Aa
assistance with lab results please and thank you
Forgive me if I am asking questions that were previously posted by other members. I am transferring to a new primary (new insurance) from an endo. I'd like to get input from the forum on my tests since my memory is a little weak on what is low, high, should be ignored, etc. I would hate to get direction from a primary without be fully armed with knowledge and for the life of me, its soooo confusing. I hate changing my meds... it always seems like a guessing game.
I was taking 50 MCG Synthroid and 4 tabs of Cytomel 5 mcg. My last labs were is Sept 2014 (below) and my endo called me and immediately told me I had shifted to hyper and asked me to bring down my cytomel. The thing is that I can't remember if she told me to adjust my synthroid. :( I know, foolish. My job has been consuming ... I remained at one synthroid per day.. with one cytomel in the am and another in the pm. My Sept 2014 labs: TSH 0.14, T4 Free 0.6, T3 Total 63.
Fast forward to Jan 2015...new primary, new labs. Now I am at TSH 6.70, T4 0.8, T3 Total 110.0. Primary is out of town for the three day weekend... just curious about what these new counts mean for me...thought I would ask this forum.
Am I still hyper, hypo, or just right? I know I have heard that you are supposed to ignore the TSH when you take meds for T3, but I thought that was when the TSH was in the low numbers.
Sorry... I am very confused. Your assistance or suggestions on med doses are appreciated.
I was taking 50 MCG Synthroid and 4 tabs of Cytomel 5 mcg. My last labs were is Sept 2014 (below) and my endo called me and immediately told me I had shifted to hyper and asked me to bring down my cytomel. The thing is that I can't remember if she told me to adjust my synthroid. :( I know, foolish. My job has been consuming ... I remained at one synthroid per day.. with one cytomel in the am and another in the pm. My Sept 2014 labs: TSH 0.14, T4 Free 0.6, T3 Total 63.
Fast forward to Jan 2015...new primary, new labs. Now I am at TSH 6.70, T4 0.8, T3 Total 110.0. Primary is out of town for the three day weekend... just curious about what these new counts mean for me...thought I would ask this forum.
Am I still hyper, hypo, or just right? I know I have heard that you are supposed to ignore the TSH when you take meds for T3, but I thought that was when the TSH was in the low numbers.
Sorry... I am very confused. Your assistance or suggestions on med doses are appreciated.
Well, at least the endo has your PCP heading in the right direction now. He's looking at increasing, rather than decreasing.
Unfortunately, being an experiment is part of this disease. We all react so differently to different meds or combinations of meds that we all have to find where we feel best. It takes a lot of patience. Some people do fine on T4 only, some have to add just a touch of T3, and some only do well on desiccated.
Why would they take you off of Cytomel? A lot of doctors don't like to use it. They were taught in med school that all everyone needed was T4, and the T3 would take care of itself...nice theory that falls flat on its face for a lot of people. Have you ever been on T4 only?
Unfortunately, being an experiment is part of this disease. We all react so differently to different meds or combinations of meds that we all have to find where we feel best. It takes a lot of patience. Some people do fine on T4 only, some have to add just a touch of T3, and some only do well on desiccated.
Why would they take you off of Cytomel? A lot of doctors don't like to use it. They were taught in med school that all everyone needed was T4, and the T3 would take care of itself...nice theory that falls flat on its face for a lot of people. Have you ever been on T4 only?
So my new primary touched base with an endo and then finally came back with a suggestion to either keep the cytomel daily intake and increase the synthroid from 50 to 75 mcg. or... dump the cytomel and go with the synthroid all together... 75 mcg + 25 + 25 = 125 mcg daily.
Ugh... not sure what to do. Why would they take me off the cytomel? I hate being an "experiment" and check back in two months.
Advice?
Ugh... not sure what to do. Why would they take me off the cytomel? I hate being an "experiment" and check back in two months.
Advice?
Jan 2015 labs:
TSH 6.70 (0.10-5.50)
FT4 0.8 (0.8-1.7)
T3 110 (50-170)
Sept 2014 labs:
TSH 0.14
T4 Free 0.6
T3 Total 63
Okay, so I just rearranged your labs so they're a little easier to look at and compare. However, since they came from different labs, and we don't have the ranges from the September set, comparison is a little shaky.
A general comment: Your doctor should be ordering FREE T3, not total T3. TT3 tells the total amount of T3 in your blood. However, much of that is bound by protein and unavailable. FT3 tells what's available, and that's what we want to know.
So, in September, your FT4 was probably below range since 0.8-1.7 or 1.8 is a typical range. FT4 said you were hypo. TT3 also looked below range, although it wouldn't have been on the range from your January labs. However, below range or not, it's way too low since it should be in the upper half to third of range. FT3 said you were hypo. TSH was 0.14 (0.3-3.0 is the range recommended by AACE), which is on the low side. However, as you mentioned, TSH often has to be ignored when it's on the low side because it's often suppressed by meds, especially meds containing T3. Obviously, your doctor was fixated on TSH and pretty much ignoring TT3 and FT4. I think you actually would have benefitted from an increase back then.
By January, your FT4 was on the floor of the range, and midrange is the target for FT4. So, it's still way too low. TT3 doesn't look bad. It's right at 50% of range, not quite in the upper half, but not bad. However, now your TSH is above your lab's range and considerably above the AACE range. So, now, all three tests are saying you're hypo (under medicated).
I do find it interesting that you lowered your T3 dose between these labs, and your TT3 and FT4 actually both went up. That could be attributed to different ranges at the two labs, but it could also indicate that your thyroid is producing more hormone. Do you know if you have Hashi's, and if not, the cause of your thyroid dysfunction?
It is difficult to separate thyroid symptoms from those of menopause. After a lifetime of clockwork regularity, my periods went whacky about ten years before they actually stopped. It gets confusing, and often the only way to tell if this is a thyroid symptom is to get your numbers right, get your other symptoms under control, and if it persists, attribute it to menopause (or something other than thyroid).
TSH 6.70 (0.10-5.50)
FT4 0.8 (0.8-1.7)
T3 110 (50-170)
Sept 2014 labs:
TSH 0.14
T4 Free 0.6
T3 Total 63
Okay, so I just rearranged your labs so they're a little easier to look at and compare. However, since they came from different labs, and we don't have the ranges from the September set, comparison is a little shaky.
A general comment: Your doctor should be ordering FREE T3, not total T3. TT3 tells the total amount of T3 in your blood. However, much of that is bound by protein and unavailable. FT3 tells what's available, and that's what we want to know.
So, in September, your FT4 was probably below range since 0.8-1.7 or 1.8 is a typical range. FT4 said you were hypo. TT3 also looked below range, although it wouldn't have been on the range from your January labs. However, below range or not, it's way too low since it should be in the upper half to third of range. FT3 said you were hypo. TSH was 0.14 (0.3-3.0 is the range recommended by AACE), which is on the low side. However, as you mentioned, TSH often has to be ignored when it's on the low side because it's often suppressed by meds, especially meds containing T3. Obviously, your doctor was fixated on TSH and pretty much ignoring TT3 and FT4. I think you actually would have benefitted from an increase back then.
By January, your FT4 was on the floor of the range, and midrange is the target for FT4. So, it's still way too low. TT3 doesn't look bad. It's right at 50% of range, not quite in the upper half, but not bad. However, now your TSH is above your lab's range and considerably above the AACE range. So, now, all three tests are saying you're hypo (under medicated).
I do find it interesting that you lowered your T3 dose between these labs, and your TT3 and FT4 actually both went up. That could be attributed to different ranges at the two labs, but it could also indicate that your thyroid is producing more hormone. Do you know if you have Hashi's, and if not, the cause of your thyroid dysfunction?
It is difficult to separate thyroid symptoms from those of menopause. After a lifetime of clockwork regularity, my periods went whacky about ten years before they actually stopped. It gets confusing, and often the only way to tell if this is a thyroid symptom is to get your numbers right, get your other symptoms under control, and if it persists, attribute it to menopause (or something other than thyroid).
Hmmm... different labs from Sept to Jan, so here is the info from Jan:
T3, Total, Range: 50 - 170 ng/dL, 110
Free T4, Range: 0.8 - 1.7 ng/dL, 0.8
TSH, Range: 0.10 - 5.50 uIU/mL, 6.70
and to answer your questions, I'm embarrassed to say that I from Sept to now has been a blur...with the holidays and back to back colds in Nov and Dec I feel like "how was I feeling" is a combination of winter and illness, etc. so its difficult to pinpoint. I do remember that prior to Sept I was starting to lose more hair, acne, get some exema which prompted me to take my labs to see where my numbers were at. That is when my endo called me to say I had swung to hypo. Those results were from a different lab.
Now I still feel foggy, sluggish, still losing hair (but at a less alarming rate), skin is slightly clearing, still a patch of exema though. I am female and experiencing a heavy period for the first time in years... its been scattered and light. However... I'm 47 and all these symptoms could be pre-menopausal.. yes? I always feel its difficult to pin point symptoms to thyroid meds when they could be contributed to age, etc. Very confusing.
T3, Total, Range: 50 - 170 ng/dL, 110
Free T4, Range: 0.8 - 1.7 ng/dL, 0.8
TSH, Range: 0.10 - 5.50 uIU/mL, 6.70
and to answer your questions, I'm embarrassed to say that I from Sept to now has been a blur...with the holidays and back to back colds in Nov and Dec I feel like "how was I feeling" is a combination of winter and illness, etc. so its difficult to pinpoint. I do remember that prior to Sept I was starting to lose more hair, acne, get some exema which prompted me to take my labs to see where my numbers were at. That is when my endo called me to say I had swung to hypo. Those results were from a different lab.
Now I still feel foggy, sluggish, still losing hair (but at a less alarming rate), skin is slightly clearing, still a patch of exema though. I am female and experiencing a heavy period for the first time in years... its been scattered and light. However... I'm 47 and all these symptoms could be pre-menopausal.. yes? I always feel its difficult to pin point symptoms to thyroid meds when they could be contributed to age, etc. Very confusing.
Please post the reference range for your FT4 and TT3. Ranges vary lab to lab, so they have to come from your own lab report. If both sets weren't done at the same lab, they may have different ranges.
How are you feeling now? In September, when your PCP lowered your dose, were you feeling hyper?
How are you feeling now? In September, when your PCP lowered your dose, were you feeling hyper?
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.
