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Lab results and TSH testing frequency question
Hi everyone! I'm new here. I noticed a lot of you are really good at interpreting lab trends...
I'm 31, female, and was diagnosed hypothyroid in January with a TSH of 6.81 I started on 50 micrograms Synthroid and retested TSH = 1 at the end of March.
I then developed a noticeable goiter and my hypo symptoms returned, so my doctor retested my TSH at the end of April, and it was found to be 4.33. We then increased Synthroid to 100 micrograms and retested TSH and for thyroid antibodies at the end of May. Antibodies were positive (antiTPO = 430) and TSH had climbed to 4.84, despite the increased Synthroid. I'm now on 150 micrograms of Synthroid and the doctor has arranged a quick card system at the lab so I can get my TSH checked every month without him having to write up lab requisitions each time.
Is it unusual to have TSH tested so frequently? Does Hashimoto's usually progress more slowly? How quickly does an increased dose of Synthroid affect TSH levels? (I've read it takes 6-8 weeks to see therapeutic effects, but does that mean symptoms, with TSH changes earlier???)
Also, I am wondering if my TSH of 4.84 would explain being so exhausted that I can barely walk a block, and being unable to work, or is there something else wrong with me? I was in very good shape prior to this, often jogging several kilometers. I developed the thyroid problem immediately after a severe case of Dengue Fever and my infectious disease specialist believes it triggured the autoimmune response. Could being hypothyroid slow my recovery from Dengue? I "should" be over Dengue by now.
Sorry, I snuck in a lot of questions there, didn't I? Any answers would be appreciated. Thanks. :)
I'm 31, female, and was diagnosed hypothyroid in January with a TSH of 6.81 I started on 50 micrograms Synthroid and retested TSH = 1 at the end of March.
I then developed a noticeable goiter and my hypo symptoms returned, so my doctor retested my TSH at the end of April, and it was found to be 4.33. We then increased Synthroid to 100 micrograms and retested TSH and for thyroid antibodies at the end of May. Antibodies were positive (antiTPO = 430) and TSH had climbed to 4.84, despite the increased Synthroid. I'm now on 150 micrograms of Synthroid and the doctor has arranged a quick card system at the lab so I can get my TSH checked every month without him having to write up lab requisitions each time.
Is it unusual to have TSH tested so frequently? Does Hashimoto's usually progress more slowly? How quickly does an increased dose of Synthroid affect TSH levels? (I've read it takes 6-8 weeks to see therapeutic effects, but does that mean symptoms, with TSH changes earlier???)
Also, I am wondering if my TSH of 4.84 would explain being so exhausted that I can barely walk a block, and being unable to work, or is there something else wrong with me? I was in very good shape prior to this, often jogging several kilometers. I developed the thyroid problem immediately after a severe case of Dengue Fever and my infectious disease specialist believes it triggured the autoimmune response. Could being hypothyroid slow my recovery from Dengue? I "should" be over Dengue by now.
Sorry, I snuck in a lot of questions there, didn't I? Any answers would be appreciated. Thanks. :)
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Two and a half years ago I was told that I am Hypo after experiencing all of the symptoms and detecting two nodes. I had an ultrasound guided biopsy on the larger node, and the test was unsuccessful as my node is too close to a major artery.
I haven't been presribed any meds, nor sent to an Endo. After taking the natural ThyroSmart, my last TSH level is 4.84. I still have all the symptoms, however the ThyroSmart has helped somewhat! I recently had an ultrasound and my nodes are unchanged.
I can't understand why I'm not put on meds or sent to an Endo Specialist, especially when it runs in my family?
I haven't been presribed any meds, nor sent to an Endo. After taking the natural ThyroSmart, my last TSH level is 4.84. I still have all the symptoms, however the ThyroSmart has helped somewhat! I recently had an ultrasound and my nodes are unchanged.
I can't understand why I'm not put on meds or sent to an Endo Specialist, especially when it runs in my family?
Thanks, guys!
Very good point about the T3 conversion. I didn't know that T4 usually depletes first. Hmm...sure am glad I'll be seeing an endo. Hopefully, he'll be willing to work with something other than Synthroid. I'll ask about the low T3 and retesting it for sure.
Very good point about the T3 conversion. I didn't know that T4 usually depletes first. Hmm...sure am glad I'll be seeing an endo. Hopefully, he'll be willing to work with something other than Synthroid. I'll ask about the low T3 and retesting it for sure.
Nice post AR - You are the guy!!
and I am impressed at the conversion solution -- you are A -1.!!
Good luck poster at that appt - post back soon!!
and I am impressed at the conversion solution -- you are A -1.!!
Good luck poster at that appt - post back soon!!
Wow.
Your Free T4 looks good, but your Free T3 looks terible.
My guess is all your guesses are correct.
You should notice a dosage increase in a week or so. It won't ramp up to full strength for six weeks, but you will notice a difference in a week or two.
I would try not to run soley off of TSH tests for a year. You may be having T3 conversion problems. Usually if you are low on hormones the T4 depletes faster than the T3. Because T4 turns into T3. You have enough T4, it looks like. The T3 hormone level should stay steady until the T4 hormone gets low.
It may straighten out on it's own. It may not. I'd watch the next test cycle and see the Free T4/T3 numbers. You may need T3 supplementing as well. Or a different med like Armour.
But with the extreme illness you've been through, and the goiter, and the antibodies, there are several things that may be going on with your thyroid. It's hard to say without more testing. Good luck at the Endo appointment.
Your Free T4 looks good, but your Free T3 looks terible.
My guess is all your guesses are correct.
You should notice a dosage increase in a week or so. It won't ramp up to full strength for six weeks, but you will notice a difference in a week or two.
I would try not to run soley off of TSH tests for a year. You may be having T3 conversion problems. Usually if you are low on hormones the T4 depletes faster than the T3. Because T4 turns into T3. You have enough T4, it looks like. The T3 hormone level should stay steady until the T4 hormone gets low.
It may straighten out on it's own. It may not. I'd watch the next test cycle and see the Free T4/T3 numbers. You may need T3 supplementing as well. Or a different med like Armour.
But with the extreme illness you've been through, and the goiter, and the antibodies, there are several things that may be going on with your thyroid. It's hard to say without more testing. Good luck at the Endo appointment.
Yes, I have Hashimoto's. My anti TPO was only 430 (I've heard some people have much higher), but I guess a few antibodies can do a lot of damage quickly since they act on enzymes. So the number of antibodies doesn't determine the rate or amount of thyroid dysfunction?
Thanks, AR-10. So I am odd... Well, my guess is that my thyroid hormone production dropped off so quickly due to amped up immune attack. The Dengue I had is infamous for provoking strong, and sometimes deadly, immune response. I'm not sure why TSH would sort of even out at the end of March on 50mcg and then suddenly decline. Perhaps it was just the time needed for antibodies to the thyroid to be produced en mass?
I am also very tall, and gained 20lbs quickly since this whole thyroid decline began making me now overweight at 190lbs, so my body mass is much more than the average woman. This body mass could affect my need for more thyroid hormone?
I had a free T4 and free T3 done at the end of May.
FT3 = 4.2 (reference range 4 - 7.8)
FT4 = 19 (r.r. 11-22)
I'm guessing the increased TSH is because of dropping T3 (almost at the end of the range). I've read that younger people usually have more thyroid hormone, so perhaps this amount of T3 is too low for me, despite being in the normal range.
How long after increasing oral T4 would you expect to see an increase in T3?
There are no plans to check T4 or T3 in the future, just TSH every month for the next year! I'll finally see an endocrinologist on July 25th. Just wondering in advance... I find the waiting so difficult and I always have so many questions.
I am also very tall, and gained 20lbs quickly since this whole thyroid decline began making me now overweight at 190lbs, so my body mass is much more than the average woman. This body mass could affect my need for more thyroid hormone?
I had a free T4 and free T3 done at the end of May.
FT3 = 4.2 (reference range 4 - 7.8)
FT4 = 19 (r.r. 11-22)
I'm guessing the increased TSH is because of dropping T3 (almost at the end of the range). I've read that younger people usually have more thyroid hormone, so perhaps this amount of T3 is too low for me, despite being in the normal range.
How long after increasing oral T4 would you expect to see an increase in T3?
There are no plans to check T4 or T3 in the future, just TSH every month for the next year! I'll finally see an endocrinologist on July 25th. Just wondering in advance... I find the waiting so difficult and I always have so many questions.
Is the dotors possibly running the labs because of the antibodies attacking the thyroid? If determined HAshi and you keep moving up and down on your TSH he/she may feel the need to monitor the levels often.
The Free testing is needed as AR states too.
The Free testing is needed as AR states too.
Normally, TSH testing is every six weeks, but in certain circumstances it is run more frequently. You are an "odd duck", so you are being monitored more closely.
Your med dosage should not be as high as it is, based on the good result you had at 50mcg. But your TSH seems to be getting greedy. It is odd to see hormone production drop off so quickly.
Are you having free T4 tests and Free T3 tests run?
There must be some reason your med dosage is being raised so quickly. Maybe you are not processing the med properly.
It takes about six weeks for a dosage change to come to full strength in your body, but you often feel the difference in a week or two. Symptoms on the other hand may go away quickly or may hang on for months.
Your med dosage should not be as high as it is, based on the good result you had at 50mcg. But your TSH seems to be getting greedy. It is odd to see hormone production drop off so quickly.
Are you having free T4 tests and Free T3 tests run?
There must be some reason your med dosage is being raised so quickly. Maybe you are not processing the med properly.
It takes about six weeks for a dosage change to come to full strength in your body, but you often feel the difference in a week or two. Symptoms on the other hand may go away quickly or may hang on for months.
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