New Labs, Help, Still Lethargic

[GReenMachineX]

I’ve been back and forth on meds and supplements over the years, trying to find the root cause of my issues, but I think these labs look good overall but I still feel bad. I’m lethargic all day, but the last few hours in the evening feel the best, but by 9pm passing out. My nails don’t really grow and they have vertical ridges and my cuticles are gone. I also have chest flutters after big meals when I expend energy. My short term memory is terrible as well. Is it the reverse t3 too high? I’m on 125mcg Synthroid daily and 100mg testosterone cypionate per week. What’s interesting is if I take Methyl-b12, I get huge mood and energy boosts, and terrrible insomnia, water retention and angular cheilitis. So I’ve been using tiny amounts of b12 to feel normal enough and dealing with the side effects until this past week, just letting everything even out (no b12), so angular cheilitis is healing, water retention leaving, but intense muscle tightness persists. Does anyone have any suggestions or insights? Thank you.

TSH .93

Thyroxine 6.8 (4.5 - 12)

T3 100 (71 - 180)

T4, Direct Free 1.48 (.82 - 1.77)

T3, Free 3.5 (2.0 - 4.4)

See picture for rest of labs.

[GReenMachineX]

How do I add another picture???

[helvella in reply to GReenMachineX]

You can't. One image per thread - on the original post only.

[GReenMachineX in reply to helvella]

Ok, guess I have to type it out...

[GReenMachineX in reply to GReenMachineX]

Updated original post.

[SlowDragon Administrator]

You need vitamin D, folate and B12 tested

Do you have Hashimoto's diagnosed by high TPO or high TG antibodies?

[GReenMachineX in reply to SlowDragon]

I’m seeing my MD on Tuesday and going to request NutrEval or SpectraCell, should I get labcorp tests for those as well?

[SlowDragon Administrator in reply to GReenMachineX]

Never heard of either

Most important is the four vitamin levels

Vitamin D, folate, B12 and ferritin

Plus to test both TPO and TG thyroid antibodies

Link about antibodies and Hashimoto's

thyroiduk.org.uk/tuk/about_...

thyroiduk.org.uk/tuk/about_...

Good info on blood tests

thyroidnation.com/important...

[GReenMachineX in reply to SlowDragon]

I’ve had all thyroid antibodies tested years ago before going on meds and all fine. My ferritin is 56.

[Ell17]

All of what SlowDragon recommended, definitely get your Dr. to add to your LabCorp list (b12, folate, ferritin, and vitamin D).

I also have the same problem with angular chelitis caused by methyl b12. Some people's systems just don't tolerate the methyl forms well. I have had to experiment over the years, which takes a bit of time because the chelitis has to heal first. But, I do much better with the cyanocobalamin injections which your doctor can prescribe for self injection. Generally, you start with 1 shot every 2 weeks for 2 months. Then maintenance is 1 shot every 4 weeks. I use Doctor's Best Fully Active B Complex capsules about 3 times a week to get the methyl forms. I have been doing it this way for a year and have not had any chelitis flairs. If the doctor won't prescribe the shots, you could try liquid cyanocobalamin daily and Doctor's Best (or other methyl brand/ formula) a few times a week. It might be worth a try.

I don't use synthroid brand now, but when I did, I had muscle tightness in my legs and leg pain. Also, one of the listed side effects for levoxyl brand is heart flutters; it may be for synthroid, too?

You may want to look into adrenal and liver support, as well. Adrenal problems can cause you to feel exhausted during the day, but have more energy later in the day for a short time, before crashing with exhaustion again. The vertical ridges in your nails can be liver related (sluggish) and/ or due to low iron. Your ferritin could stand to be higher in range. Low iron can also contribute to feeling exhausted.

Have you thought about asking your doctor to add some T3 (Cytomel or generic) along with your synthroid? I ask because your reverse T3 is high. Adding T3 would give your body some active, ready to use hormone without your body having to convert it. It might help with your Reverse T3 levels, too. It certainly wouldn't hurt to ask at any rate.

Hope you find your answers🙂

[GReenMachineX]

Had my appointment today.

I had folate, b12, and d3 blood drawn as well as a Spectracell Nutrient test done.

My doctor also prescribed 5mcg cytomel to go with my Synthroid. I think she said it’ll be 5mcg twice a day if I need it. Sound good?

[Ell17 in reply to GReenMachineX]

It's a very good start. I hope T3 is the missing ingredient that helps put the pep back in your step Just remember in order for T3 to work its best (and T4 conversion for that matter), nutrient levels need to be optimal, especially b12, folate, D3, and ferritin. Zinc and Vitamin C levels (Spectracell) are important, as well.

To feel your best, dosing generally has to be adjusted. Some people feel better when Synthroid dose is lowered and Cytomel is increased. So, take note of how you're feeling.

Also, this article addresses RT3:

naturalendocrinesolutions.c...

By the way, that doctor of yours appears to be a keeper....many won't even entertain the notion of prescribing T3 (regardless of how desperately it's needed). So, to get it the first time out.....you are among the very lucky, indeed.

Hope you are on the road to recovery and feeling up to snuff very soon😊

[GReenMachineX]

Thanks. It would be strange if I am deficient in anything (other than folate) because I take the rest in the thousandth percent of the RDA through multivitamins and extra d3. Zinc just 100%, but the folate might be deficient somehow because of the angular cheilitis and I was only getting 100% of the rda. But speculating as of now is probably useless since the results of the labcorp draw are just days away. I won’t get the spectracell results until October.

Regarding the t3, should I be concerned with 5mcg elevating my blood pressure? That’s another piece to this puzzle, mine loves to ride in the 130’s to 140’s over 70-80. I’ve had one blood pressure that was 120/70 in the doctors office and it was because I took enough folate and b2 to be excessively drowsy in an experiment. Can’t live like that.

[Ell17]

Hypothyroidism can cause high blood pressure. But, adrenal hormones play a role as well. For some people, finding the right dose and balance of T3 and T4 normalizes their blood pressure. I hope that is the case for you. But, for some it isn't. That's why I mentioned adrenal support earlier.

You also want to make sure you are getting the most benefit from your medicine. Timing is important. Some people feel better taking it at night, noting that it helps them sleep better (T3). Also, because metabolism slows at night, it would provide the opportunity for better absorption. This article gives an overview of the adrenal connection and timing of medication:

restartmed.com/take-levothy...

Right now all you can do is to start taking it and see how you respond. Keep notes (my short term memory is a spiral notebook

Something else you might want to check into is electrolyte imbalance. Healthy blood pressure is dependent on balanced electrolytes.

Hope all goes well😊