BiomedEE's Message Board Messages

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If one continues to do poorly what you want to do is go from:

A generally high or at top of range Free t4 and using TSH alone to dose.


The basic goal is to convert to:

A good or a very good FT3, at moderate to mid-level FT4 and Reverse t3 as low as possible.

What counts the most is the FT3 at a reasonable or moderate FT4. Sometimes a good FT3 at high FT4 such as can happen post TT on high levels of T4 only, even very high in range FT4, can leave a person quite sick sometimes still. Others can tolerate the higher FT4 if the FT3 is really good.

And here are examples of the kinds of labs to go from poor to better

Good and bad looking labs example.

An example of poor looking values or more likely to have issues.
Free t4: 1.8 ng/dL
Free t3: 2.2 pg/mL
Reverse T3: 31.4 ng/dl
Reasons that is bad looking data include but not limited to
Too much T4 = HYPER issues,
Too little T3 = HYPO issues,
Too much rT3 = more HYPO issues generally but for some it can cause HYPER issues during a switch to meds with T3 in them

Here is an example of a person that likely will have fewer issues, USA lab type values
Free t4: 1.09 ng/dL - moderate to avoid the too much T4 issues
Free t3: 3.62 pg/mL - good or very good
Reverse T3: 12 ng/dl - decent


This is my exact thought as well, sounds like a higher Free t4 scenario. Shortness of breath is a classic HYPER symptom caused by way too much T4 medication and as measured by the Free t4 lab.

Two common problem areas and some symptoms often faced post TT
As thyroid cancer survivors, having no thyroid, we are fairly unique medically in that we can experience both an excess (hyper) and a deficiency (hypo) simultaneously.

HYPER (most common with a high FT4 post TT on high levels of T4, but can be from too high a FT3 too) symptoms include mood changes and swings, A mean irritability or a short temper, headaches and migraines, anxiety, palpitations, shortness of breath and/or breathlessness, too fast a GI system (initially) or changes in GI system with eventual constipation from dehydration in some cases, sleeplessness and restlessness, more of a sharp body ache or pain like joint pain or sharp shoulder pain issues, weight changes due to excess hunger with little or no satiety, lots of pre-migraine and migraine aura effects (can include thyroid ocular aura disorders -TOADs) even if you never get or have never had a migraine in your life.

HYPO (most common with low FT3 even if TSH suppressed) all the symptoms of hypothyroidism, but common are the brain fog, depression, loss of attention span (forgetting things), skin issues, hair loss, fingernail issues, feeling dog tired, Sleeping lots, slowing metabolic rate leading to inability to lose weight despite honest effort, Tired irritability, more of a dull and swollen body ache or pain like swollen joint pain, irritable/sensitive GI, inability to do things like we used to, constipation or too slow a GI system, blooming allergies, just can't focus on work or family. When very HYPO a differing kind of irritability or a "tired irritability" and a differing headache than the HYPER one. A very low Free T3 can also cause bradycardia, palpitations in some, and many types of cardiac issues are possible. Many more issues are common when HYPO and can be found on internet searches.


It is always better to work with the actual thyroid hormones, Free t4, Free t3 and Reverse t3 than it is TSH, though you have to worry about when you get the blood draw to use the Free T labs well.

For some ideas


What are your actual thyroid hormone levels? TSH is a pituitary hormone, not a thyroid hormone. Thyroid hormones are:

Free t4, Free t3, Reverse t3.

Often when the Free t4 is up there over say 1.3 or 1.4 the dose needs reduction as it causes palps in some people. If one needs TSH suppression and T4 causes palps, one can take the Free t4 down to say 1 or 1.1, and add some T3 (NOT once a day!!) and it should not cause palps at the lower free t4 but will suppress TSH. See the Free t guide


RE: Bone/nerve pain

by BiomedEE - January 17, 2019

What are your thyroid hormone levels, and thyroid hormones are Free t4, Free T3, and Reverse T3. TSH is a pituitary hormone and is not a direct measure of thyroid hormones. SOmetimes when the Free T4 is too high for an individual it can cause lots of pain, I get that when it goes up but is still in the so called range.

If you have GI issues with thyroid issues three areas to look into are:

1 Carcinoid




Which is active/methyl issues with B vitamins, particularly Folic acid (such as enriched flur bread has). That can cause issues around the upper GI, some have liver issues, and other issues


Low stomach acid

See sites like Mercola or others on how to add apple cider vinegar instead of PPI's

Be sure to ask for Free t3, Free t4, reverse t3. TSH is a good thing to monitor for thyroid cancer but it isn't a thyroid hormone. Sometimes things like Vitamin D influences things as well, best to have a primary care check those things.

If there is cancer it is slow growing. I had nodules on all sides, they took something like 6 samples total during FNA, and 5 were positive for cancer. But I also had an uptake scan checking if nodules are cold/hot, ultrasound mapping, and during the FNA the pathologist and radiologist were in the room to make sure sample were good samples and that the areas of concern seen on the two imaging modalities were biopsied properly.

I would opt for another FNA at a place that handles it like the above. That was interventional radiology at academic medical center.

Good luck and let us know what you decide.

If you don't do well on T4 only, numbers like a FT4 of 1.7 can leave such people very sick. I am certainly sick at those numbers, and very much so. When the FT4 starts going up higher in the range I immediately start getting HYPER symptoms, plus I get HYPO symotoms.

I take NP Thyroid currently, in three doses to solve that issue. So it is a bit more work going to 2 or 3 doses per day, but in general a person on NDT might run numbers like FT4 of 1 or 1.1 and FT3 of 3.5 to 4. This is where I do well.


Just be sure on the Tg reading you didn't take Biotin in any vitamin, supplement, or otherwise for a few days before the reading. It can interfere with the reading.

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About BiomedEE

Patient, Survivor
Thyroid Cancer
After Treatment, Cancer Diagnosis, Cancer Treatments, Supplements, Support, Diagnostic Imaging


Papillary thyroid cancer, multiple positive nodules both sides, warthin tumor variant. Thyroidectomy April 2009.

Married. Two girls but mostly empty nest now. Wonderful caring wife - my better half.

Career: Biomedical engineer for many years at NIH in Bethesda, MD. Bio-instrumentation, LabVIEW, imaging. Spent years on several medical journals as peer reviewer on medical measurement systems articles and systems for diagnosis of various medical conditions.

Swedenborg the scientist, engineer, and world's most unique Christian theologian who has quietly inspired people of all faiths to deepen the good and take away the negative of religion. This has included people such as Helen Keller, Van Morrison, and many others. A belief of mutual respect, love, and deeper concern for others.

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