Have you been diagnosed as hypo?

No diagnosis as hypo. I've been pretty normal and in range. I have Graves.

Free T4 1.4 (range 0.8-1.8) Sweet, this may be close to right, and nice for 12 weeks post TT.

TSH 7.38 What were your last lab results ? TSH has a 6 week lag time for recovery, so if those last labs were hypo FT4 and FT3, this would be the normal response time.

Free T3 2.5 (range 2.3-4.2) Poor, poor little FT3. This could be caused by a recently past low FT4 needing to be built up first or it may be something it turns out you will need to address separately.

FT3 is converted from FT4. A tiny bit is produced by the gland itself, but most is done in peripheral tissues, mainly in the liver. The body can produce adequate FT3 without a gland.

Poor conversion has many causes, but is most common in post RAI patients beginning in the second or third year of hypo, exact cause of this unknown, but needs to be corrected with T3 medication.

To get the blood flowing and conversion taking place, the patient is wise to never skip breakfast, as that is what jump starts our metabolism each day. The built in problem of not skipping breakfast due to timing of thyroid medication needing to be taken on an empty stomach, two hours after eating and waiting at least one hour after meals, with no calcium or iron until 4 hours after the pill, is likely the reason the idea of meds before bed, rather than in the AM comes up every few years. There was another study on this recently. A Google search should yields numerous results. What works best is going to vary mostly by the individual patients habits and what works out to be the most foolproof way to never forget.

Back to that blood flow.. unfortunately this means exercise. Most difficult for a patient that has been left too hypo, for too long, with the resulting muscle loss, heart palpitations, mental fog, depression,, apathy, and just generally feeling ill all the time.

Adequate selenium is also required for the conversion process. A medium sized Brazil nut a day is a yummy option. Here is a search result over on Elaines forum for selenium.
http://www.elaine-moore.com/SearchResults/tabid/37/Default.aspx?Search=selenium

I wonder what your FT3 history is..you say ---my Free T3 finally caught up.--- that may point you in a clearer direction. While it may turn out you will need a lifetime T3 prescription, I think it's worth exploring all the options at this point. Most I know find they need to take their T3 tablets twice a day and obtaining it reliably over the years means there will be doctor searches needed once in awhile, since many don't "believe in it". sob.... Nice if it could possibly be avoided.

So sorry to hear you had such emotional upheaval, Those sorts of hings can really knock the stuffing out of us, and take some time to recover from. (((hugs))

Pam

It seems high, but without a functioning thyroid should it be high or low? I had RAI but I try to keep my TSH low 0.154 last time. I do feel better on the Synthroid 88mcg.

I know they don't dose on the TSH, but yours seems high. How do your eyes feel? I keep my TSH low because my eyes feel better, no lid lag when the TSH is low.

Hmmm... possibly my TSH is lagging behind as this is the first time that it has actually been as high as it is... way high. However, my Free T4 was below range and I was considered hypo coming out of surgery and my Free T3 wasn't even close to within range (it was way low) so that's why I say it finally caught up. I eat brazil nuts every couple days for the selenium. Maybe that's why it caught up? I'll lab again at the 4 week mark and see where my numbers are. My internal med doc is open to prescribling T3 (cytomel) if I request it but wanted to see how my FT3 does first... he thought it might catch up.

My eyes feel fine other than dry. No additional bulging.... my diet hasn't been the greatest lately.

It took some searching but I found you.
When we last spoke about conversion of FT4 into FT3, I remembered here I had a note saved in my files. so here are the parts I had forgotten.

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However, few people truly have a conversion problem, and many other things can cause the FT3 to be low. These include dietary deficiencies of selenium and zinc, low carbohydrate diets (fewer than 125g of carbs per day will lower the FT3 level), low protein diets, low calorie diets, illness, surgery, cold temperature exposure, sedentary lifestyle, exercise in an out-of-shape person, chronic stress, etc. Before concluding that you have a conversion problem, you have to rule out other causes. Also, certain prescription drugs will alter thyroid function or interfere with thyroid test values

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Sorry I failed to note the source

As Pam mentioned....Selenium helps with T4 converting to T3. I can't stress enough how important Selenium is to those of us who have this disease. I did tons of research into this. If your not supplementing with Selenium I would encourage you to start. Since our soil has been depleted of this important mineral all over North America.. it has become a North American problem. I supplement my diet with 200mcg everyday. I believe this is one of the things that has helped me to achieve remission and stay there. Big Hugs...Kathy

Hi Scorpio!
It looks like you are hypo to me, and even if your FT4 and FT3 are "in range" they may not be in range for your body. I would personally feel bad with an FT4 that low, and feel best when my FT4 scrapes the roof of the range (if the high end was 1.8, I'd be feeling well right around there.) You may need a little dose increase. I wouldn't go extreme, but bumping the t4 replacement up a notch may help.
Hugs!!
Hannah