Blood Tests

[Porgeous]

Hi there

Just had my latest results.  I started meds at 50mg gradually increasing to 100. I had a re-test after being on 100mg for two weeks and was within normal range.  Endo asked for a further test after six weeks as it was too soon to tell.  I am awaiting his comments on my latest results but thought I would post in case anyone has any insight.   Seemed a bit curious that my Free Thyroxine had gone from being one side of the range to the other!

Thanks

Original Tests:
TSH  *14.65   Range 0.27 - 4.20            
FREE THYROXINE  *10.8  Range 12.0  - 22.0              
FREE T3  4.8  Range 4.0 - 6.8  

After two weeks at 100mg:

TSH -    3.04 Range 0.27 - 4.20              
FREE THYROXINE  18.7  Range 12.0  - 22.0            
FREE T3  5.1 Range 4.0 - 6.8                

After six weeks at 100mg:

TSH *4.48  Range 0.27 - 4.20                              
FREE THYROXINE  *22.8  Range 12.0  - 22.0
FREE T3  4.4  4.0 - 6.8  Range 4.0 - 6.8      

[stella5349]

over 80% of all hypothyroid patients are lead to think.. "Oh I can take a pill everyday and be just fine". The same over 80% people find out - it's not that easy as they thought....

Great - talk to your endo. That's really good. I do however strongly advise you to research the information Goolaara and I suggested about RT3 and FT3 conversion so you can have an intelligent - well rounded conversion on these issues. It sometimes is best to know what you need to know when talking these things over with your doctor.

There's a "reason" why you are in this position. Thyroid disease does not just appear out of nowhere. Vitamin - mineral - supplementation deficiencies - stress - weight - trama - diet and lack of exercise are causes in most cases. Family genes are some too.

[Porgeous]

Thanks so much to you both, I think I am beginning to get my head around the T3/RT3, certainly enough to raise it with my Endo which is really helpful.

I haven't been taking any supplements, I'm still a relative newbie in this bewildering world but will look into that too.  I guess I am trying to judge how I feel now in comparison to when I first found out about my thyroid a couple of months ago.  At the time I was falling asleep pretty much all the time, I likened myself to a childhood doll in that whenever I led down I fell asleep!  That has certainly improved and I now consider that I lack energy rather than feeling exhausted although I think there is still room for improvement.

Now having read all your good advice I think I need to have a longer conversation with my Endo at our next session to really try and get to grips with understanding it more thoroughly as up until now I have adopted the approach of take the meds and see what happens.  After my first re-test all coming in within range I thought bingo, problem solved but these latest tests have thrown a spanner in the works!

I also still have a "palpable" goitre and am having a scan done by a specialist in the area so those results will also hopefully shed some more light on what is going on.

Can't thank you both enough for giving me some excellent info!

[stella5349]

typed this nice post to support goolaara in her comments and my stupid internet kicks me off before it got posted.... ARGH!!!

Good job Goolaara... nicely done here.

One thing I was touching on before I got kicked off  the internet... was the high FT4 and the Lower FT3 levels. Upside down is a good way of putting it here.

Porgeous - based off those labs there is no indication of hyper at all... You may think because of the high FT4 readings that would say that - but no, off all those tests there is ONLY hypo showing up. Remember FT4 is your "conversion" hormone measured and really does nothing on bringing symptoms on - or off. That would be your FT3 that tells all that when it comes to symptoms.

Question to ask?? - WHY?? that would be what you want to know.

Really goolaara hit it right on the head.. Thinking this could indicate a conversion issue and/ or an RT3( reverse T3) should be looked at. Your doctor should be able to run labs and tweek things up if need be after those are ran. Depending on the testing - a T3 med WITH your Levo - or maybe just T3 alone for a while could get things back in check for you.

You could however look at supplementation to "see" if you can put that FT4 in check better... Are you taking any multi's or daily supps right now? A few supps you may want to read about could be Vit - D-3 and B's. another real issue could be the lack of some basic amino acids like Acetyl-L-Carnitine - L-Glutamine and especially L-Tyrosine.

Also another helpful thought would be to see if liver panels ( just basic tests) could be done to see if you "filter" system organ is.... clogged ... lol. Taking steps to maintain a healthy liver is and should be critical in taking any swollowable medication since the liver will need to convert almost 100% of that into the hormone you need to feel well. Get the tests and talk to your doctor about supps DIIM maybe for a while and basic lemon/water increase.

and.... ferritin tests and RBC magnesium... get those tests with your feeling with lack of energy rearing up. Those are both easy fixes if they are an issue.

[Porgeous]

Thanks so much for all your advice, I am seeing him again in Feb after my scan and will talk more to him about the T3.  I did also think it was odd that after an initial increase after my second blood test that my T3 has actually dropped (from 5.1 now down to 4.4).  I can't pretend I find it all that easy to understand but am encouraged that you too observed that my results seemed "upside down".  From what I can understand one reading would indicate I am Hyper and the other would indicate I am "Hypo".... it's a scary and complicated world I think!

[goolarra]

I'm assuming you are now taking 100 mcg of some form of levothyroxine, not a dessicated product and no T3 meds, like Cytomel.

I think it's wise that your doctor has not increased your dose.  Your FT4 is above range, so no increase in T4 meds is indicated, in fact a decrease might be in order.

However, your FT3 is a different story.  It is very low in the range.  Often, we don't feel well until FT3 is in the upper half to upper third of the range, and yours is in the lower quarter.  FT3 can be a bit tricky.  My experience has been that FT4 goes up first, and then there is a lag (can be considerable) until FT3 follows.  So, a bit of patience might be in order here.  That's a matter of how you feel at the moment and how much patience you have.

Also, the rule of thumb is that FT4 should be about midrange, and, as I said, FT3 in the upper half to third of its range.

So, my suggestions would be:

With your FT3 so low, I doubt it will be a problem, but keep your eye peeled for hyper symptoms and call your doctor for a decrease if these occur.

If your "upside-down" FT3/FT4 balance persists (low FT3, high FT4), consider adding some T3 meds to the mix (while at the same time lowering your T4 meds - for every 25 mcg T4 that you lower, you should add in about 5 mcg T3).  At the same time, you might consider having RT3 (reverse T3) tested.  High levels of RT3 indicate RT3 dominance.  T4 is converted to T3 and RT3.  However, when taking T4 meds only, some people start converting more T4 to RT3 than T3, so their bodies are still starved for T3.

Your lack of energy, I'm sure, has to do with your low FT3 levels.  Please, I cannot even write the word "normal" without putting quotes around it anymore!!!

Personally, I'd have the RT3 testing sooner rather than later (you have to have FT3 tested at the same time and look at the ratio between the two).

[Porgeous]

Hi there

Thanks for your reply.  I was taking a gradually increasing dose starting at 50mg, then 75 and then up to 100.  It was probably 4 weeks in total before I moved up to 100 and then a further two weeks at that level before I had the blood test.

I heard back from my Endo today who wants to keep it as is for the next 6 weeks and then re-test, he is concerned about moving me up doseage whilst my free T is high, I am also having another scan at that point as well.

I'm not sure how I feel, certainly not bad but still lacking energy.  It's hard because I didn't ever go to see the doctor about symptoms, thyroid was discovered almost by accident so I guess I am not really sure what normal feels like!!

Thanks again

[goolarra]

Also, how do you feel?  Do you still have symptoms?

[goolarra]

You don't say how much time elapsed between the "original tests" and the ones after two weeks on 100 mcg.  Were there any interim tests before the increase to 100 mcg?  If so, please post your labbs just prior to the increase to100 mcg.

Which thyroid meds are you on?