Please help me understand my lab results

[gempdx]

Hello,

I am so glad to have found this forum! I was diagnosed with Hashimoto's on June 18, after getting results back that my doctor had ordered because she noticed a goiter during a regular exam. Here are what the results say:

Thyroglobulin Ab: 282.2 (ref range 0.0 - 60.0)
TPO Ab: 6500.0 (ref range 0.0 - 60.0)
FT4: 0.43 (ref range 0.47 - 1.23)
TSH: 49.34 (ref range 0.34 - 4.82)

My doctor briefly went over the results with me but I was in shock, so didn't absorb everything. She did put me on 100 mcg of Synthroid/day and advised me to call if I got an heart palpitations and so far, nothing like that.

Although I feel a *bit* better I still have problems making it through a workout, still am gaining weight despite exercising 6X/week and watching my calories. I've cut way down on caffeine and gluten, though not eliminating them entirely. Started doing yoga again to help with stress and get 8 hours of sleep each night.

Not sure what else to do? Is the weight gain/inability to lose weight possibly related to T3, which was not tested?
I am in the process of doing the saliva cortisol test, so I'll see what comes back. My antibodies seem so incredibly high compared to what I've read from others ... what does that mean?

So many questions! I've been doing a lot of reading but am still confused.

[stella5349]

I hate to look at TSH - but yours is definately on the high end and certainly hypothyroidism is playing a role in all your symptoms.

There's really nothing much but time right now to see how things go on the trial dose of 100mcgs Synthroid. I hope this helps you out.

Eliminate carbs - sugars and try to stick to a high protein diet with high digestive enzymes added in too.

[Barb135]

Your doctor "got lucky" that you apparently aren't overly sensitive to the med.  My TSH at diagnosis was 55+, my doctor started me on 25 mcg for 2 weeks, then raised to 50 for a month, then retest; up to 75 for 6 weeks, retest.  It took me longer to get there, but then as soon as my TSH went to the basement, he started taking away med - he's not my doctor any more............  

And yes, you probably are lucky that she tested more than TSH - that's the standard that a lot of doctors want to base thyroid treatment on........that's why so many of us stay sick much longer than we need to............

Maybe you aren't eating enough calories so your body is going into "starvation mode" , holding on to fat you already have because there isn't enough calories coming in?

There are also other issues that can keep you from losing weight; it's not always the thyroid.  

[gempdx]

Hi Barb,

Thank you so much for your response. The doctor did mention that 100 mcg was a higher dose than she normally started patients with, but since I was so "severely hypo" she felt like my system needed it. So far, I haven't had any of the hyper symptoms she told me to be on alert for so I guess that was a good strategy.

You are correct that she didn't test for FT3, from the reading I've been doing it seems I'm lucky she tested more than TSH! I am due to go back in about two weeks, and will talk to her about the FT3 test then.

Losing weight has ALWAYS been difficult for me but it's been impossible the past couple of years. I exercise a lot - my body is sore all the time. I eat about 1500-1600 calories a day and have cut back to less than 1 alcoholic beverage per week. I drink water. I really don't know what to do as the weight just keeps creeping up. I'm 5'4" and 165 pounds and I don't feel comfortable in my skin anymore. :-(

[Barb135]

100 mcg Synthroid is a lot to start with; it's usually better to start at a lower dose and work up slowly than to start at a high one right off the bat.  Since you've been on it since June, though, hopefully you are going to be okay with it.

It does take several weeks for your body to get the full effect of the medication.  When will you go back for labs again?  You should retest after about 6 weeks to see if the dosage is high enough.  You may have to give it a bit more time, or go up a bit on the dosage, but you should never adjust dosage without a blood test prior.

I don't see an FT3 there in the tests.  FT3 is the most important thyroid hormone as it is the one the body actually uses "as is".  FT4 can't be directly utilized; it must be converted to FT3; you should ask your doctor for that test. Some of us don't do well with the conversion process and have to supplement with a T3 med.

As far as the weight - yes, it's related to the FT3, all of the symptoms are.  The thing is, though, we can't count on the weight just falling off automatically once we get on thyroid med.  For some it comes off easily, others of us (yes, that's me) have to work at getting it off.  

Your antibody count indicates the Hashimoto's, which is an autoimmune disease in which the antibodies attack and destroy the thyroid tissue.  

Keep researching, reading and be patient.  It takes time to get back your health.