Blood results in - don’t understand what’s going on with my body! long

[Batty1]

Hello, I always feel less then good and my thyroid test always come back “ok” and this time is not much different… I confess I have only taken the extra 100mg Levo per week my Endo authorized a handful of times (I can’t remember to take it) so I just don’t.

Below is my Aug and Nov test results for this year… little history Im thyroid-less, I currently take (2) biologic drugs for horrible PSA (1) drug I started after my August blood test and the other I don’t inject until after my thyroid test because it causes an extremely low thyroid test as it causes me to feel like Im on speed for a few days after the injections …. Recap the August test had NO biologic drugs taken and the November test I actually was taking the new drug which is a pill 2xs a day (otezla).

Both test were done at same lab same time fasting and no meds… only difference was I did take the new biologic drug (otezla) 3 hours prior to the November test I did not think it would cause issues since it works differently then my injections (Cosentyx) and haven’t experienced my body speeding up after taking it… now I wonder if its screwing with me not just in my labs but also with extremely low pulse during sleep and a variety of other craziness. Can’t really discuss issues with my Doctors since they are just brain dead with these biological drugs. Anyway results below!

August 2021 (No biological drugs)

TSH - 1.660 Range: 0.450 to 4.500

T4,Free - 1.18 Range: 0.82 to 1.77

Triiodothyronine (T3) 109 : Range 71 to 180

November 2021 (Otezla 3 hours prior to test)

TSH - 0.325 (L) Range: 0.450 to 4.500

T4,Free - 1.52 Range: 0.82 to 1.77 ng/dL

Triiodothyronine (T3)- 123 Range: 71 to 180 ng/dL

FT3 test- 3.1 Range: 2.0-4.4

Im still trying to get GP to do iron, vit D and B12 … which is painful pathetic process!

Thanks

[SlowDragon Administrator]

I confess I have only taken the extra 100mg Levo per week my Endo authorized a handful of times (I can’t remember to take it) so I just don’t.

Get a weekly pill dispenser….that way you can’t forget

Never going to make progress until on constant unchanging dose levothyroxine

Don’t retest until 6-8 weeks minimum on constant dose levothyroxine

You have psoriasis?

Are you on absolutely strictly gluten free diet ….if not you need to try it

[Batty1 in reply to SlowDragon]

I have both psoriasis and psoriatic arthritis and not strictly gluten free and yes I did try for few months never felt it made a difference other then to my pocketbook and I really don’t eat very much breads, pasta or cakes anyway and If I do eat pasta it’s gluten free and I have always done this.

I wouldn’t have issues with remembering if I could add it to my schedule everyday rather then twice a week and this past month my mind hasn’t been working good … I have more deer caught in headlight episodes then I care to admit this past month and besides how would not remembering to take the extra 100 Levo per week cause such a low TSH?

[SlowDragon Administrator in reply to Batty1]

Messing about changing dose frequently causes unreliable results

Your TSH isn’t even very low

When adequately treated many people have very low TSH …between 0.1 and 0.01

[Batty1 in reply to SlowDragon]

Below is my FT3 test and yes I realize changing dose isn’t good for me but Im starting to think it’s actually the pharmacist who keeps sending me different manufacturers claiming they are the same pills that’s causing my issues.

FT3 test- 3.1 Range: 2.0-4.4

[SlowDragon Administrator in reply to Batty1]

Ft4 74% through range Ft3 only 46% through range

Suggests you’re a poor converter

Likely to need addition of small dose of T3 prescribed alongside levothyroxine, or NDT

First step is to get all four vitamins optimal

Stick on same dose and same brand levothyroxine

Retest in 8 weeks

ALWAYS Test as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test

[Batty1 in reply to SlowDragon]

SD this is my problem the pharmacist won’t send me the same manufacture no matter what I say to her she says it doesn’t matter. Im going to call my Endo and get some sort of resolution to this constant pharmacist issue.

I have appointment with my GP next week to gravel for vitamin panel its next to impossible to get this done .. aggravating.

[Sparklingsunshine in reply to Batty1]

Hi if you're in the UK you can ask your GP to state which brand of Levo you want. If your pharmacy won't play ball then change. I've frequently changed pharmacies in my time. You could always ask for a paper, rather than electronic prescription, which you can physically take to a pharmacy.

[SlowDragon Administrator in reply to Batty1]

I thought getting specific brand levothyroxine was easier in USA

Synthroid is of course more expensive

peoplespharmacy.com/article...

[Batty1 in reply to SlowDragon]

It depends on where you can get your medication from I have to order my scripts through specific online pharmacy and it seems if they put their hands on it its what they send you. I seem to bounce back and forth between Alvogen and Abbie manufactures both cause issues …

[Mandlou in reply to Batty1]

You sound a bit paranoid about this manufacturer….

Have you ever had your b12 tested? This also causes similar symptoms to thyroid and is normally low when hypothyroid ..

Once taking thyroid regularly if still haveing problems I’d defo get b12 teated causes paranoia, depression , irritable forgetfulness, fatigue, brain fog , nerve damage . Dizzy lots of symptoms x

[Batty1 in reply to Mandlou]

Im not paranoid about anything actually its just a fact I have had issues with both manufacturers and I am working on getting Vitamins and iron tested but Im at the mercy of Gp who sees no value in testing vitamins.

[Mandlou in reply to Batty1]

Sorry I don’t mean it rude .. that’s just a symptom of b12 .. hope you feel better soon x

[cyclingclimber in reply to Batty1]

I understand. I am in the US, and my doctors had to start putting *SYNTHROID* on their prescriptions because I had such poor reactions to whatever generic they gave me.

It is good to always remember that changing brands can cause issues. I had forgotten about it. My doctor here changed my T3 from 20 mcg to 15 mcg. I thought that was fine, because I was taking 20 mcg Montpellier T3 in Argentina, because they are impossible to cut in 4. However, I didn't factor in what going from 20 mcg Montpellier to 15 mcg whatever generic would do to me. I spent a week on the couch with severe depression, after being really fatigued for a week or two (one week into the change). I took the decision - without input from a doctor - to go back on 20 mcg because I was afraid of my state of mind. Now I need to convince her to give me back my 5 mcg when I run out (never allow them to take something away).

I hope you can find a way to convince the doctor AND pharmacy to always give you the same brand of levo. It is good to not run out of pills before getting new ones, so you have time to fight them on this. Check the pills immediately when you get them. I made the mistake once of not looking into the paper bag and going on vacation with some random brand levo....

Ow - and whenever my hair starts falling out again... I normally have a hard time blaming thyroid or D3, because normally both have issues... Get some good D3 supplement before testing even. No reason to wait around for that. I was taking quite a lot in the past year (still out of range after three or four 100,000 IU doses) and it was only a couple of weeks ago that I noticed having to pee a lot. Quit the D3 and definitely was that. So now I take it several times a week (10,000 IU). My point being... look up the side effects of 'too much D3' and you will probably know when you are on the wrong side of the equation (it probably will take a while to get there!... wayyyy after test day).

Good luck!

[cyclingclimber in reply to Batty1]

My endo in Argentina did the same thing; wanted me to take double my dosage on Sundays. It was bizarre and I felt horrible. Not entirely sure why doctors prescribe this.

Ask your doctor if there's a specific reason for the 100 & 100... if not... ask them if you can spread it out over 7 days (e.g., mostly 25 mcg per day) to elevate it in general and keep things consistent.

Cheers!

[greygoose]

August 2021 (No biological drugs)

TSH 1.660 uIU/mL (0.450- 4.500)

T4,Free 1.18 ng/dL (0.82-1.77) 38.43%

Triiodothyronine (T3) 109 ng/dL (71-180)

November 2021 (Otezla 3 hours prior to test)

TSH 0.325 uIU/mL (0.450-4.500) Flag L

T4,Free(Direct) 1.52 ng/dL (0.82-1.77) 73.96%

Triiodothyronine (T3) 123 ng/dL (71-180)

Sorry, your results are so difficult to read, I've redone them for you.

So, not a lot of difference in the two sets.

Your TSH has dropped, although not too low (if there is such a thing as a too-low TSH). But, that is because your FT4 and T3 have risen. However, what you have there is the total T3, which isn't very helpful at all. What we need to see is your FT3.

So, given that your TSH corresponds to your thyroid hormone levels, it's doubtful if taking the Otezla three hours before the blood draw had anything to do with it. Which I think is your question, isn't it?

[Batty1 in reply to greygoose]

My results are the way the lab does them(lol) anyway, yes I wondered if the otezla has done something to my labs….. OH MY GOSH….. I just remembered the pills I had been taking during the August test were actually a different manufacturer and I was experiencing issues and the past 3 months Ive been taking another different manufacturers levo .

August test I was taking (Alvogen)

Novembers test I was taking (Abbie)

Cytomel manufacturing is the same

My pharmacy keeps sending me different manufactures and claims it makes no difference!

Could this explain my labs/issues super low pulse and other crazy stuff? If so what would you recommend to fix this because Im really suffering right now with annoying issues worse the before.

[greygoose in reply to Batty1]

Yes, I understand that's the way the lab lays them out. But, that layout doesn't translate very well onto a post on this forum. One has to look hard to find the actual results, whereas, laid out as I have done, one can see the essentials in a glance.

It could be that you have absorbed the Abbie better than the Alvogen. Your pharmacy is wrong to claim the brand makes no difference! And, frankly, any pharmacist worth his salt should understand that. The active ingredient is always the same, of course, it's the thyroid hormone T4 - levothyroxine. But, different brands have different fillers/excipients, and we're all individuals in the way we react to those inactive ingredients. So, it could well be that one of the fillers/excipients in the Abbie brand, obstructed absorption in YOUR gut - never mind what it does to anyone else, they should be concentrating on what it does to you as an individual. So, if you have a better outcome on Alvogen, it is their duty to make sure you always get that brand. Otherwise, change pharmacies - their lose, as it shouldn't be yours!

[Batty1 in reply to greygoose]

What is bazaar is both cause me issues I felt pretty hypo on alvogen and Abbie is causing me even worse issues particularly the extremely low pulse and extreme fatigue and breathlessness. Im not sure if these issues are the thyroid meds or another issue thats is just occurring along side these meds 🤷‍♀️

[greygoose in reply to Batty1]

Or, it could be that you're not converting T4 to T3 very well - which has nothing to do with the brand of levo. But, without getting your FT3 tested, we just can't know.

[Batty1 in reply to greygoose]

FT3 test- 3.1 Range: 2.0-4.4 - current result

[greygoose in reply to Batty1]

That's a little low. Could be you need it higher.

[Batty1 in reply to greygoose]

Im gonna talk to endo and see

[helvella in reply to Batty1]

The make is far more likely to be AbbVie than Abbie.

[Batty1 in reply to helvella]

Correct

[cyclingclimber in reply to Batty1]

I am confused... you are only mentioning Cytomel here. Right? If you are taking Cytomel alongside your levo meds you most likely expect a lower TSH and higher TT3.

Are you taking Cytomel?

[Batty1 in reply to cyclingclimber]

No, I take both Levo and Cytomel

[Radio2]

Hi Batty1,Sorry to hear that you’re having issues with your meds.

I also found that different manufacturers caused me problems when trialling Levothyroxine. I found that the ones with acacia in them as a packing, made me feel awful. Again same old problem with the pharmacist saying that all of these medications are the same! I changed pharmacies and I now have one that gets me my meds without any acacia in as packing.

Hope this helps and you can resolve any issues that you are having.

Good luck.

[Batty1 in reply to Radio2]

I take only white pills for my meds suppose to have minimal additives and your right the acacia filler is awful gave me severe hives.

[helvella in reply to Batty1]

But if you are taking AbbVie Synthroid levothyroxine, the ingredients are:

Each SYNTHROID tablet contains the inactive ingredients acacia, confectioner's sugar

(contains corn starch), lactose monohydrate, magnesium stearate, povidone, and talc.

rxabbvie.com/pdf/synthroid.pdf

You are right that the 50 microgram dosages are most often without dyes and colours - but all the other ingredients are the same.

[Batty1 in reply to helvella]

Hi Helvella, I can’t locate where is has Acacia in the AbbVie 50mcg pill because if this is the case this definitely explains my hives I keep breaking out in which Im pretty shocked it has Acacia in the 50mcg pills which is the whole reason I switched to these 50mcg 2 years ago and the pharmacist said it was free of dyes particularly this Acacia.

[helvella in reply to Batty1]

Have a look at this link from the FDA:

Active Ingredient/Active Moiety

Ingredient Name Basis of Strength Strength

LEVOTHYROXINE SODIUM (UNII: 9J765S329G) (LEVOTHYROXINE - UNII:Q51BO43MG4) LEVOTHYROXINE SODIUM ANHYDROUS 50 ug

Inactive Ingredients

Ingredient Name Strength

ACACIA (UNII: 5C5403N26O)

LACTOSE MONOHYDRATE (UNII: EWQ57Q8I5X)

MAGNESIUM STEARATE (UNII: 70097M6I30)

TALC (UNII: 7SEV7J4R1U)

SUCROSE (UNII: C151H8M554)

POVIDONE, UNSPECIFIED (UNII: FZ989GH94E)

dailymed.nlm.nih.gov/dailym...

Never, ever trust a pharmacist without verifying independently. If they are good, they'll agree you should always check for yourself.

[Batty1 in reply to helvella]

Hi, I finally found it and Im shocked I told this pharmacist and every darn Endo Ive had I can not have pills that have this Acaia in them it causes hives and Ive actually had hive attack little over a month ago that has left what appears to be permanent bruising … this is insane and I wasn’t aware this was Synthyroid I was told repeatedly they can’t dispense Synthyroid even with Endos DNS on script and my paperwork doesn’t say Synthyroid. Now I have to check this other maker Alvogen never had hives with this I just felt under medicated.

[Batty1 in reply to helvella]

Helvella, I can’t locate the ingredients of Alvogen 50mcg . Can you help me?

[helvella in reply to Batty1]

Hope this helps:

LEVOTHYROXINE SODIUM

levothyroxine sodium tablet

Product Information

Product Type HUMAN PRESCRIPTION DRUG Item Code (Source) NDC:47781-643

Route of Administration ORAL

Active Ingredient/Active Moiety

Ingredient Name Basis of Strength Strength

LEVOTHYROXINE SODIUM (UNII: 9J765S329G) (LEVOTHYROXINE - UNII:Q51BO43MG4) LEVOTHYROXINE SODIUM ANHYDROUS 50 ug

Inactive Ingredients

Ingredient Name Strength

MICROCRYSTALLINE CELLULOSE (UNII: OP1R32D61U)

DIBASIC CALCIUM PHOSPHATE DIHYDRATE (UNII: O7TSZ97GEP)

POVIDONE, UNSPECIFIED (UNII: FZ989GH94E)

SODIUM STARCH GLYCOLATE TYPE A POTATO (UNII: 5856J3G2A2)

MAGNESIUM STEARATE (UNII: 70097M6I30)

BUTYLATED HYDROXYTOLUENE (UNII: 1P9D0Z171K)

Product Characteristics

Color WHITE Score 2 pieces

Shape CAPSULE Size 10mm

Flavor Imprint Code 50;T;4

dailymed.nlm.nih.gov/dailym...

[Batty1 in reply to helvella]

Thank you so much … Well this one doesn’t appear to have Acaia in it but certainly make me feel sluggish and the current pill Ive been taking (Abbvie) has Acaia in it and make me feel over medicated and definitely explains the hives…. I don’t even know what to do because both cause issues. What would you suggest?

[helvella in reply to Batty1]

Maybe a tiny incremental increase (12.5 or possibly 25 micrograms) of the Alvogen product?

[Batty1 in reply to helvella]

I will bounce this off my Endo but definitely sounds like a good idea.

[KrazyKatMT70 in reply to helvella]

Acacia is also in some Body Powder ! I woke up with a rash everywhere I put it ! Watch out for vitamins also. It has a longer shelf life for thyroid medication, but if you are on a generic, they don’t use Acacia because it’s too expensive.

[Batty1 in reply to KrazyKatMT70]

Thank goodness I don’t use body powder and definitely check all my ingredients before buying.