Graves, thyroidectomy, new labs

[leftbehind]

Taking 75 mg. NP thyroid. Just had new labs done. I waited 24 hrs. After my last dose, and fasting.

4/15/19

Tsh .011 (.450-4.5)

T4. 1.24 (.82-1.77)

T3. 3.2 (2.0-4.4)

The T3 dropped from Last labs (2/20/19) was 4.1 but test was done only 5 hrs. After I took my dose.

I'm feeling much better emotionally and brain fog is gone. I still have muscle aching on exercising and slight breathless, but much better than before when I was taking 60 mg.

I always have a slow down at 4 pm and am thinking to split the dose and take 60 mg. In the morning, and 15 mg. In the afternoon?

I have no guidance from the GP, and I added the 15 mg on my own because he wouldn't do it, so I'm having to cut a pill in four pieces to add the 15 mg.

What is your opinion on these labs? Thanks.

[SeasideSusie Remembering]

In your previous post where you gave us the results from 2/20/19

healthunlocked.com/thyroidu...

you told us that you left 9 hours after your dose of NDT before testing.

This time you've left 24 hours.

The advised time between last dose of NDT (or T3) and blood draw is 8-12 hours. Levo only requires 24 hours.

T3 starts to become undetectable in the blood after 12 hours so because you left 24 hours this time you have a false low FT3. If you did leave 9 hours last time then that was perfect, and because you left 24 hours this time it's no wonder you're showing a lower FT3 result.

You're feeling better because you raised your dose from 60mg to 75mg NP Thyroid and as you say you slow down at 4pm then it makes sense to try splitting the dose. You'll have to experiment to find the ideal dose morning/afternoon and you might find that splitting more evenly, say 45/30 may work better, but if you want an FT3 result which shows your normal circulating level then you should only leave 8-12 hours between last dose and testing.

[leftbehind in reply to SeasideSusie]

Thank you

I was wondering about the 24 hours because I thought the NP diminished sooner. So I think 75 mg. is good dose. It would be better to split the dose if I could get the appropriate size pills. I have a three month supply of 60 mg. So far my doctor is very stubborn about prescribing what I need. Thank you for that input.

[pennyannie]

Hey there Leftbehind

I'm with Graves Disease post RAI thyroid ablation in 2005.

I'm currently self medicating with NDT having given up with my UK doctor dosing me with Levothyroxine to fit into a blood test range, and ignoring my symptoms, that got progressively worse as she dropped my dose - similarities to your experience.

I was thinking, having read all your posts, have you looked at the Elaine Moore website.

This lady has the disease and is in the USA.

She was diagnosed late 1990's and found very little help and advice in her aftercare. So she took it upon herself to write a book to help others:- Graves Disease A Practical Guide. She then went on to form a Graves Foundation in the States, and devotes her time to research and advice on all things Graves for all and anybody to use.

There are open forums, very similar to this site and just thought that maybe, through her website there might be a facility of referencing doctors with an interest in Graves throughout the United States.

[leftbehind in reply to pennyannie]

Thanks. I will look her up.

[pennyannie in reply to leftbehind]

Just rereading your post and for your reference I am on 1+1/2 NDT tablets, Thyroid S.

I take it all in the early morning at around 3 - 4 am.

This is the maximum I can take at any one time, any higher a dose I feel anxious.

If I take any in the afternoon, I get a bit anxious, so now dose only once a day.

My blood test after 10 hours = T4 of 13.9 ( range 12 - 22 ) and my T3 came in over range at 7.8 ( range 3.1 - 6.8 ) - my TSH was, as usual, suppressed at 0.01.

I shall take a follow up blood test in due course, but wait 24 hours, and think this result will put my T3 into range but my T4 will probably fall out the bottom of its range. However these blood tests were introduced to be used with Levothyroxine. NDT was considered the " old fashioned " thyroid medication and prior to blood tests people were treated to dose to relieve symptoms and that is what I think I plan to do.

I have had no symptoms of over medication and am staying on 1+1/2 grains - so a little more than you are currently taking.

My brain is back which is fantastic and am working on building up my physical stamina and understand totally the afternoon slump, and the achiness of muscles and limbs.

A fully working thyroid would be supporting you with approximately 100 T4 and 10 T3 daily and my plan is to try and supplement back to this estimate.

It is all trial and error I'm afraid, and having the confidence to adjust doses and recognising signs and symptoms, and yes I'd also like a medical professional, with some knowledge and integrity to support me through the process.