New labs thoughts?

[kikiweight]

I’ve been on 60 mg Armour thyroid for about 5 to 6 months now and feel much improved, but not ideal. Still struggling with weight that I cannot lose, constipated and with a slow pulse. But definitely better than pre AT.

had a blip in my meds recently and my imperfect Endo had me taking a compound that resulted in less T3 and T4 than what I’d been taking. After only a few days, I felt pretty awful. Sluggish constipated and had migraines.

I took blood tests after just about a week and here are the results. Any thoughts appreciated

TSH 1.6 (it had been .62 in May)

T4 total 7.4 (6 in May)

T4 free- No results- not sure why? It was 1 in May

T3 free 2.8 (2.8 in May)

T3 total 95 (98 in May)

[Lalatoot]

I don't think we can say very much about the results as

They were done after a week or so after a change in tablets - you need to wait 8 weeks for things to adjust.

There are no reference ranges with the results and no ft4 result.

You do not say what this compound was or how much you were on.

[kikiweight in reply to Lalatoot]

Yeah I’m tired and it takes so long to type in the info. My reference ranges are the standard ones I see posted on here a lot.

The only thing I think I’m curious about is that I went from .6 TSH to 1.6 and felt very bad after only about a week on reduced T3 T4. I always hear about it taking weeks to see a difference but I tanked after a few days.

Also I think my T3 Is clearly low in range.

[pennyannie]

Hello Kikiweight

These results don't really say much except your T3 is still very low.

I'm self medicating with NDT and my understanding is that the TSH will go low - your T4 will be much lower in the range than when on Levothyroxine ( T4 ) and your T3 will run at a much higher level and possibly tip a little over the top of the range people refer to.

The range we refer to was designed to be used alongside the synthetic T4 pro hormone that entered the market in the 1960s along with the guidelines and rulebook and tick box exercise that we seem bound to in this current climate.

Prior to the 1960's you took a little bit of NDT and if you still had symptoms the doctor gave you a larger piece of NDT to chew on.

You dose NDT to the relief of symptoms not a blood test - and dependant on the timing of the blood draw your results may not correlate to this blood test regime that NDT was never intended to follow.

I would slowly nudge up your NDT dose by 1/4 grain a week until your symptoms are reduced - if you get up to 2 grains wait 6 weeks for that dose to bed in a then have a blood test just to see where you are compared to your bench from before starting NDT.

Your T3 is the main number to look at and this should have improved - if it hasn't it might be worth ensuring your ferritin, folate, B12 and vitamin D are maintained at optimal levels as no thyroid hormone replacement works well if these core strength vitamins and minerals are not strong and solid.

I read most people end up on about 2/4 NDT grains - but we are all different and coming at this with differing health issues - slowly edge up the 1/4 grains weekly from 2 grains until you feel a bit edgy and not as good as the week before, then drop back down to the dose before and stay there for 6 weeks and if all ok, this is your dose on NDT.

[kikiweight in reply to pennyannie]

Thank you, this is so helpful. And its so interesting to read how people used to be treated on symptoms, not blood tests.

I am watching my vitamin d, b and iron intake too although frustratingly, I can’t get any doctor to test for these things regularly so I’m often missing info.

I did speak to my Endo yesterday and she is increasing my T3 although I must admit to not trusting her much at this point. A month or so ago I’d asked her to do that- increase T3 or do something bc although I felt better on 60 Armour, I had some symptoms still. And she said no and then moved me from 60 AT to a compound of less overall medication (I don’t have the bottle now but it was a dose down) and I felt terrible. Her justification then for why I couldn’t have more T3 is that my hair would fall out. Why that meant I should dose down is beyond me. ?

A month later, after the labs above, she suggests T3? With no mention of hair issues.

I’m in the US and sadly this is the best doctor I’ve found to work with, and she is expensive.. I’ve tried and gotten nowhere with two GP, another Endo besides her, even a functional medicine doctor (one in the insurance system- she spent more than 5 minutes with me- rare in the US- but she was very young and inexperienced, and getting a follow up appt with her took two months). This all seems so crazy to me. Why should you have to self medicate?

[pennyannie in reply to kikiweight]

Well, I guess the answer for me is to get as well as I can and stay as well as I can :

I know it's a ridiculous situation :

If you can purchase the NDT yourself maybe just give it a go yourself.

Are there any platforms like this over there ?

Just thinking if nothing else you might be able to enter a zip code and have back a recommendation or two of the best endos / doctors / or functional doctor / in your area.

[kikiweight in reply to pennyannie]

I haven’t found a board nearly as informative as this one in the US unfortunately. But I have now heard of several female friends who are in the same situation as me. Only one of those is getting treated well- by a functional doctor. It’s imperfect too. And it’s out of pocket. In the US we already have to pay a lot for basic insurance, and I’ve found that to get a remotely decent doctor, you have to pay outside the network too. Nuts.

[pennyannie in reply to kikiweight]

Well it's different here in the uk as we pay in through taxes and National Insurance which is taken at source from our wages - so you can't even ' opt out ' - however I'm now paying myself for all my thyroid blood tests, vitamins, minerals and thyroid hormone replacement.

I've been fortunate as never really needed any medical help until diagnosed with Graves in 2003, and then the RAI treatment, which I deeply regret in 2005 and then the ongoing battle of synthetic T4 and fitting into ranges and guidelines that never helped me get back to better health.

Once I started self medication with NDT my brain came back on, and I've been able to get back to better health despite this treatment that has given me untold trouble and still does.