Confused about lab results

[Lolovasq]

Hi,
I recently(6/30/14) did my lab work.  My doctor says TSI was indetectable in blood.  So why am I still having (hyper/hypo) symptoms??  Anyone experience similiar issue??

TSI <89
TSH 1.80   (It was .53 in May)
Free T4 1.1  (It was 1.3 in May)
T3, Total  61

I have been having symptons - eye swelling, pressure in right eye, hair falling out/dry/brittle, weight gain, tired all the time, sleeping problems, anxiety, heat intolerance, dizzy

I was diagnosed in 1999 hyperthyroid... treated with RadioIondine 2x... put on Synthroid .112

[goolarra]

Please post the reference ranges for your FT4 and TT3.  Ranges vary lab to lab and have to come from your own lab report.  Does your doctor test FT3?

[Lolovasq]

FT4 ranges 0.8-1.7 ng/dL
TT3 ranges 50-170 ng/dL

According to my health summary, I don't see that I've been tested for FT3.  

[goolarra]

Many doctors don't like to order FT3, but it's the test that correlates best with symptoms.  TT3 tells the total amount of T3 in your blood.  However, much of that is chemically bound by protein and useless to your cells.  FT3 tells what's available (free).

Your FT4 is 33% of range, and the guideline for FT4 is around 50%.  So, it looks like needs a little improvement (increase in Synthroid).  

TT3 doesn't always correlate with FT3, but since we don't have that, let's assume for this discussion that it does.  Your TT3 is at 9% of range, and the guideline her is 50+%, so, it's really, really low.  

According to FT4 and FT3, you are hypo.

If you are on T4-only meds, like Synthroid, it's important to get your FT4 to about 50% of range.  For a number of reasons, thyroid test ranges are very flawed...the whole bottom half of the range should probably be considered hypo.  So, until your FT4 is about 50%, we can't really tell how well you convert T4 to T3 (do you understand that process?  if not, I'll explain) since there isn't enough T4 available for conversion.

If I were you, I'd ask my doctor to increase my Synthroid until FT4 was about 50% of range.  See if your FT3 (ask for that next time) tracks FT4 up.  Once FT4 is midrange, it can take FT3 a while to "catch up" at times.  Once FT4 is midrange, if you are still experiencing symptoms (after giving FT3 a chance to catch up) and FT3 is still low, it's time to look into adding in T3 meds (Cytomel and generics).