I forgot to say that I'm going to new endo in about 2 and a half hours. I want to know what I should say to him. I want to try to get either a T3 med added or natural thyroid med if possible. You Know how most endo;s are. I hope this one listens.
What you can say to him is that thyroid patient treatment should be all about relief of symptoms. The best way to do this is to test and adjust FT3 and FT4 levels with whatever meds are required to alleviate symptoms, without being constrained by resultant TSH levels. Frequently this requires that FT3 is adjusted into the upper third of its range and FT4 is adjusted to at least the midpoint of its range. The upper third of the range you listed would be 3.6-4.4.
If the doctor has some reservation about this, you might also tell him that the ranges for the Frees are far too broad to assure you are okay if your results just fall within the low end of the ranges. The rationale for this is that the ranges for the Frees have never been adjusted like was done for TSH 7 years ago. As these ranges exist currently they should be considered as guidelines within which to adjust the levels as necessary to alleviate symptoms.
Just noticed your first post. It is better to keep all on one thread, so that info does not get overlooked. From your test results, it appears that you could use some T3 as a supplement to your meds, either from a T4/T3 combo med, or A T3 med like Cytomel, depending on what your doctor is comfortable with.
While you are there you might also ask about testing for Vitamin D and B12 levels, ferritin, and also reverse T3.
Thank you so much for responding. This is my first visit with this Endo. The first endo refused to take a Free t3 test, he said it wasn't needed. I called this one and before I made an appt I asked if he would check T3free T4 free and tsh, he said he would. He said he would fax script to lab. When I went to lab there was no Free T3 test ordered just total T3. I had to call his office from lab and tell them to add Free T3 to order or I wouldn't do the lab work. They added it when I insisted. It's like pulling teeth to get these Doctors to order Free T3 tests. He said it wasn't as accurate as total T3. I thought it was the other way around. I printed many articles from about.com to show him. Wish me luck! I think I'm going to need it!
I agree with gimel. Your FT4 is a bit on the high side, but your FT3 is just at midpoint, which is often too low for us to feel comfortable. Adding just a little T3 might make you feel so much better. Don't forget that when you add T3, you have to decrease T4 meds at the same time to achieve the equivalent overall dose. The rule of thumb is to decrease T4 by 25 mcg for every 5 mcg T3 you add. This is because T3 is about four times more potent than T4. Good luck with your appointment.
I just returned from endo appt. He actually listened to me! I went to the appt armed with print outs from the New England Journal of Medicine,articles from about.com. Any and all info on Free T3 versus total T3 I could find, treating symptons not just numbers. He agreed to let me try cytomel added to T4 med since I was having symptons even though my tsh was low. I am posting my new lab results here so everything is in one place. If anyone has any more advice I would greatly appreciate it. He is also lowering T4 med when he adds cytomel. I also asked for next lab to check Vit D, B12 and Ferritin as Gimel suggested. He wouldn't check revT3 but its a start in the right direction.My lab results from 3/2/10 TSH 0.082 range 0.450-4.500, FT3 3.2 range 2.0-4.4,FT4 1.55 range 0.82-1.77 Total T3 133 range 72-180. I am being surpressed due to thyroid follicular and papillary cancer. I hope that the addition of cytomel will make me have less symptoms.
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