My weight hasn’t fluctuated in ten years except for the t3 only trial .
2am here. I typically do not have sleep issues at all, but so upset and feeling hopeless .
Oh, you are hypo, alright. But, it seems to me, you have never been on a high enough dose. Why would that be, do your think? Is it that you are too impatient, and before you get a chance to raise your dose to the right level, you decide it isn't working and change to something else.
You say that thinks work to begin with, and then the symptoms come back. Well, that's the way it works. It don't mean the tablets stop working, it means you need an increase in dose. Do you think you could stick with one thing - whatever you like - and for at least a year, and slowly increase it until your FT3 is somewhere near the top of the range? That would be a more realistic approach. It is going to take time, you've got to except that. Hormones don't work quickly, and trying to take short-cuts just gets you back to square one.
Of course, as Marz says, you do need to optimise your nutrients. Nothing will help unless they are optimised.
As to your cortisol, I'm a little concerned by the supplement you're taking. Bunches of stuff, all in one pill like that, are rarely a good idea. And I'm wondering what exactly you expect it to do. Let's have a look at your cortisol results...
morning 5.3 (3.7-9.5 ng/mL) Well, that's a little low, but nothing drastic. Your adrenals are struggling a little, but that's not surprising given your low T3.
noon 7.1 H (1.2-3.0) That is high, no doubt about it. But, rather than trying to lower it - which is what I imagine you're trying to do with that supplement - it would be better to try and raise the early morning cortisol, which would lower this reading.
evening 2.5 H (.6-1.9) Still a little high, but not as high.
night 1.0 (.4-1.0) And, it's come back down to the top of the range, so you should be able to sleep ok.
This pattern is unmistakeable. It's the early stages of adrenal fatigue. The adrenals are struggling a bit, but they still manage to put out some cortisol to get you out of bed and started on your day. However, they don't stop at that, but carry on struggling to make their quota of cortisol which means that the noon level is higher than it should be, and the evening is slightly higher than it should be, but by night, they have eased off a little and the level comes down.
So, how do we raise that early morning cortisol? Not with that supplement, that's for sure. It contains adaptogens, which are supposed, by some miracle, to raise low hormones, and lower high ones. Seems a bit too much to ask, in my opinion. And, in my experience of reading other's experiences on forums, they are better at lowering hormones than raising them.
What we really want to do is support the adrenals through these difficult times - adaptogens don't support, they stimulate, if anything. Supporting them means giving them the nourishment they need. And, they need lots of B vits (if your B vits are low, it doesn't help, so continue with that B complex), and lots of vit C. And salt. They need salt. And they need protein. The best thing you can do for your adrenals is have a high protein breakfast as soon as you get up, and have some B vits and vit C and salt with it. The early morning is the hardest time for your adrenals, so they need that support then.
And, of course, having low T3 is putting extra strain on your adrenals. So, you really need to get that optimised. And so we come back to optimising your nutrients. It's all intertwined, a vicious circle. We need to break the circle to get well. And we have to start somewhere, so you decide where you're going to start.
Thanks for your reply. One of the MAIN complicating factors is ME and my trust in working with practitioners. - And the last two year leg of this journey no exception. Let me give a bit more history.
My Primary Care Dr is an endocrinologist (specializing in diabetes- but because endo I trusted his management of my hormones?). I was on 1 grain of armour and labs were still low but I could never tolerate a higher dose. He assumed I was over replaced and basically treated me for depression and anxiety- loads of meds and TMS treatment. I always had hunch my hormones were not right.
The following is a post from December 2016.
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I have been on 1 grain Armour for years and in March I slowly added 25mcg of T4. With each bump of T4, I had 1 -2 days where I sensed improvement but then would crash. In October I switched to 63mcg of T4 and 10mcg of Cytomel (in divided doses) and noticed an improvement immediately when switching to Cytomel. October 28 I went to T3 only- 5mcg three times a day. I slowly came alive with most noticeable improvements mentally (mood and brain fog- my most debilitating symptoms). I felt more like myself and began to think life might be possible. Oddly, I gained 12 lbs in 2.5 weeks, became bloated and constipated, puffy face/eyes. I slowly titrated the dose and four weeks later was taking 10, 10, 7.5. December 3- I hit a wall and have gone straight into the pit of depression- horrific and mind blowing how quickly this can shift. I have had ferritin in the teens and was able to get it up to 52 in three weeks with iron supplement. I have not been taking the iron since t3 only as I'm not sure when to take it as it interferes with many meds I take. Would this be because the t4 is clearing?
Labs 10/6/2016
TSH .019 (.45-4.5)
FT4 1.31 (.82-1.7)
FT3 4.3 (2.0-4.4)
RT3 22.5 (9.2-24.1)
Prolactin 76.8 (4.8-23.3)
*These labs were taken BEFORE starting T3 only. Also, they were drawn 4 hours after taking 63mcg of t4 and 5mcg t3- per drs instruction.
The brain fog, despair, sadness, and apathy are truly incapacitating, especially after a four week reprieve of feeling more like myself. Thanks in advance for any input!
Labs 12/9/2016- *NOTE- I was taking T3 25mcg in divided doses. I had 10 mcg 2 hours before labs were taken. ** I get this is not ideal - but dr wanted it done this way.
TSH 2.0 (.45-4.5)
FT4 0.18 (.82-1.7)
FT3 3.8 (2.0-4.4)
RT3 <5 (9.2-24.1)
Prolactin 83.7 (4.8-23.3)
Dr. said I did not go high enough on T3. HOWEVER, I felt worse - not better in any way as I increased the dose. I eventually went back to 1 grain of armour and have stayed there for almost a year. While I haven't felt good at all on armour- I just gave up trying to figure this out. In June I went off Armour- and didn't notice any change EXCEPT the mental relief of not worrying if my meds were making me sick.
Late August I was consulting with a NP regarding my son who has Down syndrome. She was very knowledgeable re thyroid and I casually mentioned my struggle. She started me on T4 & T3 8 weeks ago and have felt much much worse. While this practitioner is perfect fit for my son, my clinical picture is not her typical experience and I have lost trust. I ordered my adrenal test on my own as my adrenals were not being addressed. Desperation got the best of me thinking this she might have answers. Ultimately, I am panicking and half assing everything.
So I am most definitely the confounding factor here. I would be so grateful for any input as to how to clean up the mess I am making and move forward. Thanks in advance
A few weeks prior I was taking 1 grain in morning . 1/2 grain .+. T3 5 in the afternoon . I have felt worse with any kind of increase and started to lower the dose.
I was on 1/2 grain at 7am and 1/2 grain at 2pm when labs were taken .
I am very unwell . Based on labs , I switched back to t4 and t3 in order to control dosing . Since Saturday , I am on t4 50 mcg at 7am and experimenting with different times to take t3. I am taking first dose around noon . Within two hours , I have nausea , chills , touch of vertigo . 2 dose around 6. End up crying until I got to bed.
Would this mean too much ? Not enough? Would SR T3 be an option ?
Good morning, Kcdb! Hope you are feeling not too bad this morning.
As promised, I have just read through all of your posts, and I have to say, it's very confusing, because the information jumps around a bit, and the time lines aren't clear.
But, for arguments sake, let's go back to when you were on NDT. You never got above one grain, is that right?
Why was that?
Did you try to increase and found it made you feel bad?
Why did you add in T4?
Did you think your FT4 was too low and needed to be raised?
At that time, did you get your nutrients tested? Vit D, vit B12, folate, ferritin? Were any of them low at that point?
So, then you went on to T4 plus T3, is that correct? And, that's what you're on now? How much T3?
Have you ever tried taking it all in one go - all the T4 and all the T3 together in the morning? Have you ever tried taking it all in one go at bedtime?
Do you have your current nutrient levels? When did you last have them tested?
Have you had your FT4/FT3 tested since you've been on T4+T3?
Sorry if you've already answered all these questions somewhere else, but it really is almost impossible to piece it all together when we get a snippet here and a snippet there. If I may make a suggestion, I think it would be very helpful - to us and to you - to make an organised time-line of events. Something like :
2015
Date
Dose
All results on that dose
How you felt/symptoms on that dose
It would be much easier to get a handle on all this with this organised information.
In answer to your last questions at the bottom of this post :
Uncontrolled crying is more likely to be a hypo/under-medicated symptom than an over-medicated symptom. But, as you don't say how much T3 you're taking, it's difficult to suggest whether you're taking too much. But, going by past data, I rather doubt it. I don't think you've ever taken enough, and that's why you continue to feel bad.
Would SR T3 be a better solution? I don't think so, because there are too many factors that could possible cause poor absorption in the gut. As you've been hypo for sometime, I believe, what you probably need is a highish dose of T3 taken in one go, to saturate the receptors, which could 'switch on' those that have been 'switched off' due to low levels of T3. Taking a tiny dose, split into several doses, won't do that. It's true that T3 has a very short half-life in the blood, but once it is in the cells, it stays there for several days. So, what you need is a means of getting as much of it into the cells as possible. And SR T3 won't do that.
So, if you could answer my questions, we might be able to make a little headway, here.
Hi Greygoose- thanks so much for your message. Not well at all as last night was exceptionally uncomfortable. Yesterday, Accidentally- I took 15mcg of srt3 (instead of 7.5). There was not too noticeable of change early on. I noticed 7 hours into it the nausea, vertigo, and chills were not as noticeable. However, around 5pm, I became very very depressed and by 7pm crying hysterically, pulling hair, scratching myself to relieve the pressure. Could hardly breathe or talk. The anxiety was SO heightened- I felt like I lost touch with reality. I took Ativan to calm myself- but was delirious and did not sleep well. Feel like run over by truck- depressed.
I did not take t3 this morning bc I am scared to death. I have complicated things by working with a few Drs. My PCP dr is an endocrinologist , but not experienced with t3 protocols. He is willing and open...which is why I stay. I have been under his care for 7 years. He also prescribes the psyche meds lexapro, concert, Ativan, so I don't have to see the psychiatrist regularly- and I feel confident that he does know enough about these meds (sadly).
Initially when I restarted meds 10 weeks ago- I was working with a my son's naturopath . She made some suggestions- and I guess I hoped it was an easy fix. I do not see her in person- just phone consults. as of last week, I am no longer working with her.
One week ago- I went to local wellness dr. She prescribed SRT3- she has more experience using armor and t3.
Everything about this is complicated- I know.
To answer your questions:
1.Yes, only on one grain.
2. felt worse
3. yes. Before surgery 2000-2008 I was on 77mcg synthroid and functioned in life. Six months after surgery, a wellness dr put me on armour. Felt better for 4 weeks, then crashed.
4 I am assuming all nutrients were supported as this dr looked at everything. I was put on cortef, and tried to raise dose. felt worse. Tested positive for lyme and went to specialist and treated for next 3 years with minimal improvement.
#I want to mention that I NEVER experienced anxiety in my life until after starting NST. While I believe t3 is needed- I think ratio is where my answer may be.
4. FF to March 2016. On one grain of Armour-(and no success trying to increase it )My labs:
March 2016 labs
tsh. 1.27. (.45-4.5 ulu/ml)
ft4. .77. (.82-1.7 ng/dl)
ft3 2.5 (2.4-4 pg/ml)
rt3. 9.1. (8-25)
I added in t4 bc I felt horrible and honestly didn't see another option (pop had no suggestions other than ketamine drip or ECT).
When I added 12.5, felt improvement 1.5 day. Waited 10 days and added 12.5 more. Improvement for 2.5 days. Waited 10 days and added 12.5. Felt worse and gave up trying. Stayed at 25mcg of t4 & 1 grain armor all in the morning.
Felt horrible and in October went to wellness dr ( same one I saw after surgery. I did not stay under his care bc he did not treat lyme) .
5.He switched me to t4 and t3 so we could manipulate the components rather than have the fixed ratio. He prefers meds to be taken morning of- to see peak levels of t3? not sure. Just doing as told.
on 63mcgt4 & 10 mcg of cytomel in divided doses (so63t4 & 5mcg t3 2.5 hours before labs.
October 2016
tsh. 0.019 (.45-4.5 ulu/ml)
ft4. 1.31. (.82-1.7 ng/dl)
ft3 4.3 (2.4-4 pg/ml)
rt3. 22.5. (8-25)
Started cytomel 5 mcg three times a day and titrated dose over 6 weeks. Five weeks I felt more like me, then crashed.
I was on t3 10mcg, 7 mcg, 5, 2.5
2.5 hours before labs, I took 10mcg if t3.
December 2016
tsh. 2.0. (.45-4.5 ulu/ml)
ft4. .18 (.82-1.7 ng/dl)
ft3 3.8 (2.4-4 pg/ml)
rt3. <5 (8-25)
My dr said I did not go up on t3 enough, however, I felt hyper when I did- anxiety, crying MUCH worse. He prescribed armor 1/2 grain to take three times a day- I eventually lost faith in this physician as it was difficult to work with his office. I only kept the morning dose ( was thinking it was 1 grain- I guess do to brain fog, idk. I only realized this later this fall.). At .5 grain a day- while I did not feel well, I was able to 'show up' for several events for my daughters, had two parties at my house, gathered 77 graduation gifts, and prepared my oldest for sorority rush and first year away at college. Mind you I had a ton of help- but I was involved and not distraught with depression and anxiety.
June 2017 went off meds- tired of mental angst of wondering if med / dosing was correct. Definitely did not feel well- but mental stuff better.
July 2017- no meds
tsh. 4.87 (.45-4.5 ulu/ml)
ft4. 0.74 (.82-1.7 ng/dl)
ft3 2.4 (2.4-4 pg/ml)
rt3. 13.4 (8-25)
August is when I showed my labs to my son's NP, and she started me on
t4 37mcg and t3 10 in divided doses. I don't know her rationale, but keep in mind her patient population are children with special needs who don't speak. I was impressed with her knowledge- AND she didn't make me fill out any new patient forms- was willing to dig thru my drop box files. felt like it was a gift.
September 10 2017 labs 4 weeks after starting meds. I requested as I felt much worse since starting meds. (last dose of t3 was take 18 hours before labs)
tsh. 1.67 (.45-4.5 ulu/ml)
ft4. .97 (.82-1.7 ng/dl)
ft3 2.7 (2.4-4 pg/ml)
rt3. 16.7 (8-25)
Felt horrible. Was switched to 1 grain of armour at 7 and 5mcg of t3 at 11 and 3pm. Stayed on this for two weeks and felt worse, vertigo, nausea, chills, constipation. anxiety. bed bound. Then switched 1 grain at 7 am and 1/2 grain at 2. drop cytomel. At this point I got my cortisol results back:
ZRT 9/15/17
morning 5.3 (3.7-9.5 ng/mL)
noon 7.1 H (1.2-3.0)
evening 2.5 H (.6-1.9)
night 1.0 (.4-1.0)
and the thought was that the t3 was driving up the cortisol
Did this two weeks, the I-ME, dropped the morning dose to 1/2 grain bc I couldn't get in touch with NP and I was scared, confused.
October 18 2017 labs ( no meds the morning of)
tsh. .893 (.45-4.5 ulu/ml)
ft4. .69 (.82-1.7 ng/dl)
ft3 2.6 (2.4-4 pg/ml)
rt3. 13.2 (8-25)
This is when I was switched to tyrosint 50 mcg by PCP. That was 10 days ago. The next week is when I went to NEW wellness dr. She started me on SRT3 7.5 bid. Started only a week ago and feel horrific.
Which brings me back around to last night. I accidentally took 15 mcg all in the morning and had ...psychotic break last night.
I did not take any t3 this morning. Don't feel better or worse at the moment. The new wellness dr is out of town until next Tuesday .
Because I don't have complete nutrient labs, perhaps I should just stick with t4 and actually raise the dose. Until I have a competent dr that is help me understand, I think it is best to not try and figure this out. I am so beat up and spirit is broken.
I APPRECIATE you taking your precious time to sift thru this chaos to help a stranger . That sentiment of love gives me hope more than any protocol can.
AS always, any input welcome- and apologize again for not posting in more organized fashion.
That was brilliant! Thank you. It's all much clearer, now. I shall have a think about it, and get back to you tomorrow night.
You have suffered a lot of mistreatment by doctors that don't have a clue what they're doing - but, then, not many of them do. Which is why so many of us self-treat - we couldn't make a worse job of it than the average endo!
But, I want to ask you, do you think your Lyme was adequately treated, or do you think you still have problems with that? Would it be possible to get retested for it? See if it's still a lurking problem?
While the. outline is of the last 2 years, the last 7 are complicated.
2006-2007 huge mold exposure in rental house - no symptoms
2008 surgery
2009-Igenex CDC positive 15 months oral abx, 15 months IV
2012- Treatment for mold exposure in clinic in Tampa
2013 TMS 26 rounds helpful, but tanked
2014 Methylation - worked with several big names
2015 Family member won World Cup
2015-2016 PMC in Atlanta- looked at SIBO, Lyme test negative, did all kinds of iv. Had tooth extracted, sinus cyst drained.
2016 -goal is just to show up and breathe.
This is a very crude outline. Many, many practitioners- all VERY well meaning. There are so many things that have been looked at- but thyroid, hormones never optimized in my opinion- just a gut hunch.
I am highly educated person married to a health care professional. I am embarrassed that I have not found answers to my physical health. I've resigned to the fact that it is a soul journey and just need to show up.
I am as confused as ever. Also, I have an event coming up in one week. While I know there is no way to FEEL good in a short amount of time, I want to come to a resting place in my mind - some kind of confidence that I have a plan moving forward that makes logical sense. And maybe that just needs to be breathe.
And then the holidays.
Thank you so much . Again, I am humbled beyond that a stranger would even care.
PS- as far as lyme, my symptoms fit neatly into hypothyroid. Many of the symptoms I had joint pain, sound sensitivity, horrific fatigue improved with abs- but never back to functioning in life
have had thyroid antibodies tested several times over years- negative. Eat clean- no alcohol, caffeine, sugar, gluten, fun.
Have tried paleo and other specific diets- I have not seen any improvement in symptoms.
I used to be VERY active, creative, engaged in life. Never a sickly person. Usually had energy to burn. I never felt - stressed out despite there being a TON of stress. My mother is 75 and runs circles around most 40 year olds. I have full time help. And yes, while that is great....my shift / part is covered. Everyone else goes on with their lives. Guaranteed if my income was needed or I depended on family for support, there may be more interest in helping me figure this out. But I am the only one inconvenienced- and on my own figuring it out.
Yes, a lot of us are on our own, trying to figure it out, that's why forums like this exist.
So, let's see what I've picked up on in your post above...
‘Yesterday, Accidentally- I took 15mcg of srt3 (instead of 7.5)... I noticed 7 hours into it the nausea, vertigo, and chills were not as noticeable. However, around 5pm, I became very very depressed and by 7pm crying hysterically, pulling hair, scratching myself to relieve the pressure. Could hardly breathe or talk. The anxiety was SO heightened- I felt like I lost touch with reality. I took Ativan to calm myself- but was delirious and did not sleep well. Feel like run over by truck- depressed.’
I find it very difficult to believe that an extra 7.5 mcg T3 could have that effect. It’s such a tiny dose, it would be hardly noticeable. Especially as your FT3 was so low in October. 7.5 mcg certainly wouldn’t have pushed you over-range. However, I am very concerned about all those psyche meds you’re taking. Are you sure you’re not over-dosing on those? Are they all really necessary? Nausea, vertigo, difficulty breathing can all be side-effects of Lexapro. Depression and joint pain are side-effects of Concerta. And Ativan has a long list of side-effects, too. And, I’m certainly not sure you should be taking them together. I think you should be having long talks with your doctor about these. It’s more than likely that your depression and anxiety are caused by your low T3. Increasing your T3 should lessen your need for them.
‘Initially when I restarted meds 10 weeks ago- I was working with a my son's naturopath’
Naturopaths are not known for their knowledge of thyroid! I’ve seen a lot of mistakes they’ve made recounted by people on here.
‘One week ago- I went to local wellness dr. She prescribed SRT3- she has more experience using armor and t3.’
And, I’m really not sure that SR T3 is the best solution. You can have no idea how much you are absorbing. It could bind with other things in the gut and become unusable by the body. And, if you have diarrhea, it could be excreted long before the hormone has all been absorbed. Personally, I think it’s a bad idea.
‘1.Yes, only on one grain.
2. felt worse’
Well, one grain was never going to make you better long-term.
‘4 I am assuming all nutrients were supported as this dr looked at everything’
Never assume anything. If you weren’t tested specifically for each individual nutrient, and you weren’t put on any supplements, then he didn’t look at everything, did he! I think it really is time to think about this particular issue. Ask to have your vit D, vit B12, folate and ferritin tested. Then post the results on here, with the ranges – in a new post.
‘#I want to mention that I NEVER experienced anxiety in my life until after starting NST. While I believe t3 is needed- I think ratio is where my answer may be.’
Ratios are, for the most part, a red herring. Just because a healthy person has a thyroid that makes x% T4 to y% T3, doesn’t mean the same amount is going to make you healthy. You need what you need, and you can tell what you need by comparing your lab results with your symptoms, and to hell with the ratios. You cannot compare the T4:T3 ratio in a pig’s thyroid with the T4:T3 ratio in a human body. It’s totally illogical. So what if the pig’s thyroid makes more T3 than the human thyroid. Most T3 comes from conversion, anyway, in a healthy person/pig. But, a hypo person might need more T3, or might convert badly, so comparing ratios is not very helpful for them. A lot of people do very well on exogenous T4 only, so the question of ratios doesn’t enter into it. Other people, like me, cannot tolerate T4 and need to be on T3 only. So, once again, no ratios involved. So, that is something you need to work on, exactly what you, as an individual, need. And, forget ratios.
‘4. FF to March 2016. On one grain of Armour-(and no success trying to increase it)’
This is where the sub-optimal nutrients come in.
‘March 2016 labs
tsh. 1.27. (.45-4.5 ulu/ml)
ft4. .77. (.82-1.7 ng/dl)
ft3 2.5 (2.4-4 pg/ml)
rt3. 9.1. (8-25)
I added in t4 bc I felt horrible and honestly didn't see another option’
This is a mistake a lot of people make – especially endos. Your FT4 is below range, yes. But, it doesn’t matter. You’re taking T3 in the NDT so it doesn’t matter. Trying to raise that FT4 is a fruitless exercise. But, what you could have done, if you couldn’t raise the NDT, is add in some T3.
‘5.He switched me to t4 and t3 so we could manipulate the components rather than have the fixed ratio. He prefers meds to be taken morning of- to see peak levels of t3? not sure. Just doing as told.’
Yes, well, he’s just showing his ignorance of treating thyroid. It’s not the peak level that’s important, it’s the normal circulating T3 that counts. If you take your T3 before the test, all the result means is that you’ve taken your dose before the test. It really isn’t helpful.
‘on 63mcgt4 & 10 mcg of cytomel in divided doses (so63t4 & 5mcg t3 2.5 hours before labs.
October 2016
tsh. 0.019 (.45-4.5 ulu/ml)
ft4. 1.31. (.82-1.7 ng/dl)
ft3 4.3 (2.4-4 pg/ml)
r
t3. 22.5. (8-25)’
And, so, you get labs like these! How does that help?
‘Started cytomel 5 mcg three times a day and titrated dose over 6 weeks. Five weeks I felt more like me, then crashed.’
What exactly do you mean by ‘crashing’?
From then on, until now, there was far too much chopping and changing, not giving anything time to work.
‘morning 5.3 (3.7-9.5 ng/mL)
noon 7.1 H (1.2-3.0)
evening 2.5 H (.6-1.9)
night 1.0 (.4-1.0)
and the thought was that the t3 was driving up the cortisol’
Is this a saliva cortisol test? It’s really not that bad. The noon reading is too high, but if you worked on getting the early morning cortisol higher, by supporting your adrenals, then you wouldn’t have that high result at noon. But, I really don’t think the T3 is driving up the cortisol. The T3 would be supporting the adrenals, taking the pressure off them.
And, then, we start chopping and changing again!
‘This is when I was switched to tyrosint 50 mcg by PCP. That was 10 days ago. The next week is when I went to NEW wellness dr. She started me on SRT3 7.5 bid. Started only a week ago and feel horrific.’
And, I think the SR T3 is a mistake.
‘Because I don't have complete nutrient labs, perhaps I should just stick with t4 and actually raise the dose. Until I have a competent dr that is help me understand, I think it is best to not try and figure this out. I am so beat up and spirit is broken.’
And, I think, that’s the best idea you’ve has since 2015! lol Yes, stick with the 50 mcg levo. Get retested six weeks after starting it, and see what your labs look like. That will give you a base-line. But, make sure you get the FT4 and FT3 tested so that we can see how well you’re converting.
Get your nutrients tested – have you ever had antibodies tested? If not, get them tested, too.
Support your adrenals by taking high doses of vit C, and make sure you get enough salt. Take your levo at night, so that you can have a high protein breakfast as soon as you get out of bed.
And try not to get down-hearted. But, you do need to rethink those psych meds. They’re not the best things for hypos to take.
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