Lab Results .. what do they mean?

[Scout2Family]

I've been taking .075 Synthroid for the last year..  and recently did labs.  My doctor usually keeps me on the higher end of the scale but my last visit I saw the nurse.  She didn't increase my strength and I feel that my doctor would have after these lab results:  (keep in mind that the doctor USUALLY keeps me on the higher end which tends to be my Optimal Range)

Thyroxine (T4)  Free,  Direct         1.07                             0.61 - 1.76 (reference)

TSH                                            3.679                           .350 -  5.500

Thyroxine (T4)                             6.9                                 4.5 - 12.0

T3 Uptake                                    30                                 24 - 39

Free Thyroxine Index                    2.1                                 1.2 - 4.9

Is it me or am I on the LOWER end of most these tests and not towards where my Optimal Range is.. on the higher end?!  

What do you think?

[kitty9309]

I would be happy with the increase. It is better to go a little slow than overshoot and be on too high a dose.
You never really know how much the TSH will change on a certain dose. I asked my endo that. I said "If 25 mcg drops the TSH by 2 points, will another 25 drop it 2 more?". She said they don't know, but it would be a great study. I think someone should do a study.
Keep me posted and congrats on getting a better dose for you.

[Scout2Family]

Ok, finally got a call... but it wasn't the doctor.. it was... yes, you guessed it, THE NURSE!  She was wanting to know why I was asking for the doctor to review my labs and adjust the meds that she just prescribed me.  I told her that the doctor like to keep me on the higher side and I am just feeling like ****.  I went on to saying that I am usually a doctor only patient and that I've known the doctor for a long time...  and I know that she would have up'ed me with those lab result.  She said  ok, and that I know my body best.  She was going to go from my .075 to 1.00.  She went on to say that she was skipping the .88 dosage.  I have to retest in 6 weeks.  I'm just wondering if the jump to 1.00 is big enough to get me where I want to be.  Guess I will just cross my fingers.  I'm hoping to feel better REALLY soon!

[Scout2Family]

Still no update today.. no call back from the doctor.  I called this morning and they said she's in this afternoon...  and they are putting another message on her desk to adjust my labs and to call me.  Soo....  we are waiting  :-)

[kitty9309]

You are welcome again!
Good luck and let us know how it goes.

[Scout2Family]

You're awesome.  Thanks for the refresher.  So, in esscence, once I take the higher dosage the TSH will not be so high.  I was thinking the medication would make that higher... but now I fully understand.  

I'm going to call the doctors office again after lunch and get her to give me the next step or two up and re test in 6 weeks.

Will keep you posted.  Thanks again!

[kitty9309]

Glad that helped.

TSH is Thyroid Stimulating Hormone and free t3/4 are the actual thyroid hormones.
The pituitary sends out TSH to keep thyroid hormone levels optimal. If the thyroid hormone levels drop too low, as in hypothyroidism, the TSH will rise to try to stimulate the thyroid gland to produce more hormone. At some point, the thyroid is damaged too much and cannot produce enough thyroid hormone for your body to function well.
The reverse happens in hyperthyroidism. Low TSH and high hormone levels.

Taking thyroid hormone for hypothyroidism lowers the TSH because it supplies the body with the missing amount of hormone. It is an inverse relationship.

The correct amount of medication (t4) will lower a person TSH into the lower end of normal and usually bring up the hormones into the mid-upper end of the range.

Ask doctor if you can try next higher dose and be retested in 6 weeks. There is room for your TSH to move downward w/o worrying about becoming hyper.

You are welcome- hope this helps, too.

Kitty

[Scout2Family]

Thanks for the breakdown..  

with me wanting to be be above the mid range..  how do I do that and correct the TSH levels?  Can you refresh me on what the TSH and why it would be high and the other levels lower?

:-)  Thanks!

[kitty9309]

The t3/4 is below mid range and the TSH is too high for someone on treatment. A TSH goal of about0.5-2.0 is widely suggested. Depends on how you feel in that range.

The t3 uptake is an outdated test and not used much anymore to monitor thyroid disease. Wouldn't even have them run that test. Maybe save you some $$.

Post back about what doc says.

[Scout2Family]

I did put a call in to the doctor to review my labs and call me.  Hopefully I'll hear something by Friday.  I do feel better on the higher end.  As of now, I feel sluggish and cold..  According to the tests tho.. where am I?  Lower to mid area of testing range?  

Kitty is right..  Left Column is the Test Name  Then my Results and the Right Column is the Reference Range.

[kitty9309]

The left column is the test, the center is the patient's result, and the right is the reference range.

I agree w/ the coment about talking to the doctor directly.

Kitty

[AR-10]

I think you need to explain all those numbers, because I'm not sure what the three columns represent.

I think I would tell my doctor that he is not getting paid to let his nurse treat me. I get that from time to time, and I HATE IT!

Call your doctor, and tell his nurse you would like your doctor to review the latest test results and you would like to have the doctor call you back.

[hypogirl80]

It really depends on how do you feel, if you feel better at the high end, then go higher, if no different, then you don't need take that much synthroid. every individual is different, better let your body tell you..