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Blood work

I currently take 50mg daily of levothyroxine. I missed 2 days of dosing during the week, (Tuesday & Wed) On Thursday, the Pharmacy didn't have the prescription ready till late, so on that day I took just a half, 25mg. Friday morning I took my regular dose before my doctor's appt. Blood work was done, the T2 and my level is up, so I'm low again. So my question is, did my missed doses give a false reading? I had mentioned it to the doctor but not sure she was focused when I actually was telling her.

Thanks for the help.
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Avatar universal
I have previously discussed with her using the older charts for thyroid. But she has to follow the guidelines of the hospital and even in the last year, Harvard published a journal on why using newer charts is not necessary. Without a larger percentage of adequate reasoning and benefits, large hospitals are not going to change.

I've been with this doctor for over 20 years and so with my other medical issues, hypertension, etc. I am comfortable with her. If my levels continue to change, I will suggest further testing. I do know my thyroid is being treated and link to my pituitary gland.

I appreciate all of the information. :)
Helpful - 0
649848 tn?1534633700
COMMUNITY LEADER
I admit -- it's quite intimidating to sit in the same room with a doctor, much less a Harvard professor (is she a thyroid expert?), and have to argue over the tests being done.  I've done it more than once and it's not fun. Depending on the ego, they can make us feel like dirt and many of us will slink out of their office and go home to bed ....... done that more than once, too.

We do find that Harvard professors (and hospitals with such strict guidelines - does this professor help set the guidelines for the hospital?) are probably an enormous stumbling block to thyroid patients, because they continue using/teaching outdated methods of both testing and treatment. They aren't keeping up with new studies that are proving better testing parameters or treatment methods, as well as narrower reference ranges that could catch many hypothyroid patients much sooner, or treat them much more efficiently.

You might mention that this Harvard professor is looking at an outdated TSH range.  We can point you to AACE website that recommended 9 yrs ago that the range for TSH be changed to 0.3-3.0, which would clearly put you in the hypo range, if we were going only by TSH, which we don't.  Doctors only go by the range the lab uses.

We can also point you to studies that show TSH doesn't correlate with symptoms; but FT3 and FT4, which are the actual thyroid hormones, do and that FT3 is most important, because that's the active hormone that the cells actually use, and without adequate testing, there's no way of knowing.  I can actually use  myself as a model for this......

If this Harvard professor were trying to treat my hypothyroidism, I'd have to kick her to the curb and look elsewhere for treatment, because she would keep me very ill - I went down that road a couple of times and would do everything in my power to avoid it again.

Some doctors have such an inflated ego that they won't even look at information indicating they're wrong.  I had a doctor who was like that...... he pooh-poohed, everything I tried to talk to him about....except TSH and when my TSH went to the basement, he started taking my medication away; I literally thought he was going to kill me.

Today, my TSH will read < 0.01 and most doctors will panic and want to reduce/take away my meds, but I still suffer from hypo symptoms because my FT3 and FT4 are not as high as they need to be........

That's my rant -- and I hope there might be something useful for you.

You need to get tested for thyroid antibodies (Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TGab)) to determine if you have Hashimoto's.  That will give you an idea of what to expect.  

In addition, you need to get the FT3 and FT4 tests done.  

If you have other options for a doctor/testing, I suggest you exercise them or you won't get better.

There are also lab tests that you can order online and take to your doctor to actually show what your levels are.  If you'd like more info, we'd be happy to provide it.





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Avatar universal
Blood work is every 6 months on average. Though I was tested in July 2011 and then again in September when I was ill with pneumonia. Most recent was yesterday. My levels only changed from September till now.

How do I tell a doctor that is a Harvard Professor to boot, that she is not testing correctly? The hospital has guidelines for testing Thyroid.
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649848 tn?1534633700
COMMUNITY LEADER
If you're able to access your lab report online and it doesn't show Free T3 and Free T4, your doctor isn't doing them, and she's doing you a disservice by leaving them out.  Free T3 and Free T4 are the actual hormones the thyroid produces, and are much more important than TSH.

Hashimoto's is an autoimmune disease in which the body sees the thyroid as foreign and produces antibodies to destroy it.  The destruction process usually takes years/decades to complete, but it as it progresses, the thyroid produces less and less hormones, so you have to keep increasing med dose in order to keep up with it.

Hashimoto's would not show up on a scan of the pituitary gland; it would only show up on an ultra sound of the thyroid or via blood tests for antibodies, Thyroid Peroxidase Antibodies (TPOab and Thyroglobulin Antibodies (TGab).

How often do you normally get blood work done?
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Avatar universal
I've been treated for Hypo for years now. I had my pituitary glands looked at thru an ultrasound I believe ... It was many years ago. I just remember seeing a specialist and having a test done in relation to my thyroid. All that I was ever diagnosed with is hypo.

The doctor hasn't ordered an increase yet as the test was just done yesterday. I'll be speaking to her this week.

I've never seen the blood work results list Free T3 or T4. But it just may be something I don't see that is listed on what I get to view ... They are now online results for patients.
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649848 tn?1534633700
COMMUNITY LEADER
Okay, now it makes sense.  Things don't always post just right sometimes.  Is TSH the only test being done?  TSH is a pituitary hormone that fluctuates widely, even in the same day.  It should never be used, alone, to diagnose or treat/determine dosage for thyroid issues.

Can you get your doctor to test the Free T3 and Free T4?  Those are the actual thyroid hormones and will give a much better picture of thyroid status.

Does sound like you may be hypo.  Did your doctor give you an increase in medication?  Do you know if you have Hashimoto's Thyroiditis?
Helpful - 0
Avatar universal
The results listed look like this: T2-TSH--- 5.75 Marked, High

Group Name TSH
Normal Range 0.40-5.00

My previous blood work was 3 months ago, and was 4.80.

Yes, I have been recently feeling very tired and having issues with prolonged periods, etc. So it was being checked now to address any changes.

Thank you for your help :)
Helpful - 0
649848 tn?1534633700
COMMUNITY LEADER
Levo takes at least 4-6 weeks to become stable in your body and stays in your body a long time.  I'm sure your missed doses didn't have anything to do with your levels being off, because those levels would have resulted from medication taken a couple weeks prior.

I don't understand what your  mean "Blood work was done, the T2 and my level is up, so I'm low again".  T2 is not a test that's done.  What level is up?  TSH?  Is that all your doctor is testing?  You need also to be getting the Free T3 and Free T4 tests done.

Do you have symptoms of being hypo?  What were your actual test results, with reference ranges?
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