Lap Test Translation - post cancer

[whittie918]

My TSH came back 0.02.  Was .044 two months ago.  Total T4 was 13.6 and range max was 12.  Doctor said I was too  hyper and lowered my meds (supposed to be suppressed for cancer).  He said I had play room with my TSH and he wants that T4 in range also.  Now the labs he did not draw so he did not know what the free t4 was.  This was a result of a physical I had.  He usually ONLY checks my Free T4 and explains that the total accounts for the part of the T4 that binds to the proteins and he dont need to know that necessarily.  Turns out after I got home that I did have a Free T4 taken and it was in range.  So I'm wondering a few things.  Should have he lowered my meds then?  What does a higher T4 total level mean?  More T4 binding to proteins.  Is this the proteins (thyroglobulin) that I'm supposed to not have much of now?).  Or all proteins in general?

Does this all make sense?  I hope so.

[whittie918]

bump

[ChitChatNine]

I am not a lab expert .. calling all others .. AR-10 and some others may be able to help you but I wanted to say hello ... sorry your orig. post wasn't answered.

Cheryl

[laura1967]

Free T4 is a measure of the amount of active T4 in the blood. T4 is converted to T3. A high T4 level can mean a conversion problem. Conversion problems can be caused by Hashimotos, adrenal insufficiency, and or selenium deficiency. Your doc should check your Free T3 level to see if it is a conversions problem.T3 is critical for the brain.....hence the lack of can cause brain fog, depression, etc. We should all be treated with T3 in small amounts. More doctors just aren't educated on it. That is why we have to be our own advocates. I have wasted a lot of time with a no brain endo and am in the process of changing docs...I should have done it eons ago. There are a lot of good docs out there we just have to find them. There are many people here on the forum that are being treated with T4 and T3 meds. Hope this helps somewhat.
Laura

[AR-10]

When a Total T4 test is run at the same time as a Free T4 test, the Total test is always higher for two reasons.

1) It is measuring the bound hormone as well as the Free hormone.

2) It is not as sensative a test and is notoriously inacurate.

The protein that binds T4 is not thyroglobulin. It is a protein specifically designed to bind T4. The Endo should be using your Free T4 and Free T3 to compare to yout TSH result and adjust meds based on all three results.

Free T3 tests are not run as often for a couple of reasons. They are more expensive, they have to be sent out, so the feedback takes longer to recieve, and running them more than once or twice a year, or to look for a specific problem, is not really neccesary.

So med changes are usually based on TSH and Free T4.

Your TSH is sinking lower, and maybe a small adjustment is warranted. I hope the adjustment was as small as possible, and you will be getting your levels checked again in six weeks.

The big question is, were you feeling hyper? TSH goes up and down through the day and the week, and if you had a draw every day the results would be slightly different.

I'd keep an eye on the calender and see if you can be retested in a month. That may be pushing it a little, but if your TSH is above the level you are seeking in a month, then you should either go back to your old dosage, or try to split the difference by taking two different strengths of the med in some sort of alternating schedule that gives you a weekly total med ingestion that keeps your TSH in the area you want it to be.

I'm not completely sold on the idea that we should all be taking small quantities of T3 med as well. I know a lot of people do. I know most people do not. Some members here can attribute ongoing problems to a shortage of T3. Most people do not have conversion problems and can manufacture plenty of T3 from the medication they are on.

What you see in a lot of people who take a T3 med as well as a T4 med is a very low Free T4, because more T4 is bound due to the abundance of T3. A high Free T4 (within limits) is not a bad thing as long as you are not suffering Hyper symptoms because of it.

Hope this helps some.

[whittie918]

He changed my dose from 150 to 137.  I did not feel hyper.  Now I'm worried that I'll feel tired more and with the summer coming, Its not good with the summer coming and I really do want to be as suppressed as I can handle it for cancer purposes.