![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by gardenergirl on June 2, 2005, at 15:48:45
Hi all,
Anyone want to help me interpret my thyroid lab results? I know I should make an appointment with the doc to discuss them, but it seem silly since we just did this when they took the blood. Perhaps he can call in a scrip change rather than me going in with another copay.Anyhoo, my T3 is elevated: 217.1 (reference range = 60-181). My TSH is very very low: <0.02.
I take 1.5 grains (90mg) of Armour Thyroid. I used to take levoxyl, but when TSH got high again, I switched. I'm guessing I should go back to just taking T4??
Any suggestions? Any symptoms associated with a high T3 and low TSH? I would think I would be feeling hyperthyroid...with the headache, insomnia, and jitteriness. I haven't really noticed anything.
Thanks in advance!
gg
Posted by Larry Hoover on June 2, 2005, at 21:28:26
In reply to Thyroid lab results: T3 is high--help?, posted by gardenergirl on June 2, 2005, at 15:48:45
> Hi all,
> Anyone want to help me interpret my thyroid lab results? I know I should make an appointment with the doc to discuss them, but it seem silly since we just did this when they took the blood. Perhaps he can call in a scrip change rather than me going in with another copay.
>
> Anyhoo, my T3 is elevated: 217.1 (reference range = 60-181). My TSH is very very low: <0.02.
>
> I take 1.5 grains (90mg) of Armour Thyroid. I used to take levoxyl, but when TSH got high again, I switched. I'm guessing I should go back to just taking T4??
>
> Any suggestions? Any symptoms associated with a high T3 and low TSH? I would think I would be feeling hyperthyroid...with the headache, insomnia, and jitteriness. I haven't really noticed anything.
>
> Thanks in advance!
>
> ggSome people feel best when their TSH is below what some doctors think of as normal, but with the T3 that high, you're saturated.
You don't have to switch back to T-4. Just take less of the Armour.
Thyroid hormones are mostly protein bound. Like little sponges full of thyroid hormone. Adjusting the dose won't have an immediate effect.
What I don't know is how hard it is to adjust the dose.
Can you take 75 mg? Alternating 60 and 90 might be an option (though some people feel the oscillation). That would give you an average of 75.
I'd get your blood checked after a month at the lower dose. You might need further dose adjustment.
Lar
Posted by Pfinstegg on June 3, 2005, at 17:13:56
In reply to Re: Thyroid lab results: T3 is high--help? » gardenergirl, posted by Larry Hoover on June 2, 2005, at 21:28:26
I agree with Larry - your dose of Armour is definitely too high. For depression, a TSH of around 0.5 considered ideal. Your system is so full of T3 and T4 right now that the part of your brain (the pituitary) which is supposed to stimulate your thyroid has essentially shut down.
The problem with using the Armour preparation is that you don't know exactly how much T3 and T4 you are getting. I know I've mentioned this before, but I think it would be much better medically to take T3 and T4 individually. It's not hard to achieve a steady, optimal TSH level that way. Everyone is different, of course, but to just give you my own example, I have been taking 5 mcg. of Cytomel twice daily, and .05 mg. of Synthroid once daily for three years: my TSH stays very steady at a little below .5. (Before treatment, I had a slightly elevated TSH of 5). I know these are my proper dosages, and don't need to have blood tests more than once a year when I have my regular check-up.
Posted by gardenergirl on June 6, 2005, at 1:15:05
In reply to Re: Thyroid lab results: T3 is high--help? » gardenergirl, posted by Larry Hoover on June 2, 2005, at 21:28:26
>
> Some people feel best when their TSH is below what some doctors think of as normal, but with the T3 that high, you're saturated.Yep, that's why I'm surprised I feel okay. A bit of insomnia at times, though.
>
> You don't have to switch back to T-4. Just take less of the Armour.
>
> Thyroid hormones are mostly protein bound. Like little sponges full of thyroid hormone. Adjusting the dose won't have an immediate effect.Yeah, it's a pain to wait until it's back to a good range.
>
> Can you take 75 mg? Alternating 60 and 90 might be an option (though some people feel the oscillation). That would give you an average of 75.I actually tried this when I first started Armour, because it felt like too much for me. The pills are round and domed. They are hard to split, especially into fourths, to get 75 mg. (My tabs are 90mg).
>
> I'd get your blood checked after a month at the lower dose. You might need further dose adjustment.sigh, yep. I do wish they would call me when the results are out of line, though. I had to call them, and it's been 3 weeks at least since they drew the blood.
Thanks for your info.
gg
Posted by gardenergirl on June 6, 2005, at 1:19:54
In reply to Re: Thyroid lab results: T3 is high--help?, posted by Pfinstegg on June 3, 2005, at 17:13:56
Pfinstegg! Thanks for your help. I do appreciate it.
> I agree with Larry - your dose of Armour is definitely too high. For depression, a TSH of around 0.5 considered ideal. Your system is so full of T3 and T4 right now that the part of your brain (the pituitary) which is supposed to stimulate your thyroid has essentially shut down.
Well that sounds just peachy. :( I'm beginning to dislike my thyroid.
>
> The problem with using the Armour preparation is that you don't know exactly how much T3 and T4 you are getting. I know I've mentioned this before, but I think it would be much better medically to take T3 and T4 individually. It's not hard to achieve a steady, optimal TSH level that way.That makes a lot of sense. And actually, I was trying to do that the time I tried Cytomel. It's just that my doc is not so good at determining doses. When he started me on the Cytomel, he kept Synthroid at 50 mcg and added Cytomel at 25. That was horrible. Way too much. So he stopped Cytomel. I'm not sure I could convince him to try it again, or convince myself to trust his doses again.
It does sound like you've found what works for you. Glad to hear that.
While I was in Chicago I got a phone messages saying my prescription is ready. I guess I'll go see what he called in. Might have to post again after that.
Take care,
gg
Posted by Larry Hoover on June 6, 2005, at 9:47:34
In reply to Re: Thyroid lab results: T3 is high--help? » Larry Hoover, posted by gardenergirl on June 6, 2005, at 1:15:05
> > Can you take 75 mg? Alternating 60 and 90 might be an option (though some people feel the oscillation). That would give you an average of 75.
>
> I actually tried this when I first started Armour, because it felt like too much for me. The pills are round and domed. They are hard to split, especially into fourths, to get 75 mg. (My tabs are 90mg).I thought it came as 30 mg tabs. (I knew somebody taking 30 mg.) The monograph talks about incrementing Armour by 15 mg, as well, during titration.
I hope your doctor does the right thing. I think Armour is a better idea than trying to titrate straight T-4 and T-3.
It's just a gut feeling, but I think there's more stuff in the thyroid extract, more important coextractives, than just the thyroid hormones that we've focussed our congitions on.
Lar
Posted by Larry Hoover on June 6, 2005, at 10:50:41
In reply to Re: Thyroid lab results: T3 is high--help?, posted by Pfinstegg on June 3, 2005, at 17:13:56
> The problem with using the Armour preparation is that you don't know exactly how much T3 and T4 you are getting. I know I've mentioned this before, but I think it would be much better medically to take T3 and T4 individually. It's not hard to achieve a steady, optimal TSH level that way. Everyone is different, of course, but to just give you my own example, I have been taking 5 mcg. of Cytomel twice daily, and .05 mg. of Synthroid once daily for three years: my TSH stays very steady at a little below .5. (Before treatment, I had a slightly elevated TSH of 5). I know these are my proper dosages, and don't need to have blood tests more than once a year when I have my regular check-up.
Big article in yesterday's newspaper....you can't even get Cytomel in Canada any more. All North American Cytomel is made in Canada (Montreal), but it is owned by a company in Tennessee, called King Pharmaceuticals (named after Jesus). It's all shipped to Tennessee. They won't sell any back to Canada. Period. If there is any to be found in Canada anywhere, it is old stock. When it is gone, it is gone.
Lar
Posted by gardenergirl on June 6, 2005, at 13:46:23
In reply to Re: Thyroid lab results: T3 is high--help? » Pfinstegg, posted by Larry Hoover on June 6, 2005, at 10:50:41
I picked up my scrip today, and it's 75 mcg of Synthroid. Why do I have the feeling that this will be too low? It seems like a big jump down from 90 of Armour.
And Lar, Armour may come in smaller tabs. I just only have the 90 tabs on hand. If I wanted to really discuss this with the Doc, I'd have to make another appt. sigh. He just called in this scrip this time.
I suppose we'll see. No instructions for when to follow up, either. Good thing I know I need to.
Thanks for your help. Wish I felt more like being insistent with doc right now.
gg
Posted by Larry Hoover on June 6, 2005, at 17:57:14
In reply to Well this is interesting » Larry Hoover, posted by gardenergirl on June 6, 2005, at 13:46:23
> I picked up my scrip today, and it's 75 mcg of Synthroid. Why do I have the feeling that this will be too low? It seems like a big jump down from 90 of Armour.
Wow. Time for some math. According to the Armour monograph, each grain (60 mg) of Armour gives 38 mcg T4 and 9 mcg T3, so you were taking 57 mcg T4 and 13.5 mcg T3. Using a rough approximation of 4:1 T3:T4 potency, that would be about the equivalent of 111 mcg T4. So, the new dose of T4 is only a reduction of 12.3% (if that crude T3:T4 potency conversion holds true). Some would argue that Armour has potency that exceeds the apparent T3 and T4 content.
> And Lar, Armour may come in smaller tabs. I just only have the 90 tabs on hand. If I wanted to really discuss this with the Doc, I'd have to make another appt. sigh. He just called in this scrip this time.
Armour comes in 15, 30, 60, 90, 120, 180, 240, and 300 mg sizes.
> I suppose we'll see. No instructions for when to follow up, either. Good thing I know I need to.6-8 weeks?
> Thanks for your help. Wish I felt more like being insistent with doc right now.
>
> ggBe insistent down the road?
You're welcome.
Lar
Posted by kerria on August 30, 2005, at 11:09:35
In reply to Thyroid lab results: T3 is high--help?, posted by gardenergirl on June 2, 2005, at 15:48:45
Hi Gardenergirl,
Last year i had trouble with thyroid and now take levothyroxine 75mg.
T3 was 248
TSH 0.13i can't tell much difference it makes. Parts switching a lot and pain meds. i feel tired and sometimes jittery also.
i hope you're able to get the best level.
love,
kerria
Posted by gardenergirl on September 1, 2005, at 0:18:09
In reply to Re: Thyroid lab results: T3 is high--help? » gardenergirl, posted by kerria on August 30, 2005, at 11:09:35
Thanks dear.
I'm now on 100 mcg of Synthoid. Seems to be better, but I go back in about four more weeks for a re-test. Thyroids are tricky things sometimes.
Now, if only your pain were manageable like thyroid changes are.
I do agree with Racer, though, that applying for disability seems like a very reasonable thing. How could anyone work with intractable pain?
..praying for an answer for you that leads to relief...
gg
This is the end of the thread.
Psycho-Babble Health | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.