Hashimotos problems

[Mggirl]

I have hashimotos and my dr raised my liothyronine to 10mcg my labs are tsh 2.74 (range 0.36-3.74) ft4 0.76 (range 0.76-1.45) ft3 2.6 (range 2.2 -4.0) I am having difficulty with anxiety and difficulty breathing. I seems like I need more t3 but I feel almost like I have too much and it's hard to tell difference in symptoms.

[Lalatoot]

Are you on lio only?

Some folk need levo as well.

If my ft4 levels are at the bottom of the range I am symptomatic even though my Ft3 is well over half way through its range.

[Mggirl in reply to Lalatoot]

I am also on 25 mcg of levothyroxine.

[Lalatoot in reply to Mggirl]

Your TSH is high for someone on replacement hormones. For me the breathing problems are hypo symptoms. I have had anxiety when I was undermedicated hypo and I have had it when I was hyper.

You need to think what you feel is best for you. If those were my results I would be looking to raise my FT4 level as some of us need it over halfway through the range to be symptom free. By increasing levo this would increase your FT4 and, depending on how well you convert, your FT3. Your FT3 level is not high so there is room for an increase that way. It has taken me 10months of adjusting FT3 and FT4 levels to begin to feel that I have my life back. You can only change one dose at a time then wait 8 weeks and then bloods.

Vitamin levels also need to be over halfway through their ranges to help us process the hormones effectively. Have them checked if you haven't already.

You don't say how long you have been on replacement hormones. It is a slow process and takes the body time to adjust.

[Mggirl in reply to Lalatoot]

I have conversion problems with t4 converting to t3 but my dr thinks my ranges are fine but I do not feel well. Your advice sounds good to me it just getting my dr to agree. I have been on my meds for years with levo and lio for 2 years.

[Lalatoot in reply to Mggirl]

Yes it is a problem getting them to understand. Often we need our hormone levels well over halfway through their ranges to feel well. That is just how it is and few doctors understand.

[SlowDragon Administrator]

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested.

Also EXTREMELY important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially as you have Hashimoto’s

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .

Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

If/when also on T3 or NDT make sure to take last half or third of daily dose 8-12 hours prior to test, even if this means adjusting time or splitting of dose day before test

Is this how you do your tests?

What’s the highest dose of levothyroxine you have ever been on?

Obviously 25mcg is extremely low dose

Ft4 is very low ....may be too low for you

Why such low dose of levothyroxine?

When were vitamin levels last tested

What vitamin supplements are you currently taking

As you have Hashimoto’s are you on strictly gluten free diet?

[Mggirl in reply to SlowDragon]

All vitamins are in good standing and yes I test early morning on empty stomach and dr said reason for low dose levothyroxine is because she said my t4 level was fine but with the raising of my dose of t3 meds my t4 levels dropped so she came back and said all looks good but I dont feel so good so that's where I am at. Yes I have been on higher dose of levo before but they lowered dose when they started me on t3. I am mostly gluten free but once in awhile I fall off the wagon.

[SlowDragon Administrator in reply to Mggirl]

Suggest you increase levothyroxine by 25mcg and retest in 6-8 weeks

Unless only just increased T3

Should only increase one or the other ...not both together....levothyroxine or T3..not both

Typically when starting T3 levothyroxine is only reduced by 25mcg

What dose levothyroxine were you on before T3 was added

Please add latest vitamin results and ranges

Gluten free diet needs to be absolutely strictly gluten free to be effective

chriskresser.com/the-gluten...

[Mggirl in reply to SlowDragon]

I was on 50mcg of levothyroxine. Vitamin levels were tested 8 weeks ago I dont have results but they were all in higher range and my t4 was raised 8 weeks ago so I think I am ok to raise t4.

[Mggirl in reply to Mggirl]

Sorry my liothyronine was raised 8 weeks ago.

[SlowDragon Administrator in reply to Mggirl]

Yes, if been on higher dose T3 for 8 weeks ok to increase levothyroxine by 25mcg

Retest in 6-8 weeks

What were your results when just on 50mcg levothyroxine (which is only a starter dose) ?

[Helcaster]

Mggirl, how are your waking temperatures before you get out of bed in the morning? It's quite a good way of assessing how your thyroid function is. I think your doses and results show you're undermedicated. For example I have to take 75mcg of liothyronine and I take 3 grains of natural desiccated thyroid also, but that is quite a big dose. When I was on levothyroxine when first diagnosed my starting dose was 75mcg, I then went up to 200mcg prescribed by my GP. If you are taking liothyronine you would expect your TSH to be extremely low, even suppressed, and your FT3 to be high in range. I feel like my lungs are being vacuumed out of oxygen when I'm very hypo so I understand this symptom. I need high doses to tick over, but I know not everyone is like me, but your results do indicate you need more thyroid medication.

[Mggirl in reply to Helcaster]

I made another dr appointment for Aug. 21, this morning so hopefully I can get dr to prescribe more meds because I agree with all the advice that I need more meds.

[Helcaster in reply to Mggirl]

Take five early morning temperatures with you to your doctors, keep the thermometer by your bedside you want to take your temp before you start moving around. My GP took a lot of notice of this and it helped me get diagnosed. My waking temperatures were all in the 35 degs.

I hope you don't meet any resistance, and you get prescribed what you need.

[Mggirl in reply to Helcaster]

Thank you.

[JAmanda]

Your levels are low in range so is likely cause of symptoms. Seems weird doc is keen to raise lio not levo, as your Levo is minimal. I seem to need a fair chunk of Levo and only a bit of lio. ( Was doing 75/10 but now trialling 100/5.)

[HMBradley53]

Cut your Liothyronine in half it is short acting so taking it 12 hours apart will keep it in your system all day long. It made a big difference for me when I my Dr told me to take it twice a day.

[Mggirl in reply to HMBradley53]

Does it keep you up at night? I was thinking of trying that but I was gonna try more like 6 hrs apart.

[HMBradley53 in reply to Mggirl]

No I take it at 2am before work and 2pm ...