Hello, new here. Doc wants to put me on nature-throid, a little confused..?

[LanieCO]

Hi everyone. I'm a 37 yo female. I recently went to the doctor due to the fact that I am having trouble losing weight and feel tired all the time. I got my blood tests back and it shows the following:

TSH - - 1.39 range 0.35 - 4.94
Free T3 - - 2.54 range 1.71 - 3.71
T4 Total - - 6.4 range 4.87 - 11.72
Vitamin D - - 17 range 30 - 96
Vitamin B12 - - 453 range 213 - 816

My doctor has prescribed 1/2 grain nature-throid and Vit D/Vitamin B12 combo. I was honestly a little surprised at nature-throid prescription because my labs seems to be within normal range. However, I do have almost every symptom of hypothyroidism; extremely fatigued(no matter how much sleep I get), very dry skin, bouts of constipation, thinning hair(although not too bad yet), some joint pain, & awful memory. I should also add, I have a large benign nodule on my thyroid.

The only other things that stood out is my homocysteine levels are elevated, 11.3 range <10.4 and my cholesterol is 200 with the desirable level being <200. I have read hypothyroidism can elevate both of these?

I cannot remember my doctor's exact phrasing(it was a lot to take in) but I believe she is wanting to get my Free T3 levels higher & see if my symptoms are alleviated. I'm very leery of starting new meds, but I desperately want to feel like my old self instead of wanting to sleep the day away.

Would appreciate any feedback :)

[LanieCO]

Thank you so much for the info Barb & Gimel. This helps a lot! I follow-up with her in 2 weeks, so I should have an update then.

Thanks again!

[gimel]

Count yourself as very lucky to have a doctor that understands symptoms are the most important indicator of possible hypothyroidism, followed by biologically active thyroid hormones, Free T4 and Free T3.  You have several hypo symptoms, plus your Free T3 is below the middle of the range and if your Free T4 is in the same part of its range as your Total T4 those would also be indicators of hypothyroidism.  

You need to make sure they test for both Free T4 and Free T3 every time you go in for tests.  Since you were started on 1/2 grain of Nature Throid, don't be surprised if your next tests in about 4-5 weeks don't show much increase.  That would be because the thyroid med will cause your TSH to go down and thus reduce the output of natural thyroid hormone.  Net result will likely be very little change in serum levels until the med dosage is increase enough to suppress TSH and then serum levels will rise along with dosage increases.  Many members say that symptom relief required Free T3 at the middle of its range, at minimum, and Free T3 in the upper third of its range, or as needed to relieve symptoms.  Symptom relief should be all important, not just test results.

Also hypo patients are frequently too low in the ranges for Vitamin D, B12 and ferritin.  Your D and B12 were too low.  D should be about 55-60 and B12 in the upper end of its range.  So the doctor was directionally correct on those.  You do need to test for ferritin.  Low ferritin can cause symptoms as well as adversely affect metabolization  of thyroid hormone.  Ferritin should be about 70 minimum.

Please let us know how you progress.

[Barb135]

Wow, that doctor's a keeper... Not many doctors will start someone on thyroid meds, based only on symptoms, just to see if it will alleviate them...

The only thing I can see that she did wrong is that she tested Total T4 instead of testing Free T4, but at least she did the Free T3... I'm impressed.

Most of us find that Free T3 needs to be in the upper half to upper third of its range; yours is only at 42% of its range.  We also find that Free T4 needs to be about mid range... You don't have a Free T4, but your Total T4 is only at 22% of its range, which indicates that Free T4 would be equally low, since 90-95% of Total T4 is bound by protein and can't be used.

You're correct that hypothyroidism can cause both, elevated cholesterol and homocysteine.  Elevated homocysteine indicates inflammation in the body.  Both levels should decrease once thyroid hormone levels are adequate.

Vitamin D levels should be be 50-60 to be optimal - you don't want that just "in range".  Vitamin B-12 needs to be near/at the top of the range... your lab is using a rather odd range, so you could stand to even be slightly above the upper end (many labs have an upper end of 1100).  

I'm not sure where you are, but I'd give your doctor a try in hearbeat; maybe I wouldn't have to fight tooth and nail to keep my med(s) at adequate dosages... LOL