Quick Question about recent labs at hospital

[danie17075rm]

I was recently in the ER for chest pains.  The doctor told me my thyroid was normal and I didn't pay much attention to it at the time (I was in severe pain).  Last night I was looking over my test rests and it was not normal.

5 weeks ago my test results were as follows:


TSH:  17.9   (.35-3.7)
free t3:  2.05  (2.18-3.98)
free t4: 1.05 (.76-1.46)

The ER did not test free t3 but this is what they got a few days ago: (note, after the bad results of the test from 5 weeks ago I increased levothyroxine from 125 to 137.. I am still on that dose).

free t4 1.23   (.61-1.12)
tsh 2.43 (.49-4.67)

Does this mean I am going hyper on this dose?  I am having heart issues right now so the last thing I want to do is go hyper?  I have an endo appointment in a few days and was going to just give him these results, but wonder if I should get my blood tested again tomorrow anyway so that it includes free t3.  Any suggestions?

[Totie]

I can't say what my EKG states other than abnormal heart rates according to the nurses, but I am always reassured when I go see my cardio doctor.

It just happens to be the way I am.

I have the chest pains off & on, but sometimes I wonder if it is chondritis (sp?)...

I do have hight metabolism I admit, but sometimes it makes you wonder...

[danie17075rm]

I will try to, although I am afraid of exercise at this point lol.  I'll do my best though.  I am trying to just not think about it.

[danie17075rm]

Do you ever have st-segment changes on your tests?  That is what they are mainly concerned about with me.  The ER doc said she thinks it is probably rate related (meaning they happen when my heart rate goes fast), but she cannot be sure.  I never had the chest pains when my heart was racing really bad for the last few years though.

[Totie]

I have the heart racing issues. ALWAYS have with thyroid problems. I guess I don't worry about them because after 18yrs you get used to it.

I also had to have the stress test as well as the nuclear one. Everything okay even though my EKG shows different everytime.

My heart just stayed with the racing off & on everyday when I developed graves/hyper. I do get chest pains, but I know they are from my racing heart because every heart test is okay. I just have as my cardio states "have a fast metabolism"...

I think if I were to have a slow heart rate it would freak me out....I am so used to the rapid HR.  In the last month I have had 3 surgerys. Abdominal, knee & removal of bladder sling & EVERYTIME I go in for pre op EKG I have to have them call my cardio to confirm that the readings are normal for me.

My fast heart rate symptom stayed behind just like my insomnia did..

[Barb135]

There's always a doctor (or in my case a PA) present when you do the stress test (at least that's what they do at the facility I went to), so if anything happens, your medical professional is right there.  I was lucky that the PA monitoring my status was very friendly and kept up a conversation; there was also a technician on the other side of me, handling the technical portions of the test, and she sometimes joined the conversation, as well.  While I had been pretty nervous at the beginning, but I felt like I was in good hands, so it didn't take long to relax.  

Just consider it your daily exercise and enjoy it.

[danie17075rm]

Wow, no nuclear stress test for me! My heart really does race.  It is better now that I am not hyper, but I do get periods of racing.  When it races it is  not uncommon for it to shoot past 120.  It is much more controlled now and actually goes too low at points, but it does go up a lot when I am moving around or something.  I know that is normal, but sometimes it will shoot up really high just from standing.  When I have a panic attack it shoots up too.  I am really nervous about this whole thing so I am sure my heart rate will be up there when I go.  My heart rate is usually over 100 at the doctor's stuff like that.  Most of the time at home though it is in the 60-70 range.  I think starting the stress test at 100 will get me in my target range quite fast lol.   After having my thyroid removed (i was hyper at the time) my heart rate would not come down from 150 after surgery.  It stayed there for hours.  I thought I would never get to leave recovery and they injected me with so many heart meds that I can't believe my heart didn't stop.  NOTHING helped.  

Due to all of these periods of heart racing, I become irrational when my heart rate increases.  I mean I can run up the stairs and feel my heart rate go up.  This is NORMAL, but I panic myself, and start to feel like I can't breathe.  My body is so conditioned to the fear of not being able to bring my heart rate down.  Otherwise, I wouldn't  be so concerned over this test.  I am just scared because this will be the first time I really pushed myself this hard since I went hyper.  Eh, but you are right.  It is better than the alternative.  Hopefully it will turn out okay, and I can have a little peace of mind.  

I don't want to know my bp and heart rate while doing it, that will just panic me more lol.  Thanks for your story.  It's nice to know what to expect.

[Barb135]

Well, you can try the walk in the park approach, but doubt you'll get by with it!!   LOL

Does your heart really race all the time, or does it just "feel" like it's racing?  I ask that, because that's the way I was.... I could have sworn my heart was beating a couple hundred times/minute, when in reality, it often didn't even get up to 60....  Even now, sometimes, I feel like's going to race right out of my chest, and when I check it, it will only be like 50-65.... it's weird what panic/anxiety can do to us...

Be sure to tell them when you do the stress test that you have panic attacks; they're trained to deal with that, as well.  

Do your best on that treadmill - they do give you a chance to "build up" -- starting with "a walk in the park" and going up from there.  The person administering my test was right beside me and he chatted with me the whole time; even as they increased the speed of the treadmill and I could no longer carry on conversation, he kept me engaged.  They watched my bp and hr, the whole time.  I actually had bradycardia rather than tachy, even though it "felt" like tachy, so they began to wonder if  my heart rate would ever come up to target.  They had my little legs running pretty fast, before it finally did....

Just try to relax - I know, easier said than done, but it's a lot better than the nuclear stress test, which I understand, literally makes you feel like you're having heart attack. I don't think you want that.........

You're going to be fine.

[danie17075rm]

Hmm maybe I can ask to just walk in the park instead lol.  I am so out of shape at this point due to the troubles of the last few years.  Plus, my heart always races so I should reach my target heart range before I even start lol.  I now start to "panic" when my heart rate gets that high due to it going that high so much while hyper.  It should be interesting if I'm having a panic attack during it.  

[Barb135]

Will look forward to seeing your new levels.  Good luck with the stress test.  I did one, when I was at my most hypo, because of having shortness of breath; it was a walk in the park.......

[danie17075rm]

Yes, I'll find out tomorrow what is happening with the test including the free t3.  I have a stress test scheduled for the 23 too so... hopefully I can figure out exactly what it is.  I'll post my new results after I get them tomorrow.  Thanks for helping.

[Barb135]

Since it takes levo several weeks to reach full potential, it's unlikely that it would have been the medication, itself, but you could have reacted to the fillers/binders in the generic.   Then again, you just might not have needed the higher dose (from 125 mcg to 137 mcg).  

Were you able to get new tests done, to include the FT3?

[danie17075rm]

I just thought of something that could be significant.  When I was on 125 mcg's, my docs office gave me samples of synthroid.  At my visit 5 weeks ago they increased my dose to 137.  They did not have samples so I just started taking the generic levothyroxine.  Looking it back, it was a few days later (from my switch of synthroid to levo) that my chest pain started.  Could this be a cause?

[danie17075rm]

Thank you.  I will get tested again tomorrow.  Luckily, I live in a small town so even though my appointment is on Wednesday, they have the blood results if I get them on Monday.  I can see if my free t3 has also went up enough or if I should still add some t3 in.  Thank you for your help!

[Barb135]

Agree that you should get a test to include the FT3, before then endo appointment, if possible.

You may need to back off the T4 med and add a source of T3, but not without proper testing.

[goolarra]

Definitely...if you can have another test tomorrow to include FT3, that would be great.

It looks like your FT4 has gone up considerably on the increase from 125 to 137.  Your FT3 was SO low five weeks ago that if I were you, I'd want to see what the increase has done to it before wasting a good appointment with your endo.

Best of luck with your appointment...