Perfect lab results?

[yesendi]

Hello everyone! I need your advice, again. Sorry that I have been MIA, well not really, I am actively reading but not always participating because I am not very knowledgeable when it comes to thyroid things. But here I am and I really need your advice.

I got my latest lab work results yesterday and my go called “perfect” . I tend to disagree as I am feeling poorly, mainly is fatigue, forgetfulness and worst of all I am loosing my hair but the bushels.

I think I am under medicated but does is why I am here…for help.

Here my newest test results

FT4 0.90 ng/dl (0.85-1.76)

FT3 3.4 pg/ml (2.3-4.2)

THS. 1.64 (.27-4.68)

My last dose of Levo (50 mcg)was taken at 5.00 AM the previous day and cytomel(5 mcg) eight hrs prior to testing on a fasting state.

My previous test back on March of this year on 75 mcg levo and 5 mcg cytomel were as follow.

FT4 1.37 ng/dl (.85-1.76)

FT3. 4.1 ng/dl (2.3-4.2)

TSH 0.02

D3. 99 ng/ml (30-100).

The reason she lowered my levo dose is because I, occasionally was having heart palps.

I do want to have my TSH suppressed some.

So what do you all think? I really appreciate your input.

Thanks!

[SlowDragon Administrator]

Approx how much do you weigh in kilo

When were vitamin D, folate, ferritin and B12 last tested

[yesendi in reply to SlowDragon]

Hi SlowDragon,My weight in kg is 49.9(110 lbs) rounded up and I am 66 yo.

All the other vitamins where tested last November? and all were good near the top range except for vit d3 which was at the very low end of range. So I was put on a 50k weekly dose for eight weeks. Now I am taking 2k iu of d3 daily.

[SlowDragon Administrator in reply to yesendi]

Vitamin D levels need retesting at end of loading dose

2000iu may not be high enough maintenance dose

Suggest you retest folate, ferritin and B12 too

Guidelines on dose levothyroxine ALONE according to guidelines would be 80mcg daily

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

Do you always get same brand levothyroxine at each prescription

Typically dose is reduced by 25mcg when 3 x 5mcg T3 is added

Not sure just 5mcg T3 is worth taking….it’s enough to lower TSH, but is it enough replacement

[yesendi]

My d3 levels were retested at the end of loading dose which went from very low to 99. My go suggested 2k iu daily but most times I take 3k 😏. I will ask my gp to retest the other fits on my next visit(Tuesday).The highest levo dose I started with was 88 mcg right after surgery but I wasn’t doing well on it as I wasn’t converting well as my ft3 was only 2.2? Then she added the 5mcg of cytomel without reducing the levo and my free t3 went to the top of the range and I went a little hyper so she reduced the levo to 75 mcg and kept the 5 mcg cytomel but my ft3 hardly moved.

Now with the50 mcg dose I don’t feel well.

So what are you thoughts, should I aske for extra cytomel or Levo? I am taking levoxyl same brand at all times.

Thanks!

[SlowDragon Administrator in reply to yesendi]

My previous test back on March of this year on 75 mcg levo and 5 mcg cytomel were as follow.

FT4 1.37 ng/dl (.85-1.76)

FT3. 4.1 ng/dl (2.3-4.2)

TSH 0.02

How did you feel on 75mcg plus 5mcg T3?

[yesendi in reply to SlowDragon]

I was feeling a lot better on that dose but I was having some palps from time to time, not always but once in a while. I think I am going to ask my gp to put me back on the 75 mcg dose or to increase cytomel…one of the two. What do you think?And thanks for you input I really appreciated.

[SlowDragon Administrator in reply to yesendi]

You could increase levothyroxine 50mcg and 75mcg alternate days

Retest in 6-8 weeks

Perhaps then add 5mcg T3 (depending on results)

[Imaaan in reply to yesendi]

Another suggestion is to take 68.5 of t4 along with your 5 mcg of cytomel. Synthroid 137 mcg has a score line and if you split it in half with a pill cutter it would give you that amount. I was taking half of 112mcg of synthroid for several years along with 5 mcg of cytomel.

If the 68.5 is too much you can go down to taking half of 125 which would give you 62.5 mcg along with your 5 mcg of cytomel. Good luck and I wish you much success.

Btw its interesting how you prepare to take your bloodwork. I've always taken mine 23 hours later after my last dose of synthroid and cytomel. I take them once in the morning.

[yesendi in reply to Imaaan]

Hi maaan, thanks!We went with the 125 mcg cut in half(62.5), retest in eight weeks and go from there.

I prep for my bw as suggested here, cytomel taken 7/8 hrs before bw and levo after bw.

Why 23 hrs later?

[Imaaan in reply to yesendi]

When I was doing combo treatment, I would take my t4 and t3 in the morning prior to breakfast and wait the next day to test. I was unable to take another dose of t3 in the afternoon hence the 23 hrs later bloodwork next day.

[yesendi in reply to Imaaan]

That’s interesting, how long after your t3 dose did you test?I’ll take it you are no longer doing combo treatment? Didn’t work for you?

[Imaaan in reply to yesendi]

About 23-24 hours later. The combo dose I was on needed to be increased and I couldn't despite my many attempts. I would get awful side effects so I've gone back to mono and I'll see the next 2 months how that goes.

[yesendi in reply to Imaaan]

23/24 hrs isn’t too long to test your t3 for accurate levels? It’s recommended to test for t3 7/8 hrs after t3 dosing because t3 doesn’t stay long in your body.I am sorry combo treatment didn’t work for you. What kind of side effects were you getting if you don’t mind my asking?

[Imaaan in reply to yesendi]

Yup I'm aware that t3 is short acting but I couldn't take a second dose and I never was interested in taking it prior to testing. C'est la vie...lol

I would get excruciating chest pain, sweating and tachycardia. I have sleep apnea and I'm not on cpap so I'm sure it's fueling my inability to not tolerate t3 more than 5mcg.

[yesendi in reply to Imaaan]

My goodness, that sounds awful, are you feeling better on the new dose? Maybe a different brand of t3 will suit you better. I really do hope that your health improves soon.

[Imaaan in reply to yesendi]

Been feeling awful and my latest bloodwork shows it. I've asked my doc to increase me back to an old dosage I was on a decade a go and we shall see what that reveals in 6 weeks. Hoping for the best God willingly. Thanks for the well wishes.

[yesendi in reply to Imaaan]

Are you staying away from foods that interfere with t4?

[Imaaan in reply to yesendi]

Yup i was following all the protocols suggested online and here. Take my meds first thing in the morning and wait 1 hour always. I take supplements four and half hours later. Stopped gluten several yrs ago which brought my antibodies lower. They were already low but they dropped even more. Stopped cow dairy for awhile and found out that my tonsils completely shrunk. Reintroduced goat milk and kefir and my tonsils remained shrunk, so I stayed with that.

Been hypothyroid for over 20 yrs or so and learnt a lot a long the way.

I'm trying to get my d3 up to optimal and see if it helps improve things.

[yesendi in reply to Imaaan]

Sounds like you have been struggling with your health for a very long time and that is not fun. Wishing you the best on you quest for better health…we need it.

[Imaaan in reply to yesendi]

Thank you, you as well.

[yesendi]

That’s a good idea! Let’s see what my gp says.Thanks!

[Roadrunnergreg]

Heart palpitations could be due to a number of other nutrient deficiencies and not nessicarily thyroid levels, could be say low Magnesium, Vitamin C, CoQ10, B vitamins, my point is you may be too low in a vitamin/mineral for the heart to handle the extra energy it has to produce. What's your cortisol level like, has it been tested...

[yesendi in reply to Roadrunnergreg]

Thanks Greg, I do think my palps were due to the high t3 level since my dose changed I don’t have them anymore. I eat a very healthy diet and take magnesium and vit d3 supplements on top of that. My B vitamins were tested and I don’t show deficiencies.Thanks