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Diagnosed With Hypoactive thyroid

mike036

Featured Member / Kilo Klub
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I tried self medicating (25mcg/day t4)last year when my numbers weren’t as bad and after 1 week stopped due to heart racing. Now my thyroid function has taken a turn for the worse and my primary prescribed me 25mcg/day t4 which I started this morning. I am hoping I have better luck with the meds because I have been so lethargic the last few months. It is crippling .Here are my recent bloods
 

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Are you also getting a really bad brain haze/fog feeling that lasts all day by any chance? I don't see Free T3 tested btw. That is kind of important.
 
I have trouble concentrating and have been very forgetful but mostly just have no desire or drive to do anything,I barely make it through the work day. My t3 wasn’t tested this time but last time it was 107 with the range being 71-180
 
Are you taking anything aas wise or specifically HGH?

I stopped gh back in the beginning of June. Using just test now and have been for several months (125mg/week test c)
 
Apparently hypothyroidism runs in my family on my mother’s side. My grandmother,mother and 2 sisters were all diagnosed
 
you need rt3 and ft3 tests down as well. t4 wont show much of whats going on
 
I'd add in so hcg to the trt. Mine was in the tank and test helped but hcg seemed to bring it up even more. I'm golden now.
 
I was in a similar situation 6 years ago. I had perfectly fine TSH (1.6) but when I went to see an endocrinologist he tested my total and free T3 and both were abysmally low along with a low (but within range) T4. He prescribed me cytomel to start and eventually raised dosage from 15mcg to 25mcg and eventually added 50mcg of T4 and my bloods are all within range now and I started to feel much better once they were.

So, as others have said, I think you really need total and free T3 tested. Best of luck and I hope you start feeling better.
 
I was in a similar situation 6 years ago. I had perfectly fine TSH (1.6) but when I went to see an endocrinologist he tested my total and free T3 and both were abysmally low along with a low (but within range) T4. He prescribed me cytomel to start and eventually raised dosage from 15mcg to 25mcg and eventually added 50mcg of T4 and my bloods are all within range now and I started to feel much better once they were.

So, as others have said, I think you really need total and free T3 tested. Best of luck and I hope you start feeling better.

I'm glad you posted this. I began self treating myself since 99% of doctors do not understand thyroid health and have worked up to 25mcg T3 with 50mcg T4. Getting bloods next week but I'm starting to feel better on this dose after starting low with the T3.
 
First of all, do you have any symptoms? Fatigue, facial bloating, cold sensitivity, constipation, crashing in the afternoon are the most common symptoms.


Free T4 you want to bring up to +1.6-1.8 ng/dL, contrary to internet dogma, Free T4 is correlated to well-being, not Free T3. (https://academic.oup.com/jcem/article/91/9/3389/2656451)


The physiological ratio of T4/T3 is around 10:1. A healthy thyroid produces about 100 mcg of T4 daily and 5-8 mcg T3 through direction secretion. A further 25 mcg of T3 is produced via conversion of T4 to T3 for a total of 32 mcg per day (direction secretion+conversion).


You want to get your Free T4 up to 1.6 ng/dL at least, if still symptomatic, add 5-15 mcg of T3, starting with 5 mcg at a time.


Most important question is, what are your symptoms now? Even without symptoms hypothyroidism is a big risk factor for atherosclerosis (plaque in the arteries) which is a big risk factor for stroke/heart attack.


People will erroneously tell you that T4 is "inactive" that RT3 blocks T3 receptors and that only T3 is the active hormone. All three statements are completely false and not how thyroid physiology works. 1. T4 has it's own functions independent of conversion to T3 (just like GH works without IGF-1 in certain processes) RT3 IS inert and does not block any receptors. T3 needs T4 to work, some tissues need T4 to convert themselves and are poor are utilizing serum T3.


You will see many symptoms unresolved in people who only take T3 without T4. I've had patients on all thyroid meds (T4/T3 solo or combo and dessicated pig thyroid). Most patients feel great on T4 only IF we go by Free T4, not TSH like most practitioners do. Treating thyroid by TSH is like doing TRT without testosterone tests but using only LH/FSH as your guide. Zero sense.
 
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First of all, do you have any symptoms? Fatigue, facial bloating, cold sensitivity, constipation, crashing in the afternoon are the most common symptoms.


Free T4 you want to bring up to +1.6-1.8 ng/dL, contrary to internet dogma, Free T4 is correlated to well-being, not Free T3. (https://academic.oup.com/jcem/article/91/9/3389/2656451)


The physiological ratio of T4/T3 is around 10:1. A healthy thyroid produces about 100 mcg of T4 daily and 5-8 mcg T3 through direction secretion. A further 25 mcg of T3 is produced via conversion of T4 to T3 for a total of 32 mcg per day (direction secretion+conversion).


You want to get your Free T4 up to 1.6 ng/dL at least, if still symptomatic, add 5-15 mcg of T3, starting with 5 mcg at a time.


Most important question is, what are your symptoms now? Even without symptoms hypothyroidism is a big risk factor for atherosclerosis (plaque in the arteries) which is a big risk factor for stroke/heart attack.


People will erroneously tell you that T4 is "inactive" that RT3 blocks T3 receptors and that only T3 is the active hormone. All three statements are completely false and not how thyroid physiology works. 1. T4 has it's own functions independent of conversion to T3 (just like GH works without IGF-1 in certain processes) RT3 IS inert and does not block any receptors. T3 needs T4 to work, some tissues need T4 to convert themselves and are poor are utilizing serum T3.


You will see many symptoms unresolved in people who only take T3 without T4. I've had patients on all thyroid meds (T4/T3 solo or combo and dessicated pig thyroid). Most patients feel great on T4 only IF we go by Free T4, not TSH like most practitioners do. Treating thyroid by TSH is like doing TRT without testosterone tests but using only LH/FSH as your guide. Zero sense.

Thanks for your input. My only symptoms have been debilitating lethargy and a little bit of forgetfulness/trouble thinking
 
Thanks for your input. My only symptoms have been debilitating lethargy and a little bit of forgetfulness/trouble thinking

I'm in the same boat as you. Tired, unmotivated and just dont feel mentally sharp anymore although after years my labs are looking good.

1) I think you need a full thyroid panel
2) Do you been tested for sleep apnea? Apnea made my labs worse
 
I'm in the same boat as you. Tired, unmotivated and just dont feel mentally sharp anymore although after years my labs are looking good.

1) I think you need a full thyroid panel
2) Do you been tested for sleep apnea? Apnea made my labs worse

I believe I have sleep apnea. My doctor gave me a referral to a pulmonologist recently and I can’t seem to get in contact with them. I have left several messages and don’t get a response. I have crap insurance and they are the only one in my area that will take my insurance.
 
I believe I have sleep apnea. My doctor gave me a referral to a pulmonologist recently and I can’t seem to get in contact with them. I have left several messages and don’t get a response. I have crap insurance and they are the only one in my area that will take my insurance.

You can get a take home sleep apnea kit for like $200.

This one is 250 but I only searched for a minute:

**broken link removed**
 
Last edited:
You can get a take home sleep apnea kit for like $200.

This one is 250 but I only searched for a minute:

**broken link removed**

Thanks so much,I had no idea this was even available. I am going to be in the area of the pulmonologist next week so I will just walk in and explain to the front desk that I have been trying to make an appointment with no luck. If that doesn’t work I will go your route and test myself
 
I'm glad you posted this. I began self treating myself since 99% of doctors do not understand thyroid health and have worked up to 25mcg T3 with 50mcg T4. Getting bloods next week but I'm starting to feel better on this dose after starting low with the T3.

I think you're definitely on the right track. Gotta monitor bloodwork as you are and also go by how you're feeling. For example, my endo wanted me to try 35 mcg of T3 and call his office the following week to report back (his office is almost 2 hours away from my house so he was happy to take the phone call). The very first day and every subsequent day I got splitting headaches so he had me drop back to 25mcg and called in the T4 to my pharmacy. My T4 is still low-normal on blood panels but my T3 is in range and as long as I don't do anything stupid (like zero sleep for work lol) I feel much better than I did prior to starting the thyroid meds.
 
I think for the vast majority of people this is true but for me, and a lot of others I've seen on forums, didnt feel better until free T3 come to middle-upper levels of the range.

Of course, once you top off the Free T4, you add a little T3 if symptoms are not fully resolved. The ideal therapy is T4/T3 in the physiological ratio.

Thanks for your input. My only symptoms have been debilitating lethargy and a little bit of forgetfulness/trouble thinking

Those are two of the big symptoms and you can see why you have them in your lab work with the very poor Free T4 levels.


Re-test every 4 weeks after a dosage change, most people's doses when optimized are somewhere around 100 mcg.


If you take a low dose it can add to your natural production/higher doses will shut down your own. Re-test your Free T4 in 4 weeks. You want to get up to around 1.8 ng/dL, TSH is pretty useless.
 
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Of course, once you top off the Free T4, you add a little T3 if symptoms are not fully resolved. The ideal therapy is T4/T3 in the physiological ratio.



Those are two of the big symptoms and you can see why you have them in your lab work with the very poor Free T4 levels.


Re-test every 4 weeks after a dosage change, most people's doses when optimized are somewhere around 100 mcg.


If you take a low dose it can add to your natural production/higher doses will shut down your own. Re-test your Free T4 in 4 weeks. You want to get up to around 1.8 ng/dL, TSH is pretty useless.
I see you wrote that my free T4 should be around 1.8 ng/dL. The high end at Labcorp is 1.77 ng/dL. That would put me over the high end of normal.
 

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