Trouble with Medication Tirosint

[palberts01]

I’ve had a thyroidectomy since 2014 started on 50mg. Then eventually had to adjust dose up to Tirosint 125mg over 7 years.

My Endocrinlogist is scratching her head for 4 years I was balanced. My freeT3 and freeT4 were both in normal. During covid I could not do “In Person” visits so my labs didn’t get ordered like they should and doctors were unable to see my body to properly diagnosis me. My levels increased out of control TSH was 0.154 in January 2021 with normal T3/T4. March 2021 level jumped TSH 12.89 T3 below normal T4 my meds were adjusted once again added Cytomel 5mg ..labs 6 weeks to have my levels at critical point TSH 20.89 T3/T4 normal gained 50 pounds since January 2021 legs are so swollen entire leg and lower, almost in a complete stupor. Labs drawn 6 weeks later shows finally decrease TSH 5.84 T3 1.1 and T4 1.4 normal per on T3/T4 reference range. To date still feeling ill tired, muscle stiffiness and no reduction in weight 278 ..swelling still abundant even on 40mg Lasix can’t increased due to stage 3 kidney disease.

My other primary diagnosis Transverse Myelitis, below waist paraesthesia. This disease TM complicates my symptoms.

Waiting for this week to be drawn. I’m on 175mg Tirosint and 10mg Cytomel. Symptoms now ..severe swelling in legs, feet, ankles and hands. Still no weight loss. In need if a solution that spiraling out of control. Any suggestions on medications to take. I have no thyroid so not taking replacement is not an option.

Feb 4 2021 Labs

Glucose 107 (65-99)

TSH 9.07 (0.45-4.50)

T4 Free 1.1 (0.8-1.7)

Feb 11, 2021

Valley Fever Negative

TSH 11.70 (0.45-4.50)

T3 2.6 (2.0-4.8)

T4 1.1 (0.8-1.7)

April 7, 2021

TSH Reflux 18.40 (0.45-4.50)

T4 1.0 (0.8-1.7)

May 4, 2021

TSH 5.87 (0.45-4.50)

T3 3.0 (2.0-4.8)

T4 1.2 (0.8-1.7)

Thank you❤️

[SlowDragon Administrator]

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)

When on T3, day before test, split dose into three smaller doses roughly equal 8 hour intervals. Taking last small dose T3 at roughly 8-12 hours before test

Is this how you do your tests?

Assuming yes .....Results show you are still under medicated

Suggest you increase T3 by 5mcg -

Do you currently split T3 dose into 2 x 5mcg?

Add 3rd 5mcg dose and trial 3 doses at roughly equal 8 hour intervals

Essential to regularly retest vitamin D, folate, ferritin and B12 levels too

What vitamin supplements are you currently taking

What are most recent vitamin results?

[palberts01 in reply to SlowDragon]

I take my thyroid and Cytomel usually around 5am and blood tests are after 4pm

[SlowDragon Administrator in reply to palberts01]

So next test get blood test at 9am latest

Last dose levothyroxine 24 hours before test

Last 1/3rd of daily T3 roughly 8-12 hours before test

[palberts01 in reply to SlowDragon]

So with me taking at 5am and blood draw at 4pm wouldn’t it be lower not higher I’m confused. I can’t drive so rely on husband to take me to labs at 4 when he gets off

[SlowDragon Administrator in reply to palberts01]

Obviously you are currently very under medicated

When adequately treated TSH should always be under 2

You could EITHER increase levothyroxine by 25mcg

or

increase T3 by adding 2nd 5mcg dose approx 12 hours after 1st dose

When adequately treated most people will have both Ft4 and Ft3 apt least 50-60% through range

TSH is highest early morning (before eating or drinking anything other than water)

Considering you took test at 4pm ...TSH would have been even higher if testing at 9am

If testing at 4pm ....Suggest you take 1/2 of daily T3 dose at 5am (approx maximum of 12 hours) before test

Take rest of daily dose T3 after blood test

[SlowDragon Administrator]

Currently Ft4 is only 44% through range Ft3 only 35% through range

Helpful calculator for working out percentage through range

chorobytarczycy.eu/kalkulator

Most people when adequately treated will have Ft3 at least 50-60% through range

Often need Ft4 similar

Poor Kidney function often linked to low Ft3

ncbi.nlm.nih.gov/pmc/articl...

ncbi.nlm.nih.gov/pmc/articl...

Retest thyroid levels 6-8 weeks after each dose change or brand change in levothyroxine or T3

[Cat013]

Hi palberts01. Has anyone looked into any of your drugs causing an allergic reaction? Can happen even after being on them for a long time if another drug interacts with it. Or a change of brand etc.

I only ask as severe leg swelling can be linked to severe allergic reactions in drugs. X

[palberts01 in reply to Cat013]

No not sure what I would be allergic too the T4 is purest form

[SlowDragon Administrator in reply to palberts01]

Could be reaction to fillers in the T3

Are you lactose intolerant

Does T3 contain lactose

[palberts01]

All my problems were in place prior to starting T3 medication. My level was perfect so I’m bumboozeled. I’ve changed nothing I just started in February gaining weight like crazy