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perplexed??
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perplexed??

hi all,
I've been feeling pretty good for most of the summer... still not like a spring chicken but basically fairly good. I still get the odd tiredness, emotional and sore thyroid symptoms...

I have taken 175mcgs of levo for a while now, I just had my first blood test in a while and my TSH seems ok at 2.92, but my free T4 is 25.3, isn't that really high?? I thought T4 normal range maxed at about 12.... My theory has allways been that I don't convert properly so inorder to get sufficient t3 I have to ramp up the t4...

any thoughts??

cheers, Owain
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499534_tn?1328707778
Hi Owain! Do you have the lab ranges that were used for the Free T4?  Every lab seems to differ in their ranges.
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Avatar_n_tn
hi laura,
I just called my surgery again and they told me that the range was 11-24, so its my mistake... :/

so i am about right... I forgot to add that I have had Hashi's for about 4 years now, although my symptoms were around prior to that..

I've just put together an excel graph of all my lab results from the last couple of years and what i've notice is that with T4 only replacement I have to run my T4 at or above normal range in order to get my T3 and TSH in the middle of normal range... seems like a compromise to me?

thanks for the reply, O
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649848_tn?1357751184
What was your latest Free T3 level, with lab range?

Does your lab report specify that the T4 is Free?
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Avatar_n_tn
they didn't do a t3 this time. at my last test (6months ago on the same dose) i requested one and the T4 came out at 25 again, TSH was very slightly lower at 2.5, T3 was lower/mid range (can't remember how much).

yes they said it was 'free t4',

thanks, O
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Avatar_m_tn
Your T4 numbers also look like TOTAL T4 not FREE.

you really want the FREE T3 & FREE T4 tests done.

It does sound like you may have a conversion issue.  But you may be able to deal with that with lowering of your T4 med and adding a T3 medication.

Most people seem to get symptom free with their FREE T4 about mid range and the FREE T3 in the upper 1/3 f the range.  NOTICE I stated UPPER 1/3 meaning higher in the range.  

Do not let a Dr only treat you so that you get "somewhere" in the so called "normal" range.  Each person is different but if converting properly the should be FT4 about mid range if not slightly above and that should result in the FT3 being above mid range if not in the upper part of the range.

TSH is virtually useless.  Especially on Thyroid meds.  The medication can result in suppressing TSH.  What this means is that if you go by TSH, it will be low and your Dr will keep you UNDER Medicated.  Your body ONLY uses Free T3 hormone so that is what is most important and what correlates to symptoms. TSH and even Free T4 has no or very little correlation to symptoms.  By trying to adjust medication to TSH is almost certain to keep you from feeling your very best.

Hashi's is a progressive condition.  That slowly kills your thyroid.  at 175 mcg would indicate that you don't have a lot of natural production from your Thyroid.  I think at 200 to 250 mcg is about 100% replacement.  This might explain why your dose of 175 has kept you stable for so long.

Recommend you get both Free T3 and Free T4 and post your results with reference ranges.
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