I did the calculation
TSH 0.14 mIU/L (0.45 - 4.5) -7.7%
Free T4 (fT4) 0.9 pmol/L (0.8 - 1.8) 10.0%
Free T3 (fT3) 2.79 pmol/L (2.0 - 4.4) 32.9%
T4:T3 Ratio 0.323
Thyroglobulin Antbodies (TgAb) 2 IU/mL (≤ 1)
Thyroid Peroxidase Antibodies (TPO) 19 IU/mL (≤ 34)
can someone help me make sense of it?
From previous post
My cytomel was recently increased to 5 mcg 1/2 tablet 3 times day and Synthroid 75 changed to unithroid 50. It has been 10 days and I am still not feeling well. I just feel unwell and feel the ups and downs of cytomel. Many changes recently due to feeling unwell . Anxiety, depression , crying spells , insomnia, fluctuating blood pressure and symptoms
Taking any T3 (cytomel) will significantly lower or suppress TSH
It’s essential to test correctly re timings of last dose levothyroxine and T3
Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)
On T3 - day before test split T3 as 2 or 3 smaller doses spread through the day with last dose 8-12 hours before test
Only test 6-8 weeks after any dose change or brand change in Levo or T3
Many, many members find they feel best when Ft4 and Ft3 are at least 70% through range. Often TSH will be completely suppressed…..0.01
Are these results from when on 75mcg synthroid?
No , these results are from unithroid 50 and cytomel 5 mcg 1/2 tab 3 times a day. The blood work was done 2 weeks after this change .
Tested too soon
But it’s obvious you need increase in Levo back to 75mcg
Then retest 6-8 weeks later
Likely to need further increase in Levo or T3 after that
3 x 2.5mcg T3 is a very very tiny dose
I am feeling worse again. My gyn said to decrease cytomel back to 1/2 twice a day. I only did that on Thursday and felt worse. Yesterday back to three times a day and still feeling worse . Unwell feeling, fatigue, shaky after waking , anxiety, hot a night and crying . Symptoms are mimicking when I was taken off thyroid meds.
What change would you recommend I ask my provider for ? I’m in despair. 🥺
You have to be patient and wait 6-8 weeks after any change in dose or brand before retesting
Meanwhile you can test vitamin levels
Getting these at GOOD levels should significantly improve symptoms
Hi Martee 🤗
Woah! Well, I would say your low TSH is not reflecting your low thyroid levels. In this instance TSH should not be considered reliable. Frequently (more than doctors understand) a TSH simply cannot be relied upon....
I have to ask you how are you feeling? So often people ask for an opinion on results as if how they are feeling have no part to play. Actually how you are feeling is the most important part of the puzzle. The fact many doctors have scant regard for symptoms is a deficit in their training it doesn't mean the symptoms are not important.
Can you tell us how you are? I'm guessing pretty lousy but it would be could if you could tell us.
Just seen you previous post - I think you are being seriously under medicated. I'm sure others will be along shortly.
And for a new member absolutely brilliant you have put your results and ranges in.
I have noticed a very small improvement in overall symptoms. Crying, anxiety , feeling unwell , insomnia all have shown a small improvement, still far from feeling well.
Not wishing to be personal (but then we are all anon here anyway) how much do you weigh? I'm still batting around the 15 stone mark and yep need to work on that, but I am actually well now and a stone lighter than when I was really hypo. On just levo, I got well at a dose of 150ug. The guideline was 1.6ug per Kg or 10 ug per stone.
So dosing is to some extent weight dependent (not rigid ratios you understand). So you are now on what would be considered a starter dose for levo having been dropped 25ug. 😱 If this doctor has been managing you from the start I would question whether they had ever got you onto a therapeutic dose of levo.
Your doctor appears to be unaware when someone is on liothyronine AND levo the TSH will drop and can no longer be used to manage dosing. As SlowDragon has said - under medicated.
my weight is 123 lbs
I have seen several doctors . All say something completely different.
In 2017 I was stable on 88 mcg of Synthroid for about 3 years. The fatigue became unbearable then cytomel 5 mcg was added. 3 months later I had irregular and increased heart rate. Doctors then stopped cytomel and I h e never felt well since. I’m the last 3-4 years I have been taken off and on different thyroid medications. Needless to say my body is so out of wack from all of it. I am also on hormone replacement therapy for surgical menopause since 2012. N estradiol patch 0.1 mg twice a week and testosterone compound 2.5mg daily. Estradiol levels are 160-45 depending on the day it is checked and testosterone level is 31 free testosterone 1.1
So 88mcg would have been about right if sticking strictly to the dosing guidelines. But if you were on HRT then you could have been slightly undermedicated. Symptoms can be so slow to develop and insidious so we can miss the onset in amongst the 'noise' of our everyday lives. Getting onto levo even, if not on a therapeutic dose can bring such an improvement that one can see this as an indication of correct dosing.
I would liken it to a reservoir constantly being topped up, but being drawn down upon a bit more. So the reservoir waterline dropping is imperceptible at first and then a while later it becomes obvious.
I felt much better on 125ug of levo, but pushed for the higher 150ug with a view I could always drop back a bit if I overshot (also still had constipation MY gold standard of assessment😂(NOT TSH) . I'm an ignoramus on sex hormones, but if I am hoping to give it a try that is something I too will have to get under my belt (so to speak).
That is extremely low oestrogen level and means you are not absorbing your patch properly. Also, 1mg is a tiny dose. The oestrogen level is so low I'm not surprised you are exhibiting so many symptoms of menopause. Anxiety, depression, crying spells, insomnia - classic menopausal symptoms. Are you in America?
Your thyroid blood results are very low, but you won't feel well with HRT levels like this. You would do better on Utrogestan for progesterone. It's the only body identical progesterone we have and you need to try a different method of applying the oestrogen. A gel, or a spray. Or even a different type of patch might do better. You will likely need a higher dose of whatever it is and you should vary the application site as much as you can. I have found the hard way that I do better on a capsule that contains both oestrogen and Utrogestan progesterone called Bijuve. But it's only 1mg oestrogen and that's not enough for me so I add 2-3 sprays of Lenzetto a day. That's an oestrogen spray. All these products are body identical. No need for expensive compounding pharmacies.
You want your oestrogen level to be over 250 at the minimum. I need mine closer to a 1000, last reading in August was 756. I also take testosterone, you don't say if you do that too. Absorption can be a big issue with HRT. Your doctor isn't taking that into account I don't think. No wonder you are exhausted.
Below are the ranges they go by in the US.
And yes I am on testosterone compound. 2.5 mg daily
ESTRADIOL 169.0 SEE BELOW PG/ML
****** EXPECTED VALUES FOR ESTRADIOL FOR FEMALES >=18 YEARS ******
FOLLICULAR . . . . . . . . . . . . . PG/ML 12.4-233.0
OVULATION. . . . . . . . . . . . . . PG/ML 41.0-398.0
LUTEAL PHASE . . . . . . . . . . . . PG/ML 22.3-341.0
POSTMENOPAUSAL SUPPLEMENTED/NON-SUPP . PG/ML <138.0/<20.0
Ah that's interesting
I'm thinking of asking for HRT myself having gone through the menopause. Have you heard of Dr Louise Newson (my personal opinion brill) she also has a pod cast. She deals with Hormones and women's health.
balance-menopause.com/menop....
I have popped this link on for you - she also has an App but I have yet to investigate that. Still 'Podcasting'.
Anecdotal on here would seem to concur (from what I have read) that the thyroid meds need to be adjusted up a bit to compensate.
Louise is doing great things for women. I was lucky enough to consult with her directly in the days when she was still a part time GP with part time menopause consultant work on the side. I attend the clinic in Stratford now. But sadly in the past year my reviews are with another doctor because Louise is so busy being interviewed and banging the drum for HRT training and prescribing etc. I only need an annual review from the clinic now anyway. But I still miss seeing her. She's very nice.
You lucky thing! I'm definitely going to look into it. Thank you for telling me 🤗
Yes, I follow her on social media and have listened to her podcast . Brilliant .
Lab results
Lab results in from Blue Horizon, could somebody help me interpret them? I don't really understand.
Am I right in thinking I’m slightly hypothyroid? (Updated post)
Help Deciphering Blood Labs
