Please help with new labs. Even my doc is confused.

[Sunshine_67]

These labs are after being on 90mg compounded dessicated thyroid for two weeks. My doc is even confused and since I've never been on T3/T4 meds, I don't understand how they work and why my FT4 is so much lower than my FT3. He wants me to see an endo, but I don't trust them after going thru 4 in 6 months and all telling me I'm hyper based on my low tsh. He is increasing my dose to 120mg, but why is the FT4 so low?

TSH .021 (.35-4.5)
FT4 .85 (.89-1.8)
FT3 3.0 (2.3-4.2)

[Sunshine_67]

Thanks. I've actually done the questioning of the nurse before and found that didn't help much either. I've had several nurses tell me they won't answer questions unless you're a current patient. My co-pay is $60, so I can't afford to keep making one appt after another. I've also found most endos will prescribe T3/T4 meds, but still are very tsh focused.

I need a doc who will also look into pituitary, hormones and adrenals. I've been undermedicated for almost two years now so I'm sure I have a lot more problems than just thyroid.

[gimel]

I know what you mean about Endos.  Most are very rigid in their interpretation of treatment protocol.  

The very best way tofind a good thyroid doctor is from a personal recommendation from a satisfied patient.  Lacking that, as most of us do, we have to resort to other means.  Some have suggested finding out from local pharmacist what doctors prescribe T4/T3 meds such as Armour, or Nature-throid.  They tend to be better prospects.  

Regardless, I suggest that you consider this approach before actually making an appointment with a doctor.  Call the doctor's office and say that you are looking for a good thyroid doctor, but you'd like to ask one of the nurses 2 questions before making an appointment.


First question would be, "Is the doctor willing to treat a patient for symptoms, by testing and adjust levels of free T3 and free T4 with medication as required to alleviate those symptoms, without being constrained by resultant TSH levels?"  

Second question should be, "Is the doctor willing to prescribe thyroid medication other than T4 types?"

If either answer is no, then keep looking.

[Sunshine_67]

I do still have many hypo symptoms, I just wonder if something else is going on to constantly make my tsh low and now my FT4 low. My tsh was low even on synthroid. I do have Hashi's and may have high cortisol and low estrogen. Would a D.O. doc be the better choice rather than an endo? I've seen 4 endos and they all seem very traditional and by the book. They all look at my tsh and tell me I'm hyper and want to lower my meds.

[gimel]

I've been there also.  I think the dose increase is the right direction, dependent upon symptoms.  If you have no symptoms, the test results don't mean very much.  If you still have symptoms, then the increase in meds is a good thing.  It will likely increase both FT3 and FT4.  Having FT3 in the upper part of its range and FT4  at least midpoint seems to work very well for many members.  If you need a better balance of FT3/FT4, then you can always incorporate some T4 only type med.  

[peggy64]

My labs were just like yours, high FreeT3, low free T3, low TSH. But I am still very symptomatic. I do not have hashis, so I don't know what is going on here.  I am on armour thyroid 120 mg.

I have seen countless drs, and they don't know "diddly squat" about helping someone with this disease.  I have made an appt with a dr from the top doc list, but can't get in to see him until March.

Its just crazy.