What does my bloodwork mean?

[Alicecabalis]

I am 40 years old, female.  My first round of bloodwork was done 3 days following my mestrual cycle start -- showed Ferritin 212, Prolactin 9, TSH of 9.73. FSH 6.8.  I was prescribed Synthroid, 6 months later (doc's office "forgot" to call me) of 0.025.  I felt fantastic for about a week and then could feel my original symptoms of tiredness, etc. again.

Had follow up bloodwork last week, approximately 4 days prior to my expected menstrual cycle and even though I feel like my thyroid med's need to be adjusted (I'm still freezing all the time and tired, thinning hair, etc) -- I am told now that my TSH is good.  Results were TSH 3.56, Prolactin 26.2 and FSH 2.2.  Now the doc wants to wait 6 weeks and check again -- the thoughts of feeling like this for 6 more weeks....

Doc did bring up the high prolactin level and that when she rechecks bw again, may refer me to an endocrinologist.  I am wondering if these levels could be related in any way?  Also my mother takes synthroid (about 5 times as much as I am prescribed and my maternal grandmother had thyroid cancer -- so I am concerned!)  Also after I had about 5 vials of blood taken on Friday I did feel fantastic the following morning so wondering if my problem could be related to high iron (high ferritin).

Just trying to make heads/tails out of this bloodwork since I am still suffering from the symptoms of hypothyroid and was POSITIVE the result would indicate I needed an increase in meds.  Any ideas?  Can you comment on the results?  

Also I am planning to try to get pregnant-- I have had 3 miscarriages in the past (about 5-6 years ago) by ~12 weeks...never had a problem getting pregnant, but would always miscarry -- had one that was thought to be molar (but D&C result proved this was not the case), one that was blighted ovum, one miscarriage -- I would like to try again but want to make sure my hormone levels are right and I'm healthy.

Any advice/comments would be much appreciated :)

[Alicecabalis]

My doctor seemed perplexed when looking at the prolactin number.  She wanted to do more bloodwork in 6 weeks and if the number was still high, then refer me to an endo.  She did mention that it could be a benign pituitary tumor but didn't think so because of my other bloodwork.  If it is something like that, do you know what the treatment is?

6 months ago my prolactin was fine, then in November I was almost 2 weeks late for my menstrual cycle (that never happens -- I'm always 28 days right on)  Not sure if this is important or not.

I am definitely going to push on this -- happy you made the comments.

On another note, In the past, I have not had the difficulty getting pregnant -- it always seemed to be trouble with staying pregnant past 12 weeks...

[Alicecabalis]

I did check the bloodwork and the FT4 was 14.5 but I don't see any result for FT3.

I will definitely be asking some questions and really appreciate your input!

[kris71]

You won't get pregnant or won't be able to sustain a pregnancy with high tsh and/or low frees. Also the high prolactin could mean a benign pituitary tumor which could also lead to trouble getting pregnant. Usually high prolactin levels really messes with ovulation. Definitely see an endo or doc that's going to treat you properly. Any tsh above a 2 seems high especially when trying to get pregnant. Good luck!

[gimel]

Just wanted you to be aware that seeing an endo does not guarantee a good thyroid doctor.  Many of them specialize in diabetes, not thyroid. In my opinion a good thyroid doctor will treat your symptoms by testing and adjusting the actual, biologically active thyroid hormones (FT3 and FT4) with whatever type meds are required to alleviate symptoms, without being constrained by resultant TSH levels.  Symptom relief should be all important, not TSH level.  Many members have reported that this requires that FT3 is adjusted into the upper part of its range and FT4 is adjusted to at least the midpoint of its range.  

To avoid wasting your time and money, I suggest that you can call about making an appointment and ask to speak to one of the nurses.  I have found them to be willing to talk and answer the question of whether the doctor is willing to treat you for your symptoms by testing and adjusting FT3 and FT4 with whatever meds are required to alleviate symptoms, without being constrained by resultant TSH levels.  Second question would be if the doctor is willing to prescribe meds other than T4 only.  Ifthe answer to either is no, then keep looking.

[Alicecabalis]

Thank you for your comments -- strangely enough, the "normal" reference on the bloodwork sheet for TSH shows 0.35 - 4.2 mU/L.  She refused to increase the synthroid because of the bloodwork showing "normal".  I think it took almost 5 months for my sister to get in to see an endo and strangely enough my GP doc told me to go ahead and try to get pregnant now -- even though I don't feel well.

I think I will get a second opinion and I will push to see the endo as you suggest.  

Much appreciated

[Super_sally888]

your tsh is still too high. target is 1.0, particularly you want to get pregnant. ft3 and ft4 should be in upper half of the fererence range.

i'd push to get referred to an endo.  make sure you tell him you want to get pregnant. they should be agressive in treating in this case.