Wondering if anyone could provide input on labs. Started Synthroid last June-----levels were never high and I never got hypo (range was 5 of higher for hypo at that time). Dr. gave me meds based on symptoms. Have felt a lot better but have ups and down..........these are most recent labs. I am feeling pretty good but could do better. My TSH went up from the last 2 tests. I was around a 2-2.25 then and want to get lower to at least 1-1.5. It is taking time. Dr. said to retest in 6-8 weeks and then we would move up to 75 of synthroid from 50.
What about T3/T4..........how does everything look?
There is not much room in your labs for an increase. FT4 is almost in the upper quarter of the range. FT3 is almost topped out in the range. What are your current symptoms? If your doctor is suggesting a possible increase, what is he basing it on? TSH is a bit high in its range, but with your FT3/4 so high, I wouldn't base an increase on it.
You say you were never hypo. What do you mean? Did you have symptoms when your doctor put you on meds? What were your FT3/4 before starting meds? Why do you want a TSH of 1-1.5?
I am still have lots of hair loss (eyebrow has almost all fallen out), fatigue, hand/face/feet swelling, water retention, and aches/pains. I have felt much better since starting synthyroid but still have lingering symptoms that interfer with day to day.
In terms if never being hypo-----I never got over the 5 range at the lab but had symptoms. Antibodies for Hash's were high. I was right at about 4.5 before starting meds (overall TSH) and would bounce around back and forth. I have now stopped bouncing. I had always heard you should get your TSH around 1-2 so that you can feel your best. I felt best around a 1 when TSH hung around those levels.
Do are my labs good? I do not know much about FT3 and FT4 and where you should have those.
Your FT3/4 are both very good. The rule of thumb (one of those rules meant to be broken!) is that FT4 should be about midrange and FT3 should be in the upper half to third of the range. Yours is considerably higher than that with FT4 almost at the 3/4 mark in the range and FT3 almost at the top of the range. FT3 and FT4 are much more important than TSH since they are the actual thyroid hormones and correlate with symptoms much better than TSH (a pituitary hormone that causes NO symptoms). FT3 correlates best of the three.
How long has it been since your last meds increase? And how long have your FT3/4 been looking so good? We often see an improvement in labs before an improvement in symptoms since the body still has to have time to heal after reaching proper lab levels. This lag can be fairly long , especially if you were hypo for a long time before starting meds. There's a lot of repair that has to go on.
TSH levels at which we feel our best are very individual. Some of us would be very hypo with a TSH between 1 and 2, and some of us would be hyper. It just doesn't work for all of us to be there. Remember, TSH is only a messenger from pituitary to thyroid to tell the thyroid to produce more hormones. TSH does not cause symptoms. Low FT3/4 causes symptoms.
Do you know what your FT3/4 were when you felt your best? Once you know that, you can adjust FT3/4 levels to get maintain maximum symptom relief.
Hi there! Thanks for all the info. I honestly cannot remember my last labs except for the TSH. I can say that I have recently felt better than any other time. Right now is the best, although the other symptoms are still remaining. I am getting checked again in 8 weeks. I will be sure to post those.
One pointer: My endo tells me to get my labs done in the AM and then take my Synthroid after my blood is drawn. If you are still having hypo symptoms, then I wonder if you had your labs after taking your meds?
Your FT4 could budge just a little higher. FT3 is in the high range. If you get your FT3 any higher and you are still feeling hypo, then maybe it would be time for a reverse T3 test to determine if you have reverse T3 working against your current T3 levels. That may explain why your FT3 is relatively high but you still feel hypo.
My doc primarily treats my symptoms, too. My FT3 is slightly high, but I feel fine.
T4 meds should not interfere with bloodwork. The important thing is consistency...either take your meds or don't before every time you have labs, and have your blood drawn at the same time of day, regardless of when that is. I have been told to take my meds before bloodwork...after all, you are now looking at medicated levels. T3 meds are a different story.
Tamra, you're projecting. Diazmommy's FT4 is a bit on the HIGH side, if anything. The recommendation is midrange on FT4, and hers is at 73%. Hello, what about midrange do you interpret as 73%??? 73% is a long way above midrange.
I'm still thinking symptom relief may take time to catch up to labs. We still don't have an answer on how long labs have been at these levels. Does her body still need time to heal? If so, symptoms will linger for a while.
My endo said that T4 meds DO interfere with bloodwork. He has been treating thyroids for 25+ years.
My FT4 is a 1.5. Hers is 1.46. My endo said 1.5-1.6 is good for Hashi.
I said her FT4 'could' budge, not that it 'should' budge. I am looking at symptoms, and yes, she could need time to adjust to these meds, but from what I was interpreting in her post, is that she is still at 50 and hasn't had a bump.
Well, my endo (been around a while...about as long as me) argues that a medicated reading should be a medicated reading, and I agree. T4 levels are just not that volatile. You want to know what the meds have done to your levels, so what logical sense does it make to skip the dose? Keep it constant and let it reflect your true day-to-day status, which is medicated...
If my FT4 were 1.5-1.6, I'd be dead. I've never gotten anywhere near that, and don't want to since I went hyper at a lot less. His statement of "1.5-1.6 is good for Hashi's" is ludicrous. We're all much different than that...much more individual. If you don't mind being pigeonholed into that kind of narrow range, fine, but I do. My advice reamins that you find the FT3 and FT4 level that is right for you and maintain that, regardless of some artificial level that your endo thinks is "right for Hashi's". It may be right for Hashi's, but it could very well be very WRONG for YOU.
I still want to know how long these levels have been in place, how long she was hypo before starting meds, and if her body has had time to heal.
I agree with you that further testing would be indicated before another increase. With her levels, an increase could send her over the edge pretty easily. I'd want an explanation before dumping more T4 meds into my body. I just don't see a T4 increase indicated in these labs...unless something else is going on that would warrant it. But, it's much more likely that some for of T3/T4 therapy or T3-only might be more appropriate.
And YOU need to realize that what is good for YOU might not be good for HER. Based on her symptoms, her endo is already planning on increasing her meds after a retest in 6-8 weeks. By that time, she will most likely need the increase. I was just agreeing with her and her endo.
I'm not telling her to rush to the nearest endo and demand an increase right now.
And, actually, I left off a part about the 1.5-1.6 good for Hashi. My endo meant in early stages. He treats my mom who's had Hashi for ages, and he keeps her frees much lower. I am assuming Diazmommy is like me and in the early stages, since she started treatment last summer around the same time as me.
But these are all assumptions and it's silly for us to bicker over assumptions.
I stand by my belief that her endo should most likely bump her next visit if her symptoms of hypothyroidism continue.
Sorry...forgot to add....
The levels look fine to me and you should be aware that the TSH can fluctuate at any given time.
The TSH can be high one week and normal two weeks later so for the time being...I'd stay as you are as in my opinion, you are at risk of going 'drug induced hyper' should you increase.
Only IF the FT3 and FT4 lower...would I increase the meds.
Just my personal opinion.......
Thanks everyone!...........I have actually been on the meds since last summer. I started out at 25 and then increased to 50 around August to September. I believe that the last labs were around midrange for both T3 and T4 last. However, I am not sure because I was paying attention mainly to the TSH. I am glad that I know to look at the others now.
I felt hypo years before I got meds........Dr. only looked at TSH then. But, I would bounce back and forth 5-2....then up to a 4 then down to a 1 all the time. Even though I did this I felt hypo.
It's not necessary to "bump" med just because a person has been at the same dosage for a while and has never HAD a bump.......it's not something that automatically HAS to happen. Chances are, she will need a bump at some point, but doing it just because she's never had one doesn't make sense, when her levels look like that.
I agree that the levels look fine -- I'd hate to see them go any higher for fear of going hyper. Personally, if I had to make a choice, I'd prefer to stay a bit hypO, rather than go hypER.
Not everyone - or all Hashi's - needs their TSH at a level of 1-2. Mine is so low, it scares everyone but myself and my endo. We are all so individual that we can't say anything "across the board" for either hypo or Hashi's. Likewise, we don't all need our FT4 at 1.5-1.6 -- let's remember that different labs use varying reference ranges. The range that MY lab uses for FT4 is 0.8-1.8, so if my FT 4 were at 1.5-1.6, I would most likely be bordering on hyper.
I'd say diazmommy needs time to heal to see if that will alleviate the symptoms AND it's possible that it's not all thyroid related. There are other issues that can cause the same or similar symptoms. Either way, she will need to give the med time to
get her "well" in order to find out.
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