TSH & FT4 Numbers

[DI123747]

I posted on Aug.24 with my TSH readings and received an answer from Tamra. I called my doctor today and got my last two lab results. They are as follows:
June 10,2009  TSH 0.08
                      FT4  21 (range is 10-20)
Aug.o5,2009    TSH 0.11
                      FT4     18 (high normal)
Did not do FT3 test either time.
Had my synthroid decreased in June to 112mg. from 125 mg
Decreased again Aug. to 100mg
I'm just wondering if you would know if this over-stimulation in a hypothyroid condition could be caused by a nodule and not by too much synthroid or if you have any ideas about what I should have my doctor checking. I see my doctor again on Sept.11 but I'm not sure if he'll do lab work again so soon.
Thanks for any advice and input
Mama D

[mtkst13]

your doctor should reorder labs for your next appointment since you just decreased your meds.  when did you start the 100?  

i would think that you're just on too much thyroid replacement.  maybe your thyroid is starting to function again.  how long have you been on meds?

[TamraW]

Is that an FT4 of an 18 or a 1.8?  

You've gone to hyper mode, IMHO. Why didn't he test FT3? Geez, what's wrong with these doctors? I do agree with him for decreasing your Synthroid, and maybe bringing the FT4 down a tad.

Synthroid should shrink nodules.

Refresh my memory, did you have a lobe removed or do you have Hashi? Have you had a thyroid ultrasound? Why were you put on Synthroid to begin with?

:) Tamra  

[Barb135]

I'm not sure that synthroid will shrink the nodules.  Have you had antibody tests - TPOab, TGab?  Those will help determine if you have Hashimoto's autoimmune disease.  

With your TSH at 0.11 and your Free T4 at 18 (high normal), I don't necessarily recommend that you should decrease your med too much more unless you are having hyper symptoms.  It takes approx 5-6 weeks for any med change to take effect; therefore, you should always have new labs done at that interval whenever you have dosage changes, until your results are steady.......  My TSH is currently running at 0.03 and my Free T4 at 1.1 (range 0.8-1.8) - your lab apparently uses different units than mine does, so if my levels were where yours are, I might feel pretty good.  

It would really be helpful if you could push for a Free T3 - a lot of doctors don't think it's necessary, but it is actually the thyroid hormone that's available for your body to use.  

More importantly, what, if any, symptoms do you have?  That's the best indicator of what course of action to take.  You have to find the levels that make YOU feel the best, no matter what the lab report says...........Some people feel best with their TSH suppressed more, so long as the actual thyroid hormones are right.  

You have to find the right combination for YOU - and unfortunately, that could take a while............most of us don't have a lot, but patience is the key here........and small changes work best......if you make too large changes, you run the risk of skipping right over the levels that are going to make you feel best.