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How do you figure mid range?
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How do you figure mid range?

FT 4 Range (0.6-1.9)
FT 3 Range (2.0-4.4)   What is the mid range of these and how do you figure it?

TSH   3.16 (0.34-4.82)     june 11                            
FT4    0.9  (0.6 - 1.9)
FT3   Dr refuses to test  Says labs are NORMAL But I feel like CRAP!!!!

My Dr lowered Synthroid from alternating .100 & .75 every other day (based on labs above) due to what he says are anxiety and depression symptoms to
.75 daily for 1 month, no new labs were done
Now he has lowered it to .50 daily and told me if I feel really anxious only take .25mcg.

This is my 3rd week on the .50mcg and I fell like death mind slow, tired, body aches (hands, wrists, knees,hips) digestive issues, sleep problems, severe anxiety, emotional, headaches, and weight gain.  

My dose has been changed 5 times in the last 8 months not sure if that may be part of the problem or not?
Dr will not retest till Oct.  Says labs are normal depression & anxiety. Prescribed Seroquel Xr and Klopin which do not seem to be doing much.(only been taking for 2 weeks)

I am going to order labs on my own so would like to know how to figure mid range of FT3 & FT4.  
Thanks in advance for taking the time to read this and any advice you have to offer.
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Avatar_f_tn
FT4 midrange is 1.25...(Subtract the lower limit of the range from the upper limit (1.9 - 0.6 = 1.3), divide that result by 2 (1.3 / 2 = 0.65), add that result to the lower limit of the range (0.65 + 0.6 = 1.25).

FT3 midrange is 3.2, fugured the same way.

Currently recommended TSH according to AACE is 0.3-3.0.  So, your TSH indicates you are a little hypO.  FT4 is quite a bit below midrange.

Of course, I'm not a doctor, but in my opinion, your doctor should be raising, not lowering, your dose based on your labs.  Anxiety and depression can be symptoms of hypo.  It sounds like you might need a new doctor.
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Avatar_f_tn
FT4 midrange is 1.25...(Subtract the lower limit of the range from the upper limit (1.9 - 0.6 = 1.3), divide that result by 2 (1.3 / 2 = 0.65), add that result to the lower limit of the range (0.65 + 0.6 = 1.25).

FT3 midrange is 3.2, fugured the same way.

Currently recommended TSH according to AACE is 0.3-3.0.  So, your TSH indicates you are a little hypO.  FT4 is quite a bit below midrange.

Of course, I'm not a doctor, but in my opinion, your doctor should be raising, not lowering, your dose based on your labs.  Anxiety and depression can be symptoms of hypo.  It sounds like you might need a new doctor.
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1202943_tn?1347844252
I would listen to your body and get a new dr.  When my TSH was 3, I felt awful.   Every symptom you are having is hypo.  I would increase your dose slowly.
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Avatar_m_tn
I agree with goolarra and Ericamegan.  In addition I thought you should have a look at this link about clinical treatment of hypothyroidism and compare it to what you are getting.  I think you will clearly see the need for a new doctor that will treat you 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.

http://hormonerestoration.com/files/ThyroidPMD.pdf
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Avatar_n_tn
Thanks so much for your comments and advice (especially on how to figure the ranges) Greatly appreciated!!!

I got the name of an MD (from a local health food store) who they say is the only MD in this area who runs the PROPER test for thyroid, say he thinks outside the box, and is willing to test FT3 and prescribe T3 meds (if needed).  
I can't get in till Oct 3 (so I hope he's worth the wait)

In the mean time I have deceided to increase my Synthroid (on my own) to .75 daily.  I know I should not be doing this with out my Dr's permission but there is no way I can go on like this for another 2 months. Since Ft4 mid range is 1.25 and mine is only 0.9 I don't think I should have any problems.  
Again thank you so much for your time.

Ecricamegan,
Thanks for your reply and you are right my body is not happy and I am hearing that loud and clear.   Have appointment with new MD and hoping for the best.  

Gimel,
Thanks for the link!  Seeing a new MD in Oct. and hopefully he is going to be the Dr. you have described.  Fingers crossed.  
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Avatar_m_tn
Why wait all that time to find out if the new doctor is one like you are looking for?  There is a way to find out a lot in advance, and perhaps avoid  a wasted appointment, after all that time.  I just call the doctor's office and tell them I am looking for a good thyroid doctor but that before making an appointment, I need to ask one of the nurses just two questions.  That almost always works to get a nurse on the phone.  

With the nurse, I ask if the doctor is willing to treat a hypo by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  Then I ask if the doctor is willing to prescribe meds with T3 in them.  If either answer is no, then I keep on looking.
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Avatar_m_tn
This is not rocket science.

Let's see.  You have depression symptoms. When you lower the medication they get worse.

Gee I wonder what could possibly be the cause of worsening depression/anxiety?

Even a 2 year old could figure that out!  Why the heck Dr's can't is COMPLETELY beyond me!  I just can not understand that!

Many people do not feel well until their Free T4 is mid range or above and the Free T3 in the upper 1/3 of the range.

You figure the upper 1/3 of the range this way.

Take the upper limit of the range and subtract lower limit of the range.  Take that result and divide it by 3 (to get 1/3).  Then subtract that result from the upper range limit.  

So in your example range of FT3 of (2.0 - 4.4)

4.4 minus 2.0 = 2.4    
2.4 divided by 3 = 0.8    
4.4 minus 0.8 = 3.6

So the upper 1/3 of the range is a FT3 is  3.6 or above
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Avatar_n_tn
can u look back at my post on my labs in july and tell me what my range would be best at? yhanks
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Avatar_m_tn
You stated the following I believe:

FT4 0.72 (0.77-1.61)
FT3 2.9 (2.3-4.2)

Mid range for FT4 = 1.19
upper 1/3 for FT3 = 3.57 or greater.

You clearly are low in both.  Which would indicate the first choice would be to increase the T4 medication, wait 6 weeks and test again.  

On the retest determine the rise in FT4 and FT3.  if both rise nicely then it is a matter of increasing the medication to become symptom free.  If however there is rise in FT4 but little or no rise in FT3 levels that would indicate you have a conversion problem.  And it would mean that you will need to add a medicine that has a T3 component in order to get the FT3 up to a level that you feel well.

Again all of this is based on symptoms.  Different people feel "well" at different levels.

IF on a a T3 med, prepare to have the TSH be well below 1.0 and the Dr. to have a fit and want to take you off or reduce your meds.  TSH is worthless test when on T3 or larger doses of T4 as the medication will suppress TSH rendering that test useless.  However you must also be conscience of Hyper symptoms,  As it is much easier to get you HyPER with a T3 med.  And that is nothing to mess with.
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649848_tn?1357751184
FT3 levels don't always rise adequately, when dosages of T4 med are first raised or when adding a T3 med.  It often takes a while for the FT3 levels to follow the FT4.  Even when I began taking a T3 med, it took several months for my FT3 to come up.  So you can't determine that you have a conversion problem on the very first increase of T4 med.
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Avatar_n_tn
thank you both..labs will be sept..7.still wondering about worse hair loss,andd fingers swellin!
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