Astroman-thyroid knowledge (new numbers in) and Did Flonase set this off?!

You know how things will just come to you in the middle of the night? Oh my goodness, guys, it just popped into my head that my daughter went to ENT last year and took double dose Flonase for a month. I just looked at the bottle in her cabinet and she started the nasal spray 3 weeks before the first tingling/paralysis feeling episode that lasted only a week.
She got over that and everything was normal until Feb 1 of this year when it all fell out like a bomb was dropped on her body. Lots of stress going on at that time w school pressures, friend issues, etc

Could it be that using the Flonase set all this off? And of course, I have to ask myself, would she be in this mess had we not used it? Was her immune system doing it’s job is keeping it in check before?

Second question...LLMD has her on 10mcg T3 liothyronine. Is that a steroid???

Post Edited (Blakeleysmom) : 10/1/2019 7:34:13 AM (GMT-6)

Yes she started her on 5mcg, then retested after a month and upped it to 10mcg.
We retested again last week and I’m supposed to hear from them before next prescription. I feel like she’s keeping a good check on it, though I can’t tell taking the med has changed anything at all with my daughters condition.

Ok on the Flonase. The timing of that is crazy though. And my daughter is sensitive to everything so I thought it could be.

This is what the lab order says from last week:
Reverse t3, serum
T3, free
T4 free, direct, s
TSH

I’ll preface this by saying I don’t know much about these numbers. I pretty much am going on what dr is telling me she needs. (So much to study)
First results were as follows:
TSH 3.86 (upper end of range)
Free T4 1.36 (mid range)
Free t3 3.46 (mid range)
Reverse t3 24.3 (upper end)
Based on the above, our first LLMD did not recommend any medication

When we got to our new LLMD, she recommended the 5mcg based on the above. She felt like the higher reverse t3 was indicating the need for med.

Test redone at her office and results as follows:
TSH 9.26 (double the highest on range)
Free t4 1.1 (mid range)
Free t3 3.5 (mid to low)
Reverse t3 11. (Low in range)
This reverse number was 24 4 months before. Without med, it now went down to 11. However, the TSH jumped to double. This is when the LLMD recommended to go up to 10 mcg.

I don’t understand this but she said the numbers flipped which also indicates an issue??

The new labs taken last week haven’t come in yet.

I’ll take any advice/wisdom you have on the subject.

"TSH 9.26 (double the highest on range)
Free t4 1.1 (mid range)
Free t3 3.5 (mid to low)
Reverse t3 11. (Low in range)
This reverse number was 24 4 months before. Without med, it now went down to 11. However, the TSH jumped to double. This is when the LLMD recommended to go up to 10 mcg. "


Well, let's see what the new labs show.

How long since taking the 10 mcg were the latest tests taken ? (the ones you haven't got back yet)

Did she say why she prescribed T3 instead of T4 (levothyroxine)?

Astroman is very knowledgeable regarding thyroid - including meds...hopefully he will shed some light on this.

Did she say why she prescribed T3 instead of T4 (levothyroxine)?

No, and I didn’t ask bc I am not familiar with thyroid issues at all.

That high RT3 needs to be treated with a lot more T3 than 10mcg. She needs to be taking T3 three times a day. Ideally 10mcg each time. To clear out all that RT3. The TSH is pretty high too. While that isn't a reliable indicator, it is if it's high. Something is wonky. The doc is headed in the right direction with the T3 but she needs much more than that. Enough to lower her TSH to below the range. If the TSH is low the thyroid won't be producing much hormone on its own which means it won't be making RT3 either.

I wouldn’t expect Flonase to be an issue. I have always heard they are not the same as oral steroids in terms of side effects, although the prescription information does include a warning about it could make you vulnerable to infections.

Acute infections like viruses and respiratory illnesses can trigger chronic Lyme symptoms, and did in my case. If she was taking the Flonase for a respiratory illness, that illness could have weakened her immune system.

Thanks Astro

Email just came in. Here are new numbers:
T4 free .89 (low)
TSH 16.09 (up 7 more points so getting worse?)
Rt3 13.2 (in range)
T3 free 2.8 (in range)

Based on this, dr increased rx of T3 to 20 mcg

I am thoroughly confused so does this sound right?😊

Post Edited (Blakeleysmom) : 10/1/2019 8:02:06 AM (GMT-6)

No problems with thyroid at all that we know about until the Lyme issue came about. So strange.

Will the increase to 20 mcg T3 head us in the right direction? Why does it keep getting worse?
It seems numbers were actually better at the beginning before any med was taken. All numbers were “normal”, only RT3 was at the upper end of range. Now it’s all out of whack.

When on thyroid T3 med, and then blood testing thyroid for comparing test results, its important to get blood drawn at the same time of the day and the same time away from the last time T3 was ingested.

T3 will get jacked up over range easily if T3 med was taken in the last 8 hours- its fast acting.

I would also get the two hashimoto antibodies (not uncommon with lyme) tested; TPO and TgAb. The start of Hashimoto can be a roller-coaster of ups and downs of labs results.