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TSH 48 now 0.675 in 6 weeks
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TSH 48 now 0.675 in 6 weeks

The above numbers reflect the change in my TSH in approx 6 weeks, tested 11/2/10 and 12/13/10 after taking levothyroxine 100mcg during that time.

TSH  47.590 Nov 2; and 0.675 Dec 13; (range 0.270-4.200)
T3     60.0    Nov 2; and  102.3 Dec 13; (range 80.0-200.0)
FreeT4 only tested once: 1.440 Dec 13; (range 0.9000-1.700)

Doctor might as well have declared me cured: said numbers are perfect and would not listen to complaints of continuing symptoms like exhaustion, too much sleep, headaches and the blues including lots of crying jags. I have had issues with melancholia all of my life, but since my thyroid crashed after quitting smoking on 5/16/10 - it's all different. The severity of my tiredness is a little bit better but still not normal.

My question: Does anyone with similar numbers feel cured, perfect or normal ?? Hope so or I will have to look again for a doctor. Mine doesn't want to see me again for 4 months. Thanks for any thoughts and Happy New Year to all, Nan
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649848_tn?1357751184
Start looking!!  

While your TSH has come down admirably, that's not an indication that you are "cured".  

First off, is that T3 "Free" or "Total"?  Tests for Total are considered pretty much obsolete and of little value, because some of that T3 will bound by protein, therefore unavailable for use.  If those results are for Total T3, it's a pretty safe bet that your Free T3 is even lower yet. The Free T3 is what's floating around in your blood, just waiting to be used; you have no idea how much, if any, you have available.

Your FT4 looks good, but again, we can't pronounce you "cured"...... because it's all too possible that you aren't converting the FT4, which is a storage hormone, to the usable FT3.  This means that you will quite likely stay sick for a while longer.  

Have you been tested for antibodies to confirm/rule out Hashimoto's thyroiditis?  That would be another important factor.  Hashimoto's is the #1 cause of hypothyroidism in the US, and while it's treated basically the same as other types of hypothyroidism, it can make treatment much more difficult.  

In addition, you need to have a thyroid ultra sound to check for nodules; nodules go along with Hashimoto's and can "leak" hormone independently of the thyroid.  This, too can make treatment more difficult.

You need to be tested every 6 weeks until your levels are stable - just because you are "in range" after 6 weeks, doesn't mean you are "cured" or even well........

Have you had vitamin B12 and Vitamin D tested?  Deficiencies in these vitamins often go hand in hand with hypothyroidism/Hashi's.  Vitamin B12 deficiency can contribute to that unending exhaustion, resulting in the need to sleep all the time.
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649848_tn?1357751184
Start looking!!  

While your TSH has come down admirably, that's not an indication that you are "cured".  

First off, is that T3 "Free" or "Total"?  Tests for Total are considered pretty much obsolete and of little value, because some of that T3 will bound by protein, therefore unavailable for use.  If those results are for Total T3, it's a pretty safe bet that your Free T3 is even lower yet. The Free T3 is what's floating around in your blood, just waiting to be used; you have no idea how much, if any, you have available.

Your FT4 looks good, but again, we can't pronounce you "cured"...... because it's all too possible that you aren't converting the FT4, which is a storage hormone, to the usable FT3.  This means that you will quite likely stay sick for a while longer.  

Have you been tested for antibodies to confirm/rule out Hashimoto's thyroiditis?  That would be another important factor.  Hashimoto's is the #1 cause of hypothyroidism in the US, and while it's treated basically the same as other types of hypothyroidism, it can make treatment much more difficult.  

In addition, you need to have a thyroid ultra sound to check for nodules; nodules go along with Hashimoto's and can "leak" hormone independently of the thyroid.  This, too can make treatment more difficult.

You need to be tested every 6 weeks until your levels are stable - just because you are "in range" after 6 weeks, doesn't mean you are "cured" or even well........

Have you had vitamin B12 and Vitamin D tested?  Deficiencies in these vitamins often go hand in hand with hypothyroidism/Hashi's.  Vitamin B12 deficiency can contribute to that unending exhaustion, resulting in the need to sleep all the time.
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Avatar_f_tn
Thank you. T3 is Total. I have not had antibody test: already have several autoimmune diseases; assuming Hashimoto. B12 was tested at 68 and now well over 1000 due to daily sublingual tablets MethylB12 1,000mcg. Diagnosed Pernicious Anemia.

Ultrasound test 11/2/10 results stated: both thyroid lobes are heterogeneous abdomen are somewhat small... no dominant nodules. Questionable hypervascularity in both.

I also take D3 2000mcg daily. Appreciate your input very much.

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Avatar_f_tn
Hello to anyone who is reading this and thank you.

I reported my second round of lab test results after about 6 weeks on levothyroxine. I am printing them here again. I hope this is not a big boo-boo. If so, please let me know. I am desperate for info and see other people getting so many answers, I assume I did something wrong. Barb15 did reply and TY.

I wasn't bragging - maybe my subject sounded like it. I'm actually extremely concerned. When starting the med levothyroxine 100 mcg i felt so good on days 4,5,6 ; like a different person: didn't sleep, energetic etc. Then crashed back down just as fast and that is where I am today. Still too tired to care, perhaps not sleeping over 15 hours per days but still too much and too tired. Lethargy and apathy sum it up. Some intestinal over activity. Headaches.


TSH          47.590 Nov 2; and 0.675 Dec 13; (range 0.270-4.200)
Total-T3     60.0    Nov 2; and  102.3 Dec 13; (range 80.0-200.0)
FreeT4       only tested once: 1.440 Dec 13; (range 0.9000-1.700)

thanks, Nancy
My doc pronounced me normal due to results which he called 'perfect' and so i have many questions about this baffling disease.

Mainly i would like to ask:
Is there a delay in feeling better ?
In other words do the labs get better before the body feels better?
Could my many symptoms lessen after another month on same dosage? or two months or more?? It has barely been  2 months since starting 100 mcg levothyroxine.

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Avatar_m_tn
Yes, there can be a delay in feeling better.  Symptoms often lag changes in blood levels of thyroid hormones, and it is somewhat dependent on severity of hypothyroidism and length of time being hypo.  In your case, I'd say that you need a source of T3 added to your meds, to raise your T3 level.  Of course Barb already mentioned the need to test for FT3 rather than TT3.

A good thyroid doctor will treat you clinically by testing and adjusting FT3 and FT4 as necessary  to relieve symptoms, without being constrained by resultant TSH levels.  If you doctor has a problem with this approach, or with prescribing meds with T3, then you need to find a good thyroid doctor that will do so.

I think you can learn more about this in this link.

http://www.hormonerestoration.com/Thyroid.html
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649848_tn?1357751184
I'm sorry I didn't respond sooner; we all volunteer our time here, and unfortunately,  personal issues, plus work, have kept me off line, most of the day yesterday, and literally, ALL day today.

I did not think you were bragging about your TSH levels dropping like that.  Mine did the same thing when I was put on thyroid med, only mine went even lower, which led my doctor to "assume" (shame on him) that I was over medicated, so he began cutting back on my med; fortunately, that has not happened to you.  

gimel is right -- there is quite often a lag between "perfect labs" (there really is no such thing, because "perfect" for me, might leave you very ill and visa versa) and feeling better.  

You lacked adequate hormones for a period of time and your body tried to adapt to the lack of them; now you are on med, so your body has to "readapt" to their presence.  Without adequate thyroid hormones, we are literally "sick"; we didn't get that way overnight, so we have to give our body time to heal and get well.

I agree that you may need a source of T3, but I'd sure like to see an FT3 before making a final comment on that.  FT3 correlates best with symptoms (over TSH and FT4).

Chances are, as time goes on, your dosage will need to be adjusted according to symptoms and labs; I'm sorry to say, it doesn't appear that this doctor is willing to think about anything other than labs/TSH/"normal range".  

Patience has never been one of my more prominent virtues, but, trust me - since I was dx'd hypo/Hashi's, I've learned to chill a bunch.  Feeling good today, doesn't guarantee feeling good tomorrow.  I was dx'd 3 yrs ago, and just within the past few months have I gotten to a point where I feel relatively confident that I will feel the same way tomorrow, that I felt today........

The link that gimel posted is a very good one and will give you tons of info.  In addition, we will be most willing answer any specific questions you have.  

Yes, there is light at the end of the tunnel; I'm just not convinced that your current doctor is going to lead you to it.  




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Avatar_f_tn
Oh joy. Thank you gimel and Barb135 for your messages. I feel much better after reading your comments.

I am going to call my doctor tomorrow and request a FreeT3 test immediately. If he won't approve it, I'll find a way to have it done myself. It is well worth knowing - so money can't even be a consideration. It must be done!

Meanwhile, I will start looking for another doctor. (Lordy, i have gone through about 6 including neurologists, GP's, and current Osteopath.) Also I want verification that i do indeed have Hashimoto's - with at least two other autoimmune diseases, it is very likely - but I want to know absolutely. Gosh I thought Pernicious Anemia was tricky but compared with Hypothyroidism, it was a walk in the park even though I was practically paralyzed.

I haven't even begun to address food interactions and the myriad other considerations, but at least I take the pill on an empty stomach (except for coffee). I am, however, absolutely consistent with my routine so it all evens out, right?

Thank you again. I was so discouraged I was ready to throw in the towel. I've been battling for so long it just seemed endless - and worse, pointless. I am seeing your light, Barb, ever so dimly in the tunnel. It no longer seems black - at least tonight! Well, we all know how quickly that can change; (smiling).

Hope is a precious gift: you two shared it with me. I'm so grateful. Nancy
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649848_tn?1357751184
I'm happy that I was able to help; makes me feel good, when I help someone else feel good, even if only for a while.  

If you can't get authorization from your doctor, for an FT3, check out healthcheckusa.com.  They send you a lab order for a lab in your area, you go get the blood drawn and within a couple days, you have the results.  A while back, I did this to check my levels between dr visits; for $85, I got TSH, FT3 and FT4.  Unfortunately, an order from your doctor is required for antibody tests; or was then.  

Your osteopath can handle your thyroid issue if s/he is willing to test and treat properly or is that the one who thinks your labs are "perfect"?  
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231441_tn?1333896366
Hi,

Another thought, in addition to the excellent advice above:

Given the B12 issues, and other autoimmune issues please ask to be checked for celiac (caused by gluten).  

Even if the test comes back negative (there is a high rate of false negative with this test), you could try a gluten free diet to see if it hleps.


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Avatar_f_tn
Barb, Hello again and I did what you suggested and actually have an appointment with a certified endocrinologist on Friday Jan 14. I am so excited. My present md does not have a clue about thyroid issues. The more I read the more I realize this fact. Thank you for being honest and encouraging me.

Posting blood work here again for your easy reference:
(taking levothyroxine 100mcg during that time)

TSH  47.590 Nov 2; and   0.675 Dec 13; (range 0.270-4.200)
T3     60.0    Nov 2; and  102.3  Dec 13; (range 80.0-200.0)
FreeT4 only tested once: 1.440  Dec 13; (range 0.9000-1.700)

So now that I will be seeing someone who knows more about this incredibly frustrating disease: HELP: what should I ask? Yikes.

Since it is only one month since i had these last tests done, I doubt they will be repeated but perhaps I can get some different tests.

Ok, I need FREE T3. I also need antibody tests: I understand there are several. which are most critical??

My head is spinning and I don't want to go in, get tongue-tied and mess up my opportunity to learn something important. Can you think of anything else that might be meaningful ?? I'm like a babe in the woods...

Thank you in advance, and thank you to anyone who has any thoughts about seeing an endo for the first time.  

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219241_tn?1357815389
Thyroid Peroxidase (known as TPO) antibodies and Thyrogloublin (known as Tg) antibodies. You could ask for Thyroid Stimulating Immunoglobulin (known as TSI)
The first two are for Hashimoto's the last one is for Grave's. People can have antibodies to both and swing one way or the other! Amazing, huh!?

  The other issue I am concerned for you is the melancholic state you get. Do you know what your Vit D levels are? If low this can contribute greatly to a depressive kind of mood. I am an expert in this! I get severe depression during winter months and our southern hemisphere doesn't allow us the amount of Vit D to utilise correctly. It is the same in the majority of USA as well.  Believe me, once I started taking it, my depressive moods changed! I also in the past five weeks have not had any, (long story) but recently purchased some more and with in the week my severe (and I mean I was thinking of going back to the psych, but suddenly remembered, VIT D!) depression was gone. Yippeeeee!

Barb suggested testing for coeliac, there are several blood tests for this.  
Nancy, get yourself a pad and paper, then in point form write what you need doing.

I. Thyroid antibodies;  TPO ab, Tg ab, TSI
2. Vit D testing.
3. FREE T3 testing
4. Coeliac testing, anti-ttg anti-bodies and anti-gliadin antibodies.
5. A large chai tea with vanilla soy milk.

The last one is for me! Hee hee.

This last one brings me to an issue you might have too, do you use any oestrogen creams or has any of your moisturisers contain any iodine, (seaweed extract) Even certain sunscreens have oestrogen-like chemicals which can affect your thyroid levels.
  Too much soy in the diet can also affect thyroid levels.


Lots to think about but they are all stepping stones along the path to the eventual journey's end!

Cheers!
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Avatar_f_tn
Oh my, redheadaussie, you have outdone yourself. Thank you; thank you; thank you. I am sincerely touched with the time and effort you spent sharing information and ideas with me.

I shall copy your message and make the list you suggested. And I definitely owe you a chai tea !! :D

You gave me some excellent things to consider and you are a true friend. I will most certainly get back to you and let you know how everything went. I am especially appreciative of your concern about my emotional state and hope my path follows yours to a better place mentally and physically.

Here's a cheer for you, Bravo!!
and here's smiling at ya'
       Nancy
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