For Science!
So the results are in: Test Value Reference Interval TSH 1.810 0.450-4.500 Free T4 2.08 0.82-1.77 Free T3 2.8 2.0-4.4 Reverse T3 24.9 9.2-24.1 TPO Ab 67 0-34 TSH This is a measure of how much I want more thyroid hormones. It's reasonably normal, though a bit higher than my baseline readings before surgery. Free T3 This is a measure of active thyroid hormone, i.e. how much is readily available for use by my body. It's normal, but on the low end of the spectrum. Free T4 This is a measure of unactivated thyroid hormone. T4 (which has a longer half-life) gets converted the active form T3 by the body. Levothyroxine (Synthroid) is T4. This is too high. It means I'm on too much T4 medication. The fact that my Free T3 is on the low end but this is high means it's not converting over. Reverse T3 This is a measure of bad T4→T3 conversions. It's a useless compound that gets in the way. It's another measure of bad conversion.
So, the conclusion is that 50mcg/day of Synthroid (which was the Sloan-Kettering endocrinologist's prescription) is not a great idea for me. (The Sloan-Kettering endocrinologist also asserted that I wouldn't notice slight changes in my dosing, or my TSH being off the charts at 10. Given how I was feeling at 8.5, I am very skeptical about how much she knows about dosing. And that is a *sad* thing to be saying about an endocrinologist at one of the top medical facilities in the US.)
Anyway, the functional medic (who prescribed these tests) thinks we should include some direct T3 in the prescription, so once the test results were in we added in 5mcg T3, which I stepped up to earlier this week.
I felt a little off, though, on 50mcg+5mcg so we also lowered the Synthroid to 47.5mcg/day. (The equivalence is roughly 50mcg T4 ≅ 16mcg T3, according to a CVS pharmacist.)
It's hard to tell, honestly, if I'm slightly overdosed. My symptoms are mainly psychiatric and there are always a million ways to explain them if they're not sufficiently dramatic. I've been noticeably less interested in killing people than last week, though, so either that's a quirk of my menstrual cycle or it's an improvement. :) TPO Ab This is a measure of the autoimmune reaction in Hashimoto's Thyroiditis (chronic lymphocytic thyroiditis).
My TPO Ab level used to be in the 90s. We're down to 60s. This is good. However, we don't know why it is down or if it will stay down. Things we are messing with currently:
- gluten-free/soy-free/dairy-free diet [in place roughly since mid-August; no measurable effects when tested in October]
- low iodine diet (using iodine-free salt) [in place since mid-October]
Over the summer I travelled a lot; one of those places was Thailand, in which I spent 4 entire weeks. Testing at a foreign lab a week later pegged my TPO Ab score at 25, below the threshold of "you have a problem". One possible explanation is that the lab was just off... but it'd have to be off by like 70%, which is a pretty huge margin of error imo. I've been trying to come up with other explanations, and based on what we know about triggers for autoimmue thyroiditis, these are some likely candidates: Food In Thailand I was strictly gluten/soy/dairy free, and these are often complicating factors. Water Thai tap water isn't safe to drink, so for the whole month I drank only bottled water. Halides like fluoride and bromides can cause problems here, and water in the US is definitely fluoridated. (It would be awesome to be like, sorry, I can only drink bottled water 'cuz I'm allergic to tap water. Right?) Iodine Iodine has a lot of effect on the thyroid, and it's possible that there wasn't iodine in my salt intake there. Miscellaneous Stress levels? Atmospheric temperature? Sunlight and nature? Sleep has been pretty constant (i.e. constantly not enough for both Thailand and my first few months in Philly) so that's not a factor here, and vitamin D levels have been consistently supplemented.
Hypothesis testing! We are doing Science! It's just kindof haphazard cuz we have a sample size of one and a lot of variables. :| Post if you've got ideas for the next experiment! Or interpretations of currently-available data. *can post more data if needed, has spreadsheets...*