Aa
Test levels
My thyroid TA-TPO level just came back at <1300. My doctor was reluctant to treat based on Free T3 and T4 levels. With this new level, she will treat.
How bad is this level? What should my next steps be? She was not going to treat me at all and I had to practically beg for this test.
How bad is this level? What should my next steps be? She was not going to treat me at all and I had to practically beg for this test.
As suggested, I got my B12, Ferritin and Vitamin D levels tested.
Ferritin is 13 normal range 24-291
B12 is 300 normal range 160-1000
Vitamin D result is not yet back.
I will also mention that I saw a Neurologist who ordered a Tilt Table test. I passed out during the test after being given nitroglycerin. My heart rate went from mid 90's down to 40 and my blood pressure bottomed out as well. I am now being referred to a Cardiologist. I can't help but feel like this is all connected.
On my own, I have begun taking an extra pill of the Levothyroxine. Hoping for symptom relief after supplementing, increasing dosage and figuring out my blood pressure.
Thank you again for all of your help.
Ferritin is 13 normal range 24-291
B12 is 300 normal range 160-1000
Vitamin D result is not yet back.
I will also mention that I saw a Neurologist who ordered a Tilt Table test. I passed out during the test after being given nitroglycerin. My heart rate went from mid 90's down to 40 and my blood pressure bottomed out as well. I am now being referred to a Cardiologist. I can't help but feel like this is all connected.
On my own, I have begun taking an extra pill of the Levothyroxine. Hoping for symptom relief after supplementing, increasing dosage and figuring out my blood pressure.
Thank you again for all of your help.
Not enough info to determine if your problems are all related to being hypothyroid, but certainly your thyroid levels are much too low in their ranges and you need to start on thyroid med as soon as you can get the doctor to do so. With your levels I'd say that your starting dose should be at least 50 mcg of T4 med, and then re-test in 4-5 weeks. Also important to get your Vitamin D, B12 and ferritin tested and supplement as needed to optimize as mentioned above. Once you get your thyroid levels and D, B12 and ferritin optimized you can see how you feel and whether there are other issues or not.
I agree with Gimel.
Post Partum thyroidosis can be temporary. But that doesn't mean that you should feel horrible and not be treated for this period.
I think it bears close watch to see that you don't go Hyper because the thyroid goes back to normal and with your medication gives you too much thyroid. But that can be "watched" by how you feel and getting blood tests periodically.
Post Partum thyroidosis can be temporary. But that doesn't mean that you should feel horrible and not be treated for this period.
I think it bears close watch to see that you don't go Hyper because the thyroid goes back to normal and with your medication gives you too much thyroid. But that can be "watched" by how you feel and getting blood tests periodically.
Many doctors don't understand that due to the way they are established, the ranges for Free T4 and Free T3 are far too broad to be functional across their entire breadth, for may people. Note the following quote from a good thyroid doctor.
"The free T3 is not as helpful in untreated persons as the free T4 because in the light of a rather low FT4 the body will convert more T4 to T3 to maintain thyroid effect as well as is possible. So the person with a rather low FT4 and high-in-range FT3 may still be hypothyroid. However, if the FT4 is below 1.3 and the FT3 is also rather low, say below 3.4 (range 2 to 4.4 at LabCorp) then its likely that hypothyroidism is the cause of a person's symptoms."
With your symptoms and those test results it is quite clear that you needed to be on thyroid med. The doctor was reluctant to do so until you were tested for the Thyroid Peroxidase antibodies. That shouldn't have been necessary to get her to prescribe thyroid med. Your Free T4 was only at 11% of the range. Mid-range is recommended. Your Free T3 was only at about 16% of its range. It typically needs to be in the upper third of its range, as needed to relieve hypo symptoms.
As I understand it, the presence of antibodies increases the risk for postpartum thyroiditis. Also, when conventional antibodies are found there is a high chance of postpartum thyroiditis proceeding to permanent hypothyroidism. Regardless, you need to start on thyroid med and gradually increase as needed to optimize as mentioned above.
A good thyroid doctor will treat a hypothyroid patient clinically by testing and adjusting Free T4 and Free T3 as needed to relieve hypo symptoms without
being constrained by resultant TSH levels. Symptom relief should be all important, not just test results. If your doctor does not agree to treat clinically as described then you will need to find a good thyroid doctor that will do so.
Also, hypo patients are frequently too low in the ranges for Vitamin D, B12 and ferritin. D should be about 55, B12 in the upper end of its range, and ferritin should be about 70. You should get those tested and then supplement as needed to optimize.
"The free T3 is not as helpful in untreated persons as the free T4 because in the light of a rather low FT4 the body will convert more T4 to T3 to maintain thyroid effect as well as is possible. So the person with a rather low FT4 and high-in-range FT3 may still be hypothyroid. However, if the FT4 is below 1.3 and the FT3 is also rather low, say below 3.4 (range 2 to 4.4 at LabCorp) then its likely that hypothyroidism is the cause of a person's symptoms."
With your symptoms and those test results it is quite clear that you needed to be on thyroid med. The doctor was reluctant to do so until you were tested for the Thyroid Peroxidase antibodies. That shouldn't have been necessary to get her to prescribe thyroid med. Your Free T4 was only at 11% of the range. Mid-range is recommended. Your Free T3 was only at about 16% of its range. It typically needs to be in the upper third of its range, as needed to relieve hypo symptoms.
As I understand it, the presence of antibodies increases the risk for postpartum thyroiditis. Also, when conventional antibodies are found there is a high chance of postpartum thyroiditis proceeding to permanent hypothyroidism. Regardless, you need to start on thyroid med and gradually increase as needed to optimize as mentioned above.
A good thyroid doctor will treat a hypothyroid patient clinically by testing and adjusting Free T4 and Free T3 as needed to relieve hypo symptoms without
being constrained by resultant TSH levels. Symptom relief should be all important, not just test results. If your doctor does not agree to treat clinically as described then you will need to find a good thyroid doctor that will do so.
Also, hypo patients are frequently too low in the ranges for Vitamin D, B12 and ferritin. D should be about 55, B12 in the upper end of its range, and ferritin should be about 70. You should get those tested and then supplement as needed to optimize.
1 Comments
Thank you so much for your thorough and helpful response. I have also posted my TSH result, as I had forgotten that one. It was high at 5.3, which prompted the additional testing.
I am barely able to function. I don't know if it is this issue causing it, or not.
I fell on Thursday and hit my head. I was u able to get up from the floor, felt as though someone was holding me down. I have a period of inability to speak for a short time after.
This morning I am so unsteady on my feet. I have also been testing my blood sugar to see if there is a correlation between the two. This is debilitating and makes it a struggle to care for my daughter. Thankfully, I have three grown children ages 20, 18 and 15 who are a tremendous help.
I am barely able to function. I don't know if it is this issue causing it, or not.
I fell on Thursday and hit my head. I was u able to get up from the floor, felt as though someone was holding me down. I have a period of inability to speak for a short time after.
This morning I am so unsteady on my feet. I have also been testing my blood sugar to see if there is a correlation between the two. This is debilitating and makes it a struggle to care for my daughter. Thankfully, I have three grown children ages 20, 18 and 15 who are a tremendous help.
5/24/2016 1 ng/dL 0.9 ng/dL 1.8 ng/dL
These are the ranges for the T4 that got cut off
These are the ranges for the T4 that got cut off
TEST RESULTS
May 31, 2016 - Thyr. Ab. Screen(Anti TPO)
TA-TPOResult: >1300 U/mLRange:
TA-TPO Detail
Result
Normal low
Normal high
5/31/2016 >1300 U/mL 0 U/mL 60 U/mL
May 24, 2016 - T4, Free
T4-FreeResult: 1 ng/dL
May 24, 2016 - T3, Free
T3-FreeResult: 2.6 pg/mLRange:
T3-Free
Normal low
Normal high
5/24/2016 2.6 pg/mL 2.3 pg/mL 4.2 pg/mL
1 Comments
TSH Detail
Result
Normal low
Normal high 5.3 uIU/mL 0.35 uIU/mL 4.50 uIU/m
Result
Normal low
Normal high 5.3 uIU/mL 0.35 uIU/mL 4.50 uIU/m
Severe dizzy spells, loss of the ability to communicate while the dizzy spells are occurring. forgetfulness, fatigue.
I should also mention I am 6 months post partum.
I should also mention I am 6 months post partum.
Have an Answer?
You are reading content posted in the Thyroid Disorders Community
We tapped the CDC for information on what you need to know about radiation exposure
Endocrinologist Mark Lupo, MD, answers 10 questions about thyroid disorders and how to treat them
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
STIs are the most common cause of genital sores.
