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Don't understand results
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This patient support community is for discussions relating to thyroid issues, goiter, Graves disease, Hashimoto's Thyroiditis, Human Growth Hormone (HGH), hyperthyroid, hypothyroid, metabolism, parathyroid, pituitary gland, thyroiditis, and thyroid Stimulating Hormone (TSH).

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Don't understand results

Peroxidase antibody was 2379.1 rang is 0.0 to 9.0 and my thyroglobulin ab was 121.0 rang is 0.0 to 20.0. I do not know what this means and my doc was concerned but I have no idea what he ment. Tsh was 64.79 and t4 was3.2 can anyone shed some light to help me understand my results?
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Avatar_m_tn
Those are tests for the thyroid antibodies.  Your results mean that you have Hashimoto's Thyroiditis, which is the most common cause of hypothyroidism.  With Hashi's the autoimmune system incorrectly identifies your thyroid glands as being foreign to your body and produces antibodies that attack the glands until over a period of time, they are destroyed.   The result is that you will need gradually increases of thyroid meds, to offset the loss of natural thyroid hormone production.

From your test results I would expect that you already have some of the 26 typical hypothyroid symptoms listed in this link.

http://endocrine-system.emedtv.com/hypothyroidism/hypothyroidism-symptoms-and-signs.html

With Hashi's there seems to be two schools of thought to treating patients.  First is to start with thyroid meds early, to prevent the worst of potential hypo symptoms.   Other doctors tend to wait until the patient has overt hypo symptoms, before starting thyroid meds.  Personally I recommend that you don't wait any longer to get started with meds.  

When you next see your doctor, I strongly suggest that you request to be tested for Free T3 and Free T4 (not the same as Total T3 and Total T4).  If the doctor resists, just insist on it and don't take no for an answer.  Free T3 is the most important thyroid hormone because it largely regulates metabolism and many other body functions.  Free T3 has also been shown to correlate best with hypo symptoms, while Free T4 and TSH did not correlate.

A good thyroid doctor will treat a hypo patient clinically by testing and adjusting free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  symptom relief should be all important, not just test results.  You can get some good insight into clinical treatment from this letter written by a good thyroid doctor for patients that he sometimes consults with from a distance.  The letter is sent to the PCP of the patient to help guide treatment.

http://hormonerestoration.com/files/ThyroidPMD.pdf

When you go back for further testing, it would be a good idea to find out if your doctor is going to be willing to treat you clinically and also if he will prescribe meds with T3 in them.  If not, you will ultimately need to find a good thyroid doctor that will do both.  

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Avatar_f_tn
Started taking tirosint 100. My doc said I was in really bad shape. Trying to feel better but it's hard. I have had symptoms for a while but honestly I thought all of them were from something else. I hurt my back I over processed my hair. I was depressed ect never put it all together
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Avatar_m_tn
Just to give you some perspective, the only thyroid hormone test you had was Total T4.  TSH is a pituitary hormone and it is not reliable as a thyroid diagnostic.  Most of total T4 (and T3) is bound to protein molecules and thereby not biologically active.  The small portion that is not bound to protein, thus free, is the portion that does all the work of thyroid hormone in your body.  You need to insist that they test you for Free T3 and Free T4 every time you go in to the doctor.

Also, just getting your FT3 and FT4 levels into the bottom of the range is not likely to be adequate for you, either.  The ranges are far too broad.  Many of our members, myself included, report that symptom relief for them required that FT3 was adjusted into the upper third of its range and FT 4 adjusted to midpoint of its range.

Another thing to be aware of is that 100mcg is a pretty hefty starting dosage.  It might be better for you to start with 50 mcg and after 4-5 weeks increase by 25 mcg and then in another 4-5 weeks, go to the full 100 mcg.  I am saying that just to guard against an unwanted reaction to the med.  
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Avatar_f_tn
I have 1 test that says t4free direct taken by my first doc ob who said something was wrong and sent me to a endo it says .51 nothing in any paper work that say t3
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Avatar_m_tn
Okay, so you really haven't been adequately tested yet.  I suggest that you read again my previous suggestions about testing, treatment, medication dosage and finding a good thyroid doctor.  
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649848_tn?1357751184
Did your doctor start you out at 100 mcg Tirosint?  That's a pretty high starting dose. How long have you been on it?  
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Avatar_f_tn
Yes about 2 1/2 weeks I have pages of test  and my doc is supposed to be a good endo I did make a appointment with another doc but I can't get in till January just to see.  I will say since I started my meds I feel worse. My muscle aches are 3 times as bad
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Avatar_f_tn
There are so many articles to read and they all seem to range so different so my question is. How do I get my doc to do all these test that he didn't do the first time.
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649848_tn?1357751184
Starting out on too high a dose can be worse than starting on too low a dose.  It's usually best to start at a very low dose and let your body get used to it, before moving up to the next higher dose.  

It's quite common for patients to feel worse after beginning medication, because it takes a while for the body to adjust to having hormones its not used to having.

Make a list of the tests you think you need done and take it back to your doctor.  Many doctors don't connect vitamin/mineral deficiencies with thyroid issues, even though they are quite common. If your doctor refuses to test, he's probably not the one for you.
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Avatar_m_tn
I think if it were me, I would have a in-depth discussion with the doctor.  Tell him that you have been doing a lot of homework, studying about your hypothyroidism, and that you need additional testing, and you need to get started on thyroid meds because you have hypo symptoms already.  

Tell the doctor that you want to be tested for the biologically active thyroid hormones, Free T3 and Free T4.  If the doctor resists, then you should insist on it and tell him that Free T3 regulates metabolism and many other body functions.  Tell him that scientific studies have shown that Free T3 correlated best with hypo symptoms.  Tell him that study data have shown that people that don't have hypo symptoms usually have Free T3 levels in the upper half of the range and Free T4 around the middle of its range.

I would also explain that many hypo patients are also deficient in other areas, such as Vitamin A, D, B12, iron/ferritin, zinc, selenium, and RBC magnesium and that you would like to be tested for those to be sure they are not contributing to your symptoms.  

Then you should tell the doctor that you are going to need to be treated clinically, for symptoms, not just based on test results.  Ask the doctor if he is going to be willing to treat you clinically.  

After such a discussion, you should know whether to proceed with that doctor or not.  By the way,   how do you know that the new doctor is going to be any better than current ?  Is the new doctor going to be willing to treat cinically for symptoms, as I described?  Is the new doctor willing to prescribe T3 meds if needed?  I think you should try to find out instead of just waiting until January and then possibly finding out that he is no better than current doctor.  

On the chance that a member could recommend a good thyroid doctor based on their personal experience, where are you located?

  
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Avatar_f_tn
I'm in Cincinnati Ohio I have looked on line for high rated doc but if the info is there I am missing it thanks
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Avatar_m_tn
Sent PM with doctor info.  
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