I am so sorry. Have you had an iron panel bloodtests, adrenals, b12 and vitamin D?

If these are low, it will make you feel bad also. With low iron or adrenal fatigue they thyroid hormones will not go into the cells properly.

Just a thought. When do you get labs again?

I know they did iron, not sure about the rest this time but I have had htem all checked in the past. I go back again in 6 weeks.

Sorry to hear of your issues!

bm55 offered up some great suggestions!

And, for whatever it's worth, there were many times during the titration process that I didn't feel better after a dose increase.

The only times I started to feel better were when the latest-greatest dose increase brought my levels to the lower end of my optimal range of levels....within the normal range.

Complete symptom elimination didn't happen until *after* my levels were optimized.

I think whether or not we feel better after a dose adjustment really depends on just how far from optimal our levels were before the dose increase.

A very high TSH is far from the suppressed TSH (.02 or lower) that a person optimally medicated on Armour will have.

What's more important than TSH is our actual thyroid hormone levels - what does "close to being normal" translate into?

Looking at your actual FT4/FT3 results will tell us just how far from "normal" you are.....would you like to share them? (please remember to post the reference ranges)

Here are my latest labs, which I had done on June 7th.

TSH 30.38 Normal Range 0.4-4.5
Free T4 0.7 Normal Range 0.8-1.50
Free T3 2.6 Normal Range 2.3-4.2
Cortisol 12.0 Normal Range 4.0-22.0
ACTH 21 Normal Range 8-50
Glucose 86 Normal Range 65-99
Insulin 8 Normal Range

Your labs explain EVERYthing - yikes! (sorry)

Your FreeT4 level is below-range and your FreeT3 level is very close to the bottom end of the range.

Yes, I guess you could consider those levels "close to being normal" as in close to being in the normal range. However, I'm sorry to tell you that the normal ranges for FreeT4 and FreeT3 tests are skewed low due to the large number of undiagnosed hypothyroid people out there.

Thyroid textbooks indicate that healthy people have FreeT4 levels near the high end of the range and FreeT3 levels above mid-range. For people taking thyroid meds, having both levels near the high ends of the ranges suit most people best.

I think you can now understand why you haven't experienced any improvements.

Just as we can't be "close to being pregnant", we can't be close to being optimized - we either are optimized or we're not.

In the meantime, we'll have symptoms.

The further we are from optimal, the more symptoms we'll have at a greater intensity and for a longer duration.

I found that I didn't start to experience any improvements until both my FreeT4 and FreeT3 levels were above mid-range.....and I still had a bunch of symptoms.

As I mentioned already, the only time I experienced only improvements was when my latest-greatest dose increase wound up optimizing my levels......and I still had minor symptoms when this happened.

It wasn't until a few weeks *after* my levels were optimized that those final symptoms dissipated.

I'm not sure if I shared the below-linked thread with you but, you might find it to be useful:

http://www.dailystrength.org/c/Hypothyroidism/forum/14455047-journal-success

What about the TSH being so far off? Is that explaining the anxiety, the body aches, the fatigue, the weight gain, the foggy head, the hotflashes....I could go on and on about how "off" I feel. Add dizziness to that list too.

Actually we mainly focus on Ft4 and Ft3 because sometimes the TSH is normal in some people but they have low Ft4 and Ft3.

About your iron labs you need serum iron, TIBC, iron saturation and ferritin. Just testing ferritin or just iron is not enough. I am dealing with low iron right now.

The adrenals should be tested by saliva, since it is more reliable then blood. Your cortisol test does how low and indicates you may need some kind of adrenal support.

Some doctors do not know all this.

You can learn much more on this site. www.stopthethyroidmadness.com

My cortisol numbers are right in the middle. Why would this be considered low? My doctor is the endo. everyone in my area says is the best, but I am really starting to question it now.

We don't "feel" TSH......we feel our actual thyroid hormone levels - FreeT4 and FreeT3.

The only thing your TSH tells us is that your FreeT4 and FreeT3 levels are too low for your body's needs.

I've seen levels like yours when people had TSH near 1.

That's why thyroid-savvy doctors do not look at pituitary hormone TSH to judge thyroid status but instead at the actual thyroid hormone levels - FreeT4 and FreeT3.

I had over 30 symptoms when I was my worst-ever hypo.....and my FreeT4 and FreeT3 levels were much "better" (higher in the range) than yours.

Due to my antibodies, my TSH was .007 at the time and most doctors would have called me hyper. Thankfully, my doctor knows otherwise.

I forgot to share this earlier - a link to an article written by a doctor who knows how to treat hypothyroidism:

http://www.mercola.com/article/hypothyroid/diagnosis_comp.htm

Me again

I was a bit busy yesterday and didn't do what I usually do when I'm having trouble remembering someone's story. And, I'm sorry to say, I wasn't remembering yours.

Yes, I can comment on labs and explain why certain things happen but, knowing what a person had been going though beforehand can often shed helpful light.

So, this morning, I looked at some old threads of yours to see if I might learn something that could be helpful to you....and I think I found something.

I was horrified to read that you've been dealing with hypothyroidism for 20 or so years....and also that you've been taken off meds and put back on them several times. Hypothyroidism is most often permanent so, I began to wonder if your doctors were only looking at your TSH and, once it got back into the normal range, they erroneously considered you "cured". That just doesn't happen.

It's like diabetics taking insulin. Doctors shouldn't take the patient off insulin once their glucose levels are optimized. It's because of the insulin that their levels are optimized. Same deal with thyroid meds.

The only time someone would come off thyroid meds would be if decreasingly smaller doses kept making the patient hyper. And NOT hyper in the form of low/suppressed TSH because that isn't hyper.

"True" hyperthyroidism is low/suppressed TSH *in conjunction with* over-range FreeT4 and FreeT3 levels.

Anyway, back to you :)

An older thread showed that back in March, you were taking 90mg Armour and, in this thread, you told us you were just increased from 60mg to 90mg two and a half weeks ago.

Knowing what motivated your doctor to bring you down to 60mg and then back up to 90mg will help you know whether or not you can rely on this doctor to achieve wellness for you.

You see, when I first read this thread yesterday, I thought you were in the early months of the meds titration process because some people are started on 60mg Armour.

I didn't think your doctor was adjusting your dose to maintain your optimal levels because Armour doses aren't adjusted 30mg in cases such as this - 15mg is the norm.

When I realized what you've been going through (and for so long - sorry), something tells me that your doctors have only been looking at your TSH.....and this is a recipe for disaster.

I hope you had an opportunity to read the article written by Dr. Mercola and perhaps compare what he has to say to the care you've received thus far.

Unfortunately, it seems many doctors just don't know how to medicate for hypothyroidism.

However, all is not lost. Those of us who learn how to interpret our labs and rally for the proper care are the ones who achieve wellness.

And, it's not enough to get our levels optimized.....we have to work to maintain those optimal levels.

I think that, after your time on here, you realize that we'd like to help you get better and stay that way.

So, if you'd like to share your lab history that corresponded to when you were taking 90mg in March, and the labs that corresponded to when you were brought down to 60mg, we can help you see just what your doctor was doing.

Understanding how your doctor approaches treatment can give you some idea of the things you might want to say to him/her and hopefully get the proper care.

If you're unable to get the proper care with your current doctor, you might need to find another one. I don't know a single soul who is still being treated by the first doctor to treat their hypothyroidism. It's a sad state of reality but, all is not lost. There *are* doctors out there who "get thyroid".

Life is too short to spend time suffering when a different doctor can help end that suffering.

Yes, you will most likely need to "lead" your treatment but, only you are living in your body.

While my doctor is pretty thyroid-savvy, I was the one who identified my optimal levels and also the one to suggest every dose adjustment.

I have been able to stay free from symptoms as long as I get the dose adjustments I need as soon as my labs show the need. The times I've developed symptoms (minor ones) were the times I didn't fight hard enough for the dose adjustment I needed....and my doctor learned via my experience.

Having my symptoms journal as it corresponds to my labs has proved to be a valuable tool in the fight for proper care.

Yes, it takes some work to succeed with thyroid disease but I think it's worth every effort. As I tell my doctor, feeling good is too important to me to do otherwise.

Let's work together at getting you well.

Thank you so much for your help. I do believe it is time to change doctors. I actually do not have the lab work from the previous times as I never asked...just believed in the doctors to know what they should do. Naive of me, to say the least. From this point on I will insist. That is why I had them this time....I insisted. We have a great hospital about an hour from me, and I am going to call them tomorrow and see if I can get in with one of their doctors for this. It is the University of Michigan Medical Center, and they are well known for top notch doctors. I have had both brain surgery and heart surgery there. Needless to say, I have not felt good in about 20 years for so many reasons. I continue to work full time as a teacher, but spend most days feeling miserable and foggy and lethargic. I appreciate all of your help.

I read the article, and believe I might be in the right direction. What do you feel my free T3 and free T4 numbers should be for me to be optimized?

Believe you me, I think we all trusted in our doctors until we found ourselves not feeling well after being (mis)treated for awhile.

Knowledge truly is power when we're talking about thyroid disease.

About optimal levels....

It's reasonable to shoot for levels that are 60-80% of range.....and then see if *all* symptoms dissipate. If not, you might be like me and need levels closer to 90-100% of range. No one functions properly with levels below mid-range.

So, using your lab's ranges.....60-80% of range for your FreeT4 would be 1.22-1.36.....and for your FreeT3 3.44-3.82.

(please know that I would need to re-do the math if you use a lab that has different ranges or your lab changes its ranges. That's why it's best to eventually learn just what percentage within the range your optimal levels fall so you can once again identify your optimal levels if your lab changes its ranges. This has happened to more people than I can count)

And, just so you know, the above-listed levels are the levels you should have without thyroid meds in your system. This means no Armour within 12 hrs. of the blood draw.

Taking meds any closer to the blood draw can skew the results artificially high. It's best to judge things based upon average levels vs. peak levels.

And, I really hope you'll consider maintaining a symptoms journal. It will help prevent any detours on the path to wellness.

Please feel free to ask any questions that come to mind. Thyroid forum members helped me so very much by sharing their knowledge and experiences as well as pointing me in the right direction for research. I am here to pay that forward.

So is it conceivable that Armour alone might take care of my levels, or will something else have to be added to get them right? It would appear I am still pretty far off then?

Also, why would I continue to gain weight despite staying with a reasonable calorie range each day and, when not exhausted, exercising three times a week? I not only do not maintain, I gain!

To answer the simplest question first - sorry but, yes, your levels are very far off.

Most people do fine on Armour only *as long as their FreeT4 level is above mid-range*.

When this happens, the FreeT3 level is usually at the top of the range.

Now, some people don't feel well with such a high-range FreeT3 level and would need to take a smaller Armour dose. Of course, not only would the FreeT3 level be lower with a smaller dose but, so would the FreeT4 level.

No matter what, if a person has an optimal FreeT3 level on Armour and ongoing hypo symptoms, there's a good chance their FreeT4 level needs help. That's when the addition of a small dose of T4 in the form of levothyroxine (Synthroid, etc.) will help.

A thyroid-savvy doctor would get your FreeT3 level around 60-80% of range and then see what your FreeT4 level is doing. If it needs help, that's when the doctor would add T4.

Weight gain is one of the gazillion possible symptoms we can have when our levels aren't optimal.

Our bodies are moving in slow motion when they don't have enough thyroid hormone to fuel it. It makes sense that we can gain weight.

In fact, here's a link to the most comprehensive list of possible hypo symptoms I've ever seen:

http://hypothyroidmom.com/300-hypothyroidism-symptoms-yes-really/

Believe it or not, I've had a couple of symptoms that aren't on the list. I knew they were thyroid symptoms because they developed after a dose adjustment and dissipated once my levels were restored to optimal. I wouldn't have even had those symptoms if my doctor adjusted my dose properly from the beginning. blech