TRACKING SYMPTOMS & SIGNS (Vitals)
TRACKING SYMPTOMS & SIGNS (sometimes called Vitals)
When using T3 it is very difficult if not impossible to use thyroid blood tests to manage dosing in order to get the right overall amount of T3 or the right number, sizes and timings of individual doses.
The Recovering with T3 book lays out a protocol (the T3 Dosage Management System), for determining doses of T3 and for slowly and safely increasing the T3 doses in order to find the optimal dosage for an individual. The protocol uses both Signs and Symptoms. Signs are measurements that are not subjective, i.e. not based on an opinion. An example of a sign is body temperature measured by a thermometer. Symptoms are subjective. An example of a symptom is whether someone feels their energy level is good or not (there is no device to measure this). Signs are sometimes also known as vitals (or vital signs).
When using T3-only it is critical to track signs and symptoms in a rigorous way and record them. If this is done daily then it is the best way to assess T3 dosage changes.
HERE IS A GOOD SUMMARY OF HOW TO GO ABOUT THIS.
WHEN to collect sets of signs / symptoms for those on T3 (or T4/T3 or NDT):
1) Do not attempt to take vitals around the time of a CT3M dose, as this will disrupt sleep.
2) On waking/getting up or within 30 minutes of getting up which is probably more ideal. Don't do it in bed. Actually get up, dressed then do it.
3) Just before (5-15 minutes before) the first daytime T3 dose - so you can see what the situation is before the dose was taken.
4) 2-3 hours after the first daytime T3 dose - which is when it ought to be helping to raise metabolism. The difference between 3 and 4 (these points) can be very helpful with assessing dosing.
5) Just before (5-15 minutes before) the second daytime T3 dose.
6) 2-3 hours after the second daytime T3 dose.
7) If you have a third daytime dose of T3 then repeat 5) and 6) for that third daytime dose of T3.
8) Once in the evening e.g. 7 or 8pm.
For those NOT on Thyroid Treatment yet, take them:
1) Within 30 minutes of getting up.
2) Late morning.
3) Mid-late afternoon.
4) Eary-mid evening.
HERE IS AN EXAMPLE OF A PATIENT'S SYMPTOMS AND SIGNS IN THE RIGHT FORMAT:
*** START EXAMPLE ***
DATE: 8th March 2011
Date any T4/NDT Meds were Last Taken: 7 weeks.
GET UP TIME (we need to see if CT3M was being used): 7:00 am.
T3 (and other thyroid meds) Dosage:
SIGNS / VITALS:
TIME TEMP HR BP
07:30: 36.7, 95, 107/64
10:00: 36.8, 97, 101/65
12:00: 36.8, 92, 105/63
13:40: 37.0, 97, 109/65
15:50: 37.0, 94, 109/66
18:00: 37.0, 92, 106/63
If there had been any laboratory test results then these would be included, along with reference ranges - as laboratory test results are also signs.
SYMPTOMS SUMMARY: Tired in the morning with headache. Didn't sleep well previous night. Felt warm from 12 noon & a bit on edge in the afternoon. Had energy in the afternoon, body feels 'lighter' & head feels clearer.
*** END EXAMPLE ***
The above is clear and organised and only has the essentials in it. This thyroid patient created a diary with time stamped (dated) entries with this type of information, which made it easy for her to track progress after any thyroid medication change (in this case it was T3 medication).
Too much information, with many detailed descriptive comments, is almost as bad as too little, as it can be very difficult to understand it. Summarising the symptoms and signs collected into a few lines makes it easy to create a diary that the thyroid patient and their doctor can easily assess. Pages of information with many detailed descriptive comments are much more difficult to use. When the information is summarised tidily, and in a short amount of space, then any obvious patterns or results may be found far more easily.
The type(s) of thyroid medication being used, and the doses and timings, need to be recorded along with the signs (heart rate, body temperature and blood pressure, and any other laboratory test results). The time the thyroid patient gets up should also be recorded if they are using CT3M.
The get-up time is very important to have this if someone is using CT3M but helpful to know anyway.
Note: Waking temperatures can be lower when a woman's period is due.
All the information is in the Recovering with T3 book but I felt it might be useful also to have this recorded here.