Hon,

Sorry to tell you this but, your doctor ran a standard thyroid profile which is basically useless.

Based upon your "Free Thyroxine" result, I suspect that's actually a Free Thyroxine Index.

Before the invention of FreeT4 and FreeT3 testing, doctors used the Free Thyroxine Index result along with the T3 uptake and thyroxine results in attempts at guesstimating the patient's FreeT4 level.

There's no need to do this now that we have better testing.

The only somewhat useful test you had done was the TSH which is waaayyy too high for someone taking thyroid hormone replacement.

If I remember correctly, you're taking T4 and T3.

Well, people who are optimally medicated with T4 will have TSH less than one. Throw T3 in the mix and an optimally medicated person will often have suppressed (below-range) TSH.....as in .02 or lower.

You need a dose increase but, without the proper labs, it's hard to say whether you need a T4 increase or a T3 increase..

Your labs explain your issues - sorry.

Thanks!!!! You are confirming exactly what I suspected. Now the doctor is telling me to "stay the course..." I think one month of increasing symptoms is enough time to figure out that this isn't working.
I am going to tell her I want to come back for another blood test. The TSH actually DID go down from the prior month, from 3.84...

Hope this doesn't turn into a battle.

I don't have very much energy to fight with right now....

Thanks, cd, as always!!!

Spoke with the nurse and will go back again tomorrow to test free T4 and free T3.... Enough of this nonsense!!!

Good for you!

uh on. Doctor is resisting and wants to send me to a rheumatologist. Silly. I am trying not to be obnoxious, but I am insisting that the free T4 and free T3 tests be done.

:(

At least half of this battle is finding a good Doc. The other half is spent trying to manipulate the one you got. LOL

One doc told me I needed RAI ( this is when my antibodies were negative and I was already hypo)

Another told me cytomel is for whiners

I'm sorry about your doc, I know how it is.

As cd said, your labs are not complete and you need to have your Free T3 FreeT4 tested.

With the resistance of your "doctor" and his misdiagnosis, its best to find another practitioner who understands thyroid and adrenals, both values are vitally important. Its rarely mentioned on this forum, but your adrenal values should be tested through the saliva test before you even think of treating your thyroid.

Thanks Gage!!!! I haven't had the spit test, but if my adrenals were to be wacky, is there any alternative to animal-based medications? I am vegetarian and have religious concerns too.

Thanks again!

Right on, Gage!!

Hi Jeep! I was venting this morning in another thread and was wondering why more doctors don't educate themselves on this VERY COMMON condition... After all, we have to titrate so incredibly often, you would think they would understand that each time we have an office visit, the doctor sees us for 5 minutes and then charges a huge amount of money for the time....

If they can't have compassion and curiosity, they can surely have GREED to motivate them....

Shaking my head...

Getting free T4 and free T3 tests done today along with iron.

Probably won't do the spit test thingy for adrenals unless there is some sort of vegetarian remedy....

Hope everyone is having a great day!!

there's a "vegetarian" remedy for adrenal disorders - prednisone and hydrocortisone are synthetic drugs for the most part.

Thanks MB!!!!

So - here are the results for the missing tests:

Free T3: 3.0 (2.3-4.2)
Free T4: 1.08 (.80-1.76)

Yes - it is the hypo nightmare! I am supposedly "normal" but I feel like crap.

Will see what the doctor says, but I think I will need a new doctor.

Meanwhile, I am going to try to cut down even more on sugar and try to get more sleep.

I drank some green tea at breakfast yesterday and was buzzing around with more energy during the day, but I paid a big price because I didn't sleep.

The green tea energy felt "artificial" somehow. Has anyone ever experienced that feeling?

Would love any insights into what to do next....

I'm sure you recognize that both your FreeT3 and FreeT4 levels need improvement.

I think you should write/type up a list of all the classic hypo symptoms you're currently dealing with and share a copy with the doctor.

Then, you can politely point out to him/her that both your FreeT3 and FreeT4 levels have plenty of "room" to increase and still fall within the normal range.

That said, it's reasonable to ask for a dose increase to help with the symptoms that are plaguing you.

Since your FreeT4 level needs more help right now than your FreeT3 level, you might ask for a 12.5mcg T4 dose increase....with the possibility of adding another 12.5mcg if still doing well after 2 wks.

You're best off not leaving the office without *some* type of dose increase.

Yes, "artificial" energy (ala caffeine, etc.) does not feel anywhere near as good as the real stuff :)

Sigh. Doctor will NOT increase my synth because she says I will get osteoporosis.... She wants me to see a rheumatologist..... Oy.
That being said, I suddenly from OUT OF THE BLUE started to feel a bit better!!!!! Had a one-hour massage from my therapist last Saturday & I think that made all the difference.
YAY!

Sorry to say but, your doctor is clueless (sigh).

I hope you're able to find a new one - it's your only chance at wellness.

If you need some doctor-find resources, just let me know....there are some in the Thyroid Resources section of Groups.....click on "Groups" located at the top right hand corner of your screen and then scroll down to Thyroid Resources and click (I'm not sure if you have to join the group to read....)


VERY happy to hear you're feeling much better! A little pampering can go a long way. Hope it lasts!!!