Hashimotos/Confusing Test Results

[aireamdh]

I have been diagnosed since October of last year.Been quite the battle since. This is the first time I am upset with the doc.
November 1 TSH was 1.543/ Ft4 1.68 At this time a metabolic panel was also done. I had been on .125 mcg synthroid for only 3 weeks ,having gone up from .112.
November 2nd I underwent GYN surgery: hysteroscopy to remove uterine polyps, and D & C . Had a very difficult time with nausea/vomiting about 2 hrs after waking, lasting into the next day. Soon after this I noticed "hyper" symptoms increasing, along with an increase in what I can only describe as "dread" feelings with adrenaline rushes in the early ayem. This relieved by getting up and moving around. Have had this for months.
Results of metabolic/iron panel showed low values in all Iron areas. Iron=39 (ref range 45-145), %SAT=9(ref range 20-55%) Hemoglobin 11.8 (ref range 12.0-15.0)Ferritin=6 (ref range 10-291). Internist wrote he believed the am "restlessness" symptoms and nightmares were result of these low levels. I tried the recommended Iron supplements but was unable to tolerate. OTC Slow-Fe is better tolerated,tho not the dose he would like to see. Since I had been having an increase in hyper symptoms; worsening insomnia, anxiety, to name a few, he agreed I might be overmedicated and repeated TSH last week. The results have me baffled: TSH UP=4.034/ FT4=1.65. To further baffle, he said in note these results were fine. All along I had been told he wanted me somewhere around 1. Could 3 skipped doses, the surgery, the iron(especially ferritin) be contributing to symptoms/levels? Thanks

[GravesLady]

Three weeks after a med dose change is way too soon for testing, should be done 6 to 8 weeks after each med does change.
Your doctor is probably going by the Labs reference range when saying "results are fine." Your levels, without knowing your
F/T-3 and your Labs reference ranges, suggest chronic infection and could be due to recent surgery or sinustis.  
Three skipped dose would not affect levels due to the accumulated prior doses. Meds. are accumulated and last in our system up to approx 6 days, so you probably had enough in your system from past doses.  
Iron is a critical mineral, because while it is very necessary and often low in thyroid disease, iron intake without a corresponding intake of copper can deplete copper. In hypothyroidism iron is probably more deficient than copper and so should be supplemented first. Once iron is built up then a small amount of copper can be added. Iron is known as the strength mineral.  Are you taking zinc?  Too much zinc can cause hyperthyroid symptoms.
I'd retest in 6 weeks.  Also take into consideration healing time from your surgery.  Any operation is very hard on the system and probably will reflect in levels as well.  So heal first before changing medications.  Then go from there.


Good Luck - Feel Better!

[aireamdh]

Thanks VERY much for answering, and so quickly. I might post into the doctor forum as well, just for another opinion.  Up until now, my doc has been very supportive, telling me we would work together to find that "sweet spot" medication wise. That he would dose by how I felt, not so much the #'s.And he is usually good about sending me copies of the actual lab results.  The ref range from this lab for tsh =0.050-5.50, which I understand is an older range.

I am not taking extra zinc, but there is a small amount in the multivitamin I also have been taking.

The doc generally explains more in the results pages he sends, I am disappointed at no explanation for these higher #s and that he wants to retest in 6 months. Up till now it has been every 6-8 weeks. The test that was done only 3 weeks after change ocurred because of a mix up in my receiving mail instructions to up the dose from .112 to .125.  That mail traveled everywhere :) before it got to me.   He went ahead with test anyway,telling me it might be "off"

I wish he had told me the surgery could do this, explained more all around as was usual before now. In any case, thanks again. I have been reading this forum and belong to another in efforts to stay informed. I will indeed give this time, but putting in call to doc this morning as well to express disappointment in this reaction to results.