Where do I go from here

[Gina2474]

Had blook tests taken for hypothyroidism, Been on synthroid 7 yrs. off 2003-2007, on and off 2007-2009 with TSH results reading normal.  Now on natural form for 6 weeks, tested FT4 .67 (.71-1.85)  TSH 3.08 (.32-5.0).  First time the T4 was ever tested.  Had pituitary scan in 1998 normal.  I'm not losing weight or feeling right.  Don't know where to go from here, wondering do I need pituitary rechecked?

[magpieannie]

What desiccated hormone are you on? Did the doctor not test the freet3 too? You must know this number, especially when on desiccated as it has a large amount of t3 in it. Remember, t3 is the active hormone and t4 is the storage hormone that must convert into t3 in the body. By looking at the freet4 and TSH number, I'd say you probably need to raise meds by 1/2 a grain. It takes awhile to adjust to the t3 in desiccated, you will probably feel better with a slight increase. Also, are you splitting your meds? My daughter is on Nature-throid and she does best when we are on a strict schedule with dividing her medication by three doses (1 grain every 4 hours one hour before she eats) Consistency is the key for her. Hope this helps and get that freet3 checked asap!

[gimel]

First, the AACE recommended over 6 years ago that the ref. range for TSH should be lowered to .3-3.0.  Many thyroid authorities have stated that anything over 2.0 should be suspect.  In addition, TSH is a pituitary hormone that is only an indicator of thyroid hormone levels in the blood.  It is affected by many variables, including the time of day when the blood was drawn for the test.  Also, it does not correlate very well at all with hypo symptoms.  Why the medical community continues to use the old test range and rely predominantly on TSH as a diagnostic, when it is not, is a mystery to most of us on the Forum.

The most important tests are for FT3 and FT4, which are the actual, biologically active thyroid hormones.  Free T3 is actually four times as potent as free T4, and it correlates best with hypo symptoms.  Many patients with hypo symptoms have reported the best result by medicating until  FT3 and FT4 move into the upper part of their ranges.  Just being within the low limit of the reference ranges for FT3 and FT4  doesn't mean everything is okay.  The ranges should really be considered as guides within which to adjust levels as required to alleviate symptoms.

Suggest that you insist on testing for FT3, along with FT4.  Then you will need to make your doctor aware of your desire to treat your symptoms by testing and adjusting your FT3 and FT4 levels with whatever medication is required to alleviate your symptoms.  Alleviating symptoms is what is should be all about.