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lab Results
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lab Results

Can anybody help me my Doctor says I am ok and I have all the symtoms (symptoms) of everybody post here and I gain 60 pounds this last year.

10/25/11
TSH 1.57
   T4 7.0
   T3 92

11/02/11
TSH 3.140
   T4 7.1
    T3 124

11/10/11
TSH 6.2
  T4  8.0
  T3 118

12/24/11
TSH 2.2  did not do T4T3 this time
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Avatar_m_tn
If you look through this list of 26 typical hypo symptoms, which ones would you say that you have?

http://endocrine-system.emedtv.com/hypothyroidism/hypothyroidism-symptoms-and-signs.html

The next thing is that TSH is a pituitary hormone that is affected by so many variables that it is inadequate as a sole diagnostic for thyroid.  You did have the other two tests earlier, but those are for Total T3 and Total T4, which are outdated and not very revealing.  You really need to request testing for Free T3 and Free T4, along with TSH, instead of Total T3 and T4.  Free T3 is the most important test because it largely regulates metabolism and many other body functions.  Scientific studies have shown that Free T3 correlated best with hypo symptoms, while Free T4 and TSH did not correlate.

A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.   Symptom relief should be all important, not just test results.  You can get some good insight into clinical treatment from this letter written by a good thyroid doctor for patients that he sometimes consults with from a distance.  The letter is sent to the PCP of the patient to help guide treatment.

http://hormonerestoration.com/files/ThyroidPMD.pdf

You need to go back to the doctor and request testing for Free T3 and Free T4.  If the doctor resists and makes excuses as to why that is not necessary, just insist on it and don't take no for an answer.   If you have never been tested for the thyroid antibodies, you should do that also.  The tests are TPO ab and TG ab.  

While at the doctor's, you should ask if he is willing to treat you clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms.  Also ask if he is willing to prescribe T3 type meds.  If either answer is no then you should start looking for a good thyroid doctor that will do both.

When test results are available,  if you will get a copy of the lab report and post results and references shown on the report, then members will be glad to help interpret results and advise further.
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Avatar_m_tn
Thank you so much for your input the test T4 and T3 are the free from labcorp

11/10/11

  TSH 6.2  (0.5-4.8)
  Free  T4 1.07 (0.82-1.77
  Free   T3 3.3  (2.2-4.4)
  Vitamin D  28  (32-100)
   ACTH   10  (6-48)
   DHEA   113 (17-286)
  IGF 149  (118-298)
   CBG  4.1 (2.3-3.9)
   cortisol,serum   3.7 (8.0-19)
   free cortisol,serum 0.05  (0.2-1.8)
   percent free cortisol  1.5 (2.3-9.5)
    Testost, Bioavailable  4.5 (1.1-14.3)
  

  I agree to do the test again and did my TPO negative the doctor told me no hashi/addison's that I am fine. can you tell me the brands for T3 types of meds

  Thank you so much
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Avatar_m_tn
I'm glad you had some test results for Free T3 and Free T4.  That is very helpful.  Your Free T3 is right at the middle, which often is not optimal for hypo patients.  The ranges for Free T3 and Free T4 are so broad, and have never been corrected like done for TSH over 8 years ago, that many members, myself included, report that symptom relief for them required that Free T3 was adjusted into the upper third of the range and Free T4 adjusted to around the middle of its range.  So you have plenty of room for adjustment of those.  

Another couple of observations are that your Vitamin D is way too low.  You need to supplement with D3, that you can buy anywhere, to get your level above the midpoint of the range.  Also, I see that many of your cortisol tests were low as well.  From what I have read it would be good to address the adrenal issue first, even before starting on any thyroid meds.  Here is a good article about that.  

http://www.bellaonline.com/articles/art44711.asp

A couple of other tests that would be advisable are full test panel for iron anemia,  and Reverse T3, just to rule it in or out as a possibility.  And of course don't forget to ask the doctor about clinical treatment.

There are several meds with T3 in them.  They include Armour Thyroid and  Nature-Throid, which are desiccated types containing both T3 and T4.  Then there are the T3 only types like Cytomel, or its generics.  








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Avatar_m_tn
Thank you so much for your input :-)

  do you know any doctor in los angeles that will give me Armour Thyroid
  I do not think my doctor will get this and I have telling him I feel bad and he tells me that he is trying

   Thx
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Avatar_m_tn
Sorry, but I don't have a doctor in the Los Angeles area that I can recommend based on members personal experience.  The best I can do right now is to give you this list of Endocrinologists that are Top Rated by their patients.  

http://www.healthgrades.com/diabetes-metabolism-endocrinology-directory/ca-california/los-angeles_2

You could try selecting any of these doctors that look to be the best prospects for you, based on their location, insurance coverage and patient's reviews.  Then you could call and ask questions about how they treat their hypothyroid patients.  For example I call and say that I am looking for a good thyroid doctor but before making an appointment I'd like to ask one of the nurses two questions.  That almost always works to get a nurse on the line.  Then I ask the nurse if the doctor is willing to treat a hypothyroid patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  Then I also ask if the doctor is willing to prescribe T3 type meds.  If either answer is no, then don't waste your time with that doctor, just keep looking.  

In your case, don't forget about addressing the adrenal issue before the hypothyroid issue.  Also, your vitamin D is way too low, so that must be a priority for you as well.
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