Recent/New labs and have a couple of questions...

[ktr19]

My previous labs were:

Initial Diagnosis: 02/13/2012: TSH 4.55 (0.450-4.500 1IU/ML) FREE T4 1.07 (0.82-1.77 ng/dl) NO FT3

After 3 months on 25mcg Levothyroxine 04/13/2012...TSH 1.99 (same range as above), FREE T4 1.13, No FT3

And 07/12/2012... TSH 2.230, T4 1.13, No FT3

New lab and new doctor:
09/17/2012...TSH 2.83 (.040 -4.50), FREE T4 1.0 (.08-1.8), FREE T3 3.3 (2.3-4.2) Thyroglobulin Ant ≤20 (≤20), Thyroid Peroxidase Ant 16 ( ≤35)....

Ferritin 166 (20-380), B12 789 (200-1100, Vit D 51 (30-100), DHEA 162 (45-345), Total Testosterone 422 (250-1100), FREE testosterone 47.3 (46-244), Bioavailabe Test. 105.5 low (110-575), SHBG 39 (10-50)

Since those labs I I’ve been bumped up to .50mcg Levothyroxine.

My questions are this...Why does it appear that my FT3 looks good (it looks like it is at about 50%, correct?) And it looks like my FT4 has dropped after supplementation (albeit a small .25=mcg dose)? As well as my TSH increasing as well?

And if I am converting well, which it looks like I might be, will increasing the FT4 by supplementation increase the FT3 too high... and would that cause hyper symptoms? I guess I'm a little confused on the large gap between the two!

And any comments about the low testosterone would help too since they appear a bit low, I will address that with the doctor in December when I'm scheduled for my next labs....

Thanks everyone...

[ktr19]

Thanks all…I think I will stay at the 50 mcg until I see the doctor in December, see what my numbers are, and then address the possible testosterone issue.  The low T may explain my exercise routines being affected and the abdominal weight gain I’ve gotten over the past several months.  

I typically don’t have a problem falling asleep but tend to wake off and on…it was just not till I bumped up to the .75 dose that the severe insomnia started. I won’t be doing that again until I get the labs checked! Hopefully the other hypo symptoms will level off by then as well!

[flyingfool]

Symptoms also can lag behind blood labs by quite a few weeks.  So this again is another reason to go about in small increments and over longer periods of time when changing doses.  You may want to stay at the 50 mcg for quite some time and test regularly to see how things settle out.

Anxiety and insomnia are both symptoms that cross over.  Meaning that they can be a symptom of Hypo OR Hyper.  So don't just assume that you are Hyper because you have some anxiety or problems sleeping.

Many people who are hypo report the ability to fall asleep easily because they are so tired. Yet they are unable to stay asleep or sleep soundly, which compounds their fatigue.  My wife is like that when she falls back into Hypo.  Tired all the time but complains she can't sleep well.  Whereas I think more often hyper people just never seem tired in the first place.  But again, everyone's symptoms can be unique.

[goolarra]

Raising your FT4 will raise your FT3.  That's why it's important to increase slowly and keep testing every 4-6 weeks along the way.  You may find that you don't have to be at 50% of range to relieve symptoms.  If your symptoms go away sooner, then you're good to stay at whatever level that happens at.  

Your body doesn't use either FT3 or FT4 any faster just because more is available.  That's one of the reasons we can take too much and raise our levels too high.

Sorry, can't help you with the guy thing!  LOL  You might start a new thread with low T in the title if you want the guys' opinions.  

Good luck.

[ktr19]

I was calculating step 2 the wrong way… lol

And Red_Star, I’m with you… I suck at math! :)

That makes more sense that my FT4 is still a bit low before starting on the .50mcg dose… the number I was coming up with just did not make sense! I guess I’ll stick with the .50mcg dose I’m on now and will re-test in a couple of weeks.  But if I’m converting well, which I guess I am, will raising my FT4 from 20% to 50% or close to midrange raise my FT3 too high? Or will your body simply use that quicker since I know FT3 is pretty fast acting?    

The nurse practitioner I saw seemed to think the doctor may address the testosterone issues at my next visit. And yes I have symptoms for that as well. The problem is, for a guy, most low T symptoms are almost exactly the same as those that are Hypo!

I guess from what I understand they like to get your thyroid #’s looking good before they start supplementing testosterone.  

Any guys out there have low T, along with being Hypo or formerly Hypo? I’d like to know more about that process since it sounds like that may be the way I’m heading!

[goolarra]

Sorry, that should read

top of range - bottom of range = breadth of range (darn shift key!)

[goolarra]

FT4 of 1.0 with a range of 0.8-1.8 is 20% of range, not 53%.  Percent of range is calculated as follows:

top of range - bottom of range + breadth of range (1.8 - 0.8 = 1.0)
result - bottom of range (1.0 - 0.8 = 0.2)
divide second result by first result and multiply by 100 (0.2 / 1.0 x 100 = 20%)

FT3 is calculated the same way, and you're right that your FT3 is at 52.6% of range.

Your FT3 relative to your FT4 looks very good.  FT3 is higher in its range than FT4 is in its (52.6%/20%), so it looks like you convert very nicely.

"...is it possible that all of the hypo symptoms I had at the start of this last spring,  and to a degree am still feeling today, may be something else and not my thyroid?"  

It is possible.  The rules of thumb for FT4 (midrange) and FT3 (upper half to upper third of range) are guidelines.  They're not for everyone.  We all have to find where we feel best.  Unfortunately, added to that, on initial diagnosis, FT3 wasn't tested, so we don't have a complete picture.  However, it's also possible that your FT4 is still low enough that your symptoms haven't been alleviated yet.  It could be that your FT4 has gone down, not because of the meds, but because you are losing more and more natural thyroid function as time goes on.

[Red_Star]

Low testosterone symptoms include weight gain (particularly around the waist), and exercise intolerance. I'll leave the maths to someone else. Maths is a whole bowl of wrong LOL.

[ktr19]

Ok after getting over a brain fart and doing some additional math, I took a second look at my most recent numbers done a month ago(from above) and may have miss calculated my FT4 results… If I am reading this correct, my FT4 is at 53% and my FT3 is at 52%, correct???  FREE T4 1.0 (.08-1.8), FREE T3 3.3 (2.3-4.2.)

And those were when I was on .25mcg T4 meds!

Ok, now I’m frustrated… No wonder when I went to from .50mcg to .75mcg recently I began to feel and have hyper symptoms (insomnia, anxiety, etc.).

You couple that with what appears to be no antibody problems, some lower testosterone , my increasing weight, lower exercise tolerance and just not feeling “right” since being on the levothyroxine…is it possible that all of the hypo symptoms I had at the start of this last spring,  and to a degree am still feeling today, may be something else and not my thyroid?

I guess I’m just looking to verify that I indeed have a thyroid problem… the frustration of the process, given my need for such a low dose, is having me question everything as it pertains to what I have been taking???

I’m really half inclined to quit the .50 for a while just to see what happens… but afraid of what may occur!