Help with labs-Doctor says looks good, but I feel so tired.

[Shelly55]

I take 50mg Levo and 20mcg Cytomel daily also on Cymbalta for Neuropathy pain.

TSH 0.306

FSH 46.2

T4 FREE 0.73

T4 5.0

T3 FREE 2.8

DHEA 153

CORTISOL 10.7

B12 431

VIT D 85.4

PROLACTIN 11.2

TESTOSTERONE 223

ESTRADIOL 52.5

PROGESTERONE 1.3

[SeasideSusie Remembering]

Shelly55

Please add reference ranges for your result so that we can interpret them, ranges vary from lab to lab so we need the ranges that came with your results.

Please also add units of measurement for Vit D and B12.

[Shelly55 in reply to SeasideSusie]

I take my Levo/T3 @ 10pm 25mg/Levo & T3/5mcg then I split my Cytomel the next day (7.5mcg @ 5am) ( 7.5mcg @ 11am) to help me get through the workday. Trying this for about 3 weeks to see if helps with the fatigue. I was taken 25mg/Levo & T3 10mcg @ 5am then 10mcg @noon.

RESULTS REFERENCE RANGE

TSH- 0.306uIU/mL 0.450-4.500

FSH -46.2 mIU/mL NO RANGES

T4 FREE -0.73 ng/dL 0.82-1.77

T4- 5.0 ug/dL 4.5-12.0

T3 FREE -2.8 pg/mL 2.0-4.4

TPO - <8 IU/mL 0-34

DHEA – 153 ng/dL 31-701

CORTISOL- 10.7 ug/dL 6.2-19.4

B12 -431 pg/mL 232-1245

VIT D- 85.4 ng/mL 30.0-100.00

PROLACTIN -11.2 ng/mL 4.8-23.3

TESTOSTERONE- 223 ng/dL 4-50

ESTRADIOL -52.5 pg/mL 6.0-54.7

PROGESTERONE- 1.3 ng/mL 0.1-0.9

Appreciate any advice, Thanks

🙂

[SlowDragon Administrator]

Was test done early morning, ideally before 9am and last dose levothyroxine 24 hours before test

Day before test, split T3 into 2 or 3 smaller doses spread through the day and last dose approx 8-12 hours before test

What vitamin supplements are you currently taking

How do you feel

No ferritin or folate

Do you have autoimmune thyroid disease also called Hashimoto’s usually diagnosed by high thyroid antibodies

[Titaniumfox in reply to SlowDragon]

OP's results said: TPO - <8 IU/mL 0-34,

so no autoimmunity based on that result, but of course also needs TG antibodies tested to rule it out completely.

[SlowDragon Administrator in reply to Titaniumfox]

Yes…with negative TPO antibodies will need to test both TPO and TG thyroid antibodies together

Significant minority of Hashimoto’s patients only have high TG antibodies

And 20% of Hashimoto’s patients never have high thyroid antibodies

Ultrasound scan of thyroid can confirm diagnosis of autoimmune thyroid disease

[Shelly55]

Test Taken @ 8am no food or meds that morning, but I take my Levo/T3 @ 10pm 25mg/Levo & T3/5mcg then I split my Cytomel the next day (7.5mcg @ 5am) (7.5mcg @ 11am) to help me get through the workday. Trying this for about 3 weeks to see if helps with the fatigue. I was taken 25mg/Levo & T3 10mcg @ 5am then 10mcg @noon. I have not known about ferritin is that a vitamin I should take. I don't know if I have Hashimoto's I don't think my doctor has ever tested she has never said anything to me about it. She will just say my labs look good, so tired of being tired all the time and I sleep well through the night anywhere from 11pm to 5am.all advice and any suggestions are greatly appreciated. Thank you,

[SlowDragon Administrator in reply to Shelly55]

You absolutely must take EXACTLY same dose of T3 everyday

You can’t take 5mcg T3 one day and 2 x 7.5mcg the next day

Ft4 is too low

Suggest you increase your levothyroxine by 25mcg per day

And try 2 x 7.5mcg cytomel everyday

Retest thyroid levels after 6-8 weeks

Last dose levothyroxine 24 hours before test

Last dose T3 approx 8-12 hours before test

Ferritin is storage form of iron

Get full iron panel test done

[Gingernut44 in reply to SlowDragon]

SD, I think OP is basically taking 20mcg Liothyronine per day - her dosing day starts at 10pm to 11 am the next morning and so on. Her FT3 is quite low so if she drops to 2 x 7.5 per day, that will be a reduced dose.

[SlowDragon Administrator in reply to Gingernut44]

Ahh …misunderstood

Thanks for flagging up

[SlowDragon Administrator]

I take my Levo/T3 @ 10pm 25mg/Levo & T3/5mcg then I split my Cytomel the next day (7.5mcg @ 5am) ( 7.5mcg @ 11am) to help me get through the workday.

So stay on 20mcg T3…..

7.5mcg at 5am

7.5mcg at 11am

5mcg at 10pm plus 25mcg levothyroxine

But try increasing levothyroxine to 50mcg

You might consider splitting levothyroxine

25mcg at 5am

25mcg at 10pm

Retest in 6-8 weeks

If you normally take all or some levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test

If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal

[Shelly55 in reply to SlowDragon]

thank you will give this a try.

[Carlosdoug]

Hi Shelly55, with a b12 upper range of 1245 your numbers are woefully low. I would be looking to increase to at least 700 minimum. Fatigue is a symptom of b12 deficiency.

[Shelly55]

Thanks for the advice was very helpful, will try these suggestions.

[Batty1]

Cymbalta does not play well with thyroid meds and it doesn’t matter how long apart you take your thyroid meds from the Cymbalta. I learnt this the hard way.