BellaOnline Forums Health and Fitness Thyroid Health What is my problem?

Ok, Here is my history: I have been Hypo since 1991. I had a bad case of thyroiditis in 1996/1997. Was put on 88mcg Levothyroxine and 15 mcg cytomel this past year (i do not convert).

My current symptoms: extremely tired i have to drag myself out of bed and just go through the motions all day; taking naps on weekends, weak, hives, tremble off and on, sore muscles to the point that it hurts to touch them it is like they get super tight and wont relax, dizzy off and on and upon standing, buzzing sensation in head off and on, vibration in muscles off and on, hands sometimes shake when I do things, and slurring of words.

I thought it was all related to my thyroid but my thyroid levels are great right now with a TSH of .74. I thought it might be adrenal fatigue but my waking cortisol level was 22 (range 6-28). With it being so high, I doubt it would be worth getting the saliva test, do you? my only other thoughts are MS. I don't know, at this point, what else to do and I am frustrated cause I have brought all this up with my doctor and all he wants to do is change my anti-depressant meds. He thinks it is all related to that. I do not.

Does any one have any ideas or thoughts? I am open to anything right now.

Thanks
Teresa

Hi, Sorry you are feeling so bad. I know how awful it is. We are in a battle with this thyroid, that is for sure.

Your TSH is ok, but it could be a bit low for you. You might feel better if it is around.

Also, the Free T's 3 and 4 need to be checked.

Sorry, I should have listed my last test results:

FT4 = 0.937 (range 0.930-1.700)
FT3= 144.9 (range 80.0-200.0)
TSH= 0.784 (range 0.27-4.200)

Teresamang,

When I saw your first post, I was thinking similar to pmcgall, that your treatment was good because of the lower-normal TSH of .74.
When I look at your Free T-4 and T-3 however, it seems to tell a little different story. Your Ft-4 is at lowest-normal (not terribly uncommon when taking T-4/T-3 combo). Your Ft-3 is just barely above mid-range (mid being 140).
While in some patients, this level resolves their symptoms, others nead a slight tweaking of their dose because their TSH over reacts and suppresses slightly more than it should with the dose they are taking.
Your Ft-3 could go up another 40 or 50 points and you would still be within normal range. This would raise your Ft-4 closer to mid-range.
Some Dr.s will not touch a dose level when seeing a suppressed TSH, despite the fact that TSH is not a thyroid hormone but usually an accurate reflection of the thyroid hormone levels. It is not accurate in all patients however and some need TSH suppressed to very low normal or even below normal. Dr.s will argue this point but is evident in these patient's blood test results.
In my case, my TSH has to be very suppressed to near undetectable(0.01), for my Free T-3 to be between mid range and highest normal. If my dose only places my TSH at lowest-normal (o.3 or 0.5), my Free T-3 will only be at mid range or below mid range and I will develop worsening fatigue and joint aches at that level.
Doctors fear inducing dose-toxicity if they suppress TSH but the fact is, some patients need a more suppressed TSH than others do. I'm not the only one who experiences this scenario but have seen this attested to by other patients over the years.
In my opinion, doctors should be willing to do a trial of a slightly higher dose in these cases because close monitoring with blood restests and patient symptom monitoring (for hyper type symptoms, e.i. increased heart rate, elevated BP etc...) will prevent any possibility of thyrotoxicity/over-treatment.
I admit these trials of dose tweaking require special attention but it is worth it, to keep these patients from experiencing loss of quality-of-life due to ongoing hypothyroid symptoms.
If dose tweaking doesn't resolve the stubborn symptoms, other causes could then be searched for.
This is non-pro, layperson opinion but even my own personal experience tells me this does happen, although it is not common.