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THE Q & A
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Welcome to The Q&A with Elaine Moore. Registered members are invited to ask any question of Elaine Moore on autoimmune diseases, Graves' disease, other thyroid diseases and subconditions, laboratory work, traditional and complementary medicine, triggers and environmental influences, thyroid and immune disorders in pets and animals, and other relevant areas of inquiry.
Each thread represents one question with one answer and will only appear at the time it is answered. Once answered, further replies cannot be made to the same thread since each thread represents only one question. A new thread will need to be started for additional questions.
Questions are answered solely by Elaine Moore, a medical writer and clinical laboratory scientist, MT, CLS, with more than 30 years of experience in immunology. Moore has also authored and edited over a dozen books in the area of health sciences and is an editor for McFarland Publisher's Health Topics Series.
Copying of any posts is prohibited without permissions.
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Notice: No notices today.
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| CA |
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Joined: 11/30/2011
Posts: 4
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Hello Elaine,
I have a couple of questions that would appreciate your opinions on. I had RAI treatment last December and became hypo during the end of January. I had a blood test on Jan 24 and the result showed Free T4 0.16 (reference 0.61-1.12), and FREE T3 1.7 (2.5-3.9). The doctor then put me on Levothyroxin 88MCG on Jan 26 and last week I started experiencing a heart rate increase, shortness of breath, some chest pains, etc. I called the doctor about and told her about my symptoms and she sent me to get a blood test on Feb 23. The result came back: TSH 2.55 (reference 0.34-5.60), Free T4 1.04 (0.61-1.12), and FREE T3 2.7 (2.5-3.9). I am in all the normal range for everything, but why am I experiencing symptoms similar to hyper? Is this a side effect of Levothyroxin? I am slowly switching to being a vegan could this contribute to my symptoms as well? I talked to the doctor on Feb 24, she said it is kind of significant for the level to increase 1 whole point in a month for Free T4 and FREE T3. Is her diagnosis correct? The doctor had me stop taking medication for three days and she wants me to start on a lower Levothyroxin 75MCG on Feb 28. I was a little bit concerned that she had me stop Levothyroxin for this long but she said the medicine half life is 7 days so I can go without any for that long and I will be ok. Is this correct? The doctor also said that part of the reason I might be experiencing these symptoms is because my body is trying to get used to the medication. I don’t even know what that means and it doesn’t make sense at all.
Thank you
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| Elaine |
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Joined: 8/1/2008
Posts: 3374
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Hi,
Shortness of breath is typically a hypothyroid symtom and can be related to your low FT3. The TSH is falsely decreased after RAI so even though your level is within the normal range, this result isn't reliable. Because TSH receptor antibodies are dramatically increased by RAI, and these antibodies falsely lower the TSH level, your FT4 and FT3 levels are better indicators of your thyroid status. It's unfortunate that you became severely hypothyroid and weren't given replacement hormone earlier. It's important to avoid hypothyroidism after RAI since it can easily trigger thyroid eye disease.
It's true that replacement hormone can cause transient hyper symptoms that typically resolve within a week. However, a low FT3 can also affect your heart rate. Ideally, with your low FT3, you'd be prescribed either a glandular extract (containing T1, T2, T3, and T4), or T3 (Cytomel) along with Synthroid (T4). With optimal levels of FT4 and FT3 your symptoms should improve. Most of us who have RAI rarely have TSH levels over 0.3 unless we're under-medicated. Best, Elaine
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TO USERS: Q&A posts are visible to all readers. Users can delete their own threads at any time. Users must provide information which is true and correct to the best of their knowledge as well as provide sources or references to any health / medical information if not taken from personal experience. All users including the moderator must behave at all times with respect and honesty. Advertising and self-promotion is not allowed. The moderator or site administrator has the right to ban users with or without warning for not following the basic rules of this site. All posts by default are not to be considered that of medical professionals unless otherwise indicated. As sole moderator, Moore has no conflicts of interest in the sponsorship of this forum.
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