Rechecking on hypothyroidism

[Joanne49]

I am being treated for hypothyroidism.  From research my daughter (she is hypo) has done, I found out the TSH range since 2003 has been .3-3.0.  My doctor is still using the .45-4.5 range.  When I first complained about symtoms my TSH was 3.67 but she wouldn't order other tests.  Where can I find out what the current ranges are for the various thyroid tests.  
My TSH since June 2008 has been 2.42-3.67, T4 .7-.8, T3 free only one test at 2.8, Total T3 only one test at 122, my current TPO (and only test) is <10, Intact PTH 23 and now 28.  My Calcium Iodized has been 5.02 -5.41, B12 345-571, D-OH Total 27-35 and D-OH D2 is current < 4 but in early 2008 was 12?  Magniusm just tested at 2.0.
I am trying to find out more about monitoring my own test results to determine if I am seeing the correct doctor (endocrinologist).  I have complained now for over a year about abnormal weight gain despite what my internist said was a reasonable diet among other issues.

[Leigh1234]

Here is a link to the AACE press release with updated ranges (there are also links at the bottom of the page for further reading).

http://www.aace.com/public/awareness/tam/2003/explanation.php

[gimel]

Probably about 6 weeks after starting Levoxyl you will be retested.  At that time you should make sure that free T3 is included, along with free T4, and the ever present TSH.  I would be sure to talk to doctor about wanting to be medicated enough to alleviate symptoms, by monitoring and adjusting the Frees, instead of TSH.  That should be enough to find out if the doctor is willing to take that approach, instead of treating your TSH to get it into whatever range the doctor considers as acceptable to him.  Just insist that symptoms correlate to free T3 and free T4 much better than to TSH.  good luck and please keep us tuned in.

[Joanne49]

My endocronoligst has not mentioned trying to find a cause for the hypothyroidism!  I do have small small nodules on my parathyroid that are being monitored, but I have not been told there is any relationship.  In fact these were discovered over 1 1/2 years ago and she didn't seem concerned about the thyroid.

I just started meds - levoxyl

[gimel]

First, it would be valuable to know if the doctor has identified any cause for your hypothyroidism.  This can affect the target values for the various thyroid tests after medication.  

Regarding the TSH range, yes the reference range was recommended to be changed by the Amer. Assn. of Clinical Endocrinologists over 5 years ago and most labs and doctors still seem to be using the old range.This is unfortunate for a lot of people with doctors that do not want to treat them unless their TSH is above the old range (or even higher).  Reference ranges for other thyroid tests vary dependent upon the measurement units being reported, as well as some variation among labs.  I think that the T4 result you gave is for free T4.  If that is the case, it would be at the very low end of the reference range that I have seen (.7-1.9).  Free T3 is the most important test because it is the most active thyroid hormone and largely regulates metabolism.  The  free T3 result  you listed is below the midpoint of what I think is the appropriate range (1.6-4.2).

You said you are being treated for hypothyroidism, but you didn't mention if you are already on meds.  Regardless, the thyroid test data you provided is consistent with hypothyroidism and needs further medication to relieve symptoms.  In prep for your next appt. with doctor I would suggest reading through the messages attached to this post.

When TSH simply will NOT go down
by goolarra
, Apr 28, 2009 04:21PM