So glad to hear your nodules were benign. Would you by chance be able to post the ranges for each of those tests? Without knowing those ranges, my opinion is only a guess, as different labs use different ranges. That said, its no wonder youre feeling anxiety on many drugs. Your Free T3 is much higher than your Free T4, which tells me youre getting a bunch of T3 from somewhere. Since you have nodules id suspect the nodules themselves to be producing hormone. What usually happens in this case is no matter what thyroid medication you take pushes T3 too high and you actually feel hyper.
As you see from your TSH @ 5.0, and your Free T4 @ .9, the Hashimotos is already destroying your thyroid. Further proof is your TPO of 900.
You also are low on Vit D. Your doc should start you at 10,000 iu per day until your levels come up to around 60. D3.
Armour or other T3/T4 combination medications are what is what is usually best, but in your case you need a T4 only medication such as levothyroxine, synthroid, or tirosint to bring your T4 up into range(about
mid way) but your doctor needs to keep a close eye on your Free T3. If you dont have a problem converting T4 t T3, your T3 will rise above range and cause a lot of anxiety, heart palpitations, etc.....no worries though, if taken slow and tested often youll be just fine.
That said, you need to find out why your T3 is much higher in relation to T4. Usually, as I said, it can be your nodules are producing T3. But, it could also be other issues such as low iron, or adrenal issues.
Additional testing should be done. Get your iron levels checked. This will include ferritin, % saturation, TIBC and serum iron. Treat anything thats out of range. Get your cortisol checked. Request a cortisol test that is checked at 4 pts throughout the day. Preferrably a saliva test. Again, treat anything out of range. For these tests you can do a search and find what numbers are optimal for each.
After your doctor gives you thyroid medication, ask to be tested as soon as 4 weeks, preferrably 3 due to your Free T3 levels to monitor how Free T3 is responding. Make sure you get these tests...
TSH(not necessary the first test, you already know its high. But further tests checknit t make sure its being suppressed.)
Make sure you do the Reverse T3 at the same time as Free T3 so you can check the ratio between them. You can check this ratio online(theres calculators) and see if its higher than 20, which is healthy. Lower than 20 points to other issues such as low iron, low or high cortisol, etc. What your looking for with Reverse T3 is making sure your body is using T3 at the cellular level, if not your body will convert(sometimes heavily) T4 into RT3 instead of T3. T3 is the active hormone, Reverse T3 is useless and could potentially indicate an systemic inflammation issue.
Personal opinion here....if you can get your doctor to wrap his mind around the whole endocrine system instead of a few lab numbers, youll probably find your panic attack disorder greatly reduces, or disappears. I have a suspicion its directly related. Ok, hope I didnt forget anything. Good luck!
PS.... 25 mcg is a litte low. Stay there for now, but at the first chance you get tested, you will want to raise to 50. Again, no worries, but youre in for a long ride. Adjustment takes time and you have a ways to go. At each increase you may feel a little "off" but that should change in a week as the T4 rises. This is a marathon, not a sprint. Youll get there.
PSS....knew I forgot something :D since youre going to get tested again for iron and such, add folate and B12. You may need these for furture reference. They can be very useful if thyroid issues cant be resolved(due to inflammation).
Post Edited (trader758) : 5/6/2015 10:43:31 PM (GMT-6)