Fran I myself would need the ft4 higher in the range.

Hi,
Thank you for answering me. Do you think this is what is contributing to all the problems that I am having and since I just upped the dose how long would it be till I expect some improvement?
Thanks,
Fran

Your ft4 is about middle range. Some people feel good with higher ft4 and others lower. It's matter of finding your sweetspot. have you had full Iron panel, adrenals, b12 and vitamin d tested? if these are not optimal you can still feel bad.

Your FT4 is middle range, that is too low for most people, you want to be in the upper ranges, lets say 75% or more given how you feel, by symptoms. Healthy people without hypothyroid disease have levels in the far upper ranges FYI, so I think an increase for you is in order. You are far from being hyper, dont worry about that! Far more likely that you are still hypo and your increases have not yet kicked in. You are still quite under dosed with the Levo. Both hypo and hyper have very similar if not sometimes exact symptoms. Only labs will tell you which applies to you, which you have done.

As mentioned, have you had your adrenals checked via saliva test?
Iron levels?

Hi
Yes I have had all of that checked many times but what is considered optimal because I don't think even my doc knows. Also how long would it take to notice improvement with the dosage change. Do you start to see some improvement if its the right one?
Thanks again,
Fran

Hi Fran,
Glad you found us. Sounds like you at least found a thyroid savvy doctor - so that's a celebration right there YAY!

I did want to share some info with you - optimal is about finding your "sweet spot" as bm55 pointed out so aptly.

Sometimes, hyper symptoms are actually HYPO symtpoms. And, for someone who had grave's to begin with, I'm sure that's frightening.

Here's a list: http://hypothyroidmom.com/300-hypothyroidism-symptoms-yes-really/

How do you tell? Well, keeping track of your labs is a wise thing to do :)

Now, to take a look at your labs: (To clarify - these ARE after adding levo to the mix, right? If so, how long after?)

Free T4
Range: 0.820 -1.770
Result: 1.280
Percent of range: 48.42%

Free T3
Range: 2.000 -4.400
Result: 4.300
Percent of Range: 95.83%

As you stated, your Free T3 is at the top of the range, but your Free T4 is lagging at 48% of the range. Most people feel well at 75% of the range or above.

Based on those labs - adding levo was the right thing to do.

I'm not sure WHEN you had your labs or how long you were on your meds, and that makes a difference in what I'm about to tell you.

It takes T4 about four to six weeks to get into your system. It takes T3 just a few hours to enter and exit your system. They work very differently. So, if your labs were AFTER you started the last levo increase - then keep in mind the Free T4 lab levels probably won't increase until four to six weeks after the start date.


My advice is this: Don't make too many changes at once. Slow and steady wins the race. I know the palps are scary, but until your thyroid levels are optimized, you'll probably keep having them (as is often the case).

The best way to reach optimal is this way:
Add a med (or take one away)
Wait 4-6 weeks and have labs
Based on those labs (and how you feel) adjust ONE med (NOT TWO)
Rinse, repeat until you're at optimal (no symptoms)

I hope that makes sense. If you have questions - just post 'em below. I'll be in and out the next few days.

PS YES it will get better at optimal :)

MB explained things in her usual great way.

As a fellow Graves' patient who also went hypo, I can tell you that my research (and personal experience) shows that many Graves' patients need their FT4 level near the high end of the range, if not slightly over-range.

Even though I'd feel great with your FT3 level, I'd still be dealing with a LOT of symptoms if I had your FT4 level.

Both levels need to be optimal if we are to be free from symptoms.

It does take some tweaking (in the orderly and logical manner MB described) but please keep the faith that you'll achieve freedom from thyroid symptoms once you're able to maintain optimal levels.

Please know that we won't necessarily "feel" those optimal levels once they "hit". Instead, symptoms will slowly dissipate in the weeks afterwards.

That's why I always recommended "wearing" the "most commonly comfortable" levels (upper range FT4 AND FT3) for awhile.

Basically, if the latest-greatest dose combination is "the one", you might start feeling improvements within 3 weeks or so.....and those improvements will continue.....manifest in labs....and then those final symptoms will dissipate in the weeks following the labs.

If you feel improvements and then backslide, that's a sign you need a dose adjustment.

Unfortunately, there's no rushing the process. It takes,on average, 6-12 months (or slightly longer) to optimize levels...and that's if dose adjustments have been appropriate all along.

You're more than halfway there since it's clear you have a cooperative doctor....now your body needs to cooperate :)

Best of luck to you!

Hi,
Thanks for all the good advice. Its hard to keep the hope sometimes since I have been going down this road for years now with every no talent endo. Luckily my internal doc is helping me now. My latest labs were better FT4 came up to 1.38 but I had taken all my meds in the morning. Are you supposed to not take the lexoxyl if you are getting blood done. How much does it really alter the result? Because if that is the case then my FT4 could potentially be lower. I have always taken my med like normal but I usually take the armour 6 to 8 hours before the blood draw. I really feel as though I will never be palp free so I'm hoping one day as my levels increase.
Thanks,
Fran

As a rule, I generally schedule my blood draw first thing in the morning and I don't take any medication until after the blood draw.

I had really severe palps on 70mgs of Armour, they started when I was on Synthroid. I was referred to a cardiologist, did an echo, and it was discovered I have borderline MVP (mitral valve prolapse) Now I am in the confusing position of not knowing whether my palps are due to MPV or too much medication. My tsh is 0.35, my ft3 low end, ft4 even lower. With the palps I am afraid to take more medication..I also have hair loss and anxiety. I started having palps, just last year, I have been taking T meds for 5 yrs now. It's such a slippery slope..in all truth I felt better before taking meds, with tsh of 16!! I have severe Hashimoto's..with only one half thyroid remaining.

People dealing with palps might want to have their magnesium levels checked....RBC magnesium not serum.

Magnesium is involved in over 300 body processes and is obviously a vital mineral.

It's estimated that at least 70% of Americans are deficient in magnesium and the symptoms caused by this deficiency seem to be endless.

According to Dr. Carolyn Dean, author of "The Magnesium Miracle", a healthy RBC magnesium level is higher than 6.

The high end of the older RBC magnesium lab ranges used to be 8.

Now that there are so many magnesium-deficient people and their blood is being used to establish lab ranges, the high end of many labs' ranges is 6 - 6.5.

I have PAC's (premature atrial contractions). I noticed them most in the evening when relaxing.

I can't say I remember feeling any after making magnesium part of my daily supplement regimen.

Oh, for whatever it's worth, palps are more common in hyPOthyroidism.

Elevated heart rate is more common in hyPERthyroidism.