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Recent Lab Results...Need Help Understanding
In March 2017: I was taking 125mcg (Synthyroid) seven days per week plus (one)50mcg on Sunday. My Endo removed the 50mcg and tried to get me to take the 112mcg (Sat & Sun) only. HE SAID I WAS HYPER I had no symptoms of hyper I felt I was hypo. I refused to take the 112mcg due to previous misey while on it for 8 weeks I dropped only the 50mcg and stuck with the 125mcg. THYROIDECTOMY 7 months ago pap cancer.
MARCH RESULTS: Had lots of body pains, weight issues, water retention in lower body etc...
FT4: 1.77 (Range) 0.93 - 1.7
TSH: 0.663 (Range) 0.27 - 4.20
Current Results May 2017: (125mcg Synthyroid Only) Weight is still horrible in spite increased activity from 3 to 6 days per week and Random pains that are not as severe and water retention has eased up some.
FT4: 1.63 (Range) same as above
TSH: 1.54 (Range) Same as above
Can someone tell me if Im Hypo or Hyper or Ok I have a (2nd opinion this Friday)
MARCH RESULTS: Had lots of body pains, weight issues, water retention in lower body etc...
FT4: 1.77 (Range) 0.93 - 1.7
TSH: 0.663 (Range) 0.27 - 4.20
Current Results May 2017: (125mcg Synthyroid Only) Weight is still horrible in spite increased activity from 3 to 6 days per week and Random pains that are not as severe and water retention has eased up some.
FT4: 1.63 (Range) same as above
TSH: 1.54 (Range) Same as above
Can someone tell me if Im Hypo or Hyper or Ok I have a (2nd opinion this Friday)
Good news about the doctor: T3 med plus FT4 and FT3 tests.
How much Cytomel? Is that in addition to your 125 mcg of T4?
How much Cytomel? Is that in addition to your 125 mcg of T4?
6 Comments
He started me on 5mg (Cytomel) and kept me on the 125mcg Synthroid. And will adjust if needed after I have blood work done at the end of June. My ears seem a little stuffy not sure if its the meds or our weather.
Any idea how long cytomel last once you take it ? I cant find solid info
T3 meds reach their peak daily effect in about 3-4 hours, and then diminish over that amount of time. That is why many people like to split T3 meds and take half in the morning and half in the early afternoon. That kind of evens out the effect over the day.
T3 meds have a half-life of less than a day. That means the full effect of your dose builds up over about 5-6 days, and similarly it takes that amount of time to dissipate if you stop the dose.
T3 meds have a half-life of less than a day. That means the full effect of your dose builds up over about 5-6 days, and similarly it takes that amount of time to dissipate if you stop the dose.
I take my synthroid at 4:15am should I wait an hour or so after I take the synthroid before I take cytomel or is it best to take them together? (Doc says together)? I cant imagine splitting 5mcg
That 5 mcg is a very small dose, so I see no great benefit to waiting. You might as well make it convenient and take both. Later on as you increase your T3 dose, you might want to do it a bit differently so that you get some T3 later in the day.
Why do you take your Synthroid at 4 a.m.?
Why do you take your Synthroid at 4 a.m.?
My husband gets up at 4:15 for work and he wakes me to take my pills other wise I would not hear the alarm. I don't even start to take the rest of my meds until 8am.
TSH moves in opposite directions from Free T4 and Free T3. Reducing meds would decrease FT4 and FT3, thus TSH would increase; however, TSH is affected by so many things that it doesn't even correlate well with either FT4 or FT3, much less with symptoms So TSH should never be used to determine medication dosage. A hypothyroid patient should be medicated adequate to relieve hypo symptoms, without creating any hyperthyroid symptoms. So symptom relief should be the only criterion for successful treatment, and FT4 and FT3 and their ratio are the best way to monitor progress with increasing doses of thyroid med.
1 Comments
Hi Gimel
I just got back from my new improved Endo not only did he listen to all my issues he also put me on low dose T3 cytomel and put me in to have FT3,FT4 AND TSH at end of June. I hope this helps.
I just got back from my new improved Endo not only did he listen to all my issues he also put me on low dose T3 cytomel and put me in to have FT3,FT4 AND TSH at end of June. I hope this helps.
It seems that most doctors want their patients to have a suppressed TSH after a thyroidectomy for cancer. This is reported to minimize the possibility of a recurrence. That works well for you since most people find that when taking adequate thyroid med, their TSH becomes suppressed anyway.
Try this link again.
http://www.thyroiduk.org.uk/tuk/TUK_PDFs/diagnosis_and_treatment_of_hypothyroidism_issue_1.pdf
I just sent you a PM with info on some doctors. To access, just click on your name and then from your personal page, click on messages.
Try this link again.
http://www.thyroiduk.org.uk/tuk/TUK_PDFs/diagnosis_and_treatment_of_hypothyroidism_issue_1.pdf
I just sent you a PM with info on some doctors. To access, just click on your name and then from your personal page, click on messages.
1 Comments
Thank you I got the names for the Dr. One more question If supressing my TSH is good why did my TSH get higher after Dr reduced my meds? Does this indicate that im hypo or hyper ? I have zero hyper symptoms (never) had hyper symptoms even on the extra thyroid pill.
Good thyroid doctors don't need to be Endos. They just need to diagnose and treat as I explained. If you will tell us your location perhaps we can suggest a doctor that has been recommended by other thyroid patients.
Don't be concerned about TSH. TSH is affected by so many things that it varies by up to 70% over the entire day. When already taking thyroid meds it has very little use (except to doctors who use it erroneously to adjust med dosage).
Note in Rec. 5 on page 10 of the link I gave you, "If the diagnosis of hypothyroidism is confirmed, then thyroid hormone replacement should aim at eliminating the signs and symptoms of hypothyroidism without producing any signs or symptoms of thyroid hormone excess. " Also, in Rec. no. 6 on page 10, "Dosages should be adjusted according to symptoms first and FT4 and FT3 second. It is totally ineffective to dose a hypothyroid patient to just bring the TSH level within the reference range determined using group test data" 40,41, 51.
Don't be concerned about TSH. TSH is affected by so many things that it varies by up to 70% over the entire day. When already taking thyroid meds it has very little use (except to doctors who use it erroneously to adjust med dosage).
Note in Rec. 5 on page 10 of the link I gave you, "If the diagnosis of hypothyroidism is confirmed, then thyroid hormone replacement should aim at eliminating the signs and symptoms of hypothyroidism without producing any signs or symptoms of thyroid hormone excess. " Also, in Rec. no. 6 on page 10, "Dosages should be adjusted according to symptoms first and FT4 and FT3 second. It is totally ineffective to dose a hypothyroid patient to just bring the TSH level within the reference range determined using group test data" 40,41, 51.
3 Comments
I live in Northern Virginia (Princewilliam county)
So, TSH is unimportant even though I had thyroidectomy for cancer? I read your link I had to copy and past which pulled up many links really unsure if I seldcted the correct one. Thanks
Selected^
I suggest that you supplement with Vitamin D3 to raise your level above 50. I doubt that a B complex would be enough B12. You might consider supplementing with about 250-500 mcg of B12 daily. You don't mention ferritin. It is very important and needs to be at least 100.
High cholesterol is a common symptom of hypothyroidism.
Make sure you request Free T4 andFree T3. If you just sk for T3, you might get a Total T3 test, which is not nearly as revealing as a Free T3.
When you get test results and find your FT4 in the high end of the range, and your FT3 in the lower half of the range, you can talk with the doctor about having inadequate conversion of T4 to T3, and request that a source of T3 be added to your meds, while reducing your T4. FT4 is fine around mid-range.
How much selenium do you take? Selenium is one that can be a problem when level is too high.
Don't assume that the new Endo will be a good thyroid doctor. Many specialize in diabetes, not thyroid. Many of them think that diagnosis and treatment of thyroid issues is very easy. It is not. Many of them have the "Immaculate TSH Belief" and only pay attention to that, which is very wrong. If they test beyond TSH it is usually only Free T4 and then they use "Reference Range Endocrinology" and will tell you that a FT4 test that falls anywhere within the range is adequate. That is also very wrong. You might consider taking with you a copy of the link above and if you run into resistance from the Endo, give it to him and ask him to review and consider treating you clinically, by testing and adjusting Free T4 and Free T3 as needed to relieve hypothyroids symptoms, without being influenced by resultant TSH levels. Symptom relief should be all important, not just test results.
High cholesterol is a common symptom of hypothyroidism.
Make sure you request Free T4 andFree T3. If you just sk for T3, you might get a Total T3 test, which is not nearly as revealing as a Free T3.
When you get test results and find your FT4 in the high end of the range, and your FT3 in the lower half of the range, you can talk with the doctor about having inadequate conversion of T4 to T3, and request that a source of T3 be added to your meds, while reducing your T4. FT4 is fine around mid-range.
How much selenium do you take? Selenium is one that can be a problem when level is too high.
Don't assume that the new Endo will be a good thyroid doctor. Many specialize in diabetes, not thyroid. Many of them think that diagnosis and treatment of thyroid issues is very easy. It is not. Many of them have the "Immaculate TSH Belief" and only pay attention to that, which is very wrong. If they test beyond TSH it is usually only Free T4 and then they use "Reference Range Endocrinology" and will tell you that a FT4 test that falls anywhere within the range is adequate. That is also very wrong. You might consider taking with you a copy of the link above and if you run into resistance from the Endo, give it to him and ask him to review and consider treating you clinically, by testing and adjusting Free T4 and Free T3 as needed to relieve hypothyroids symptoms, without being influenced by resultant TSH levels. Symptom relief should be all important, not just test results.
1 Comments
What type of endo would you reccomend? Your right these Drs are most diabetic/weight lose (laughable). The Selenium I take is only 100mg per day and Mag is 500 and B complex im not sure last time my B12 was checked it was well over the reccomended amount but (I use vitamin protein powder)that has B vitamins. I will ask for FT3 & FT4 from this Endo but im sure they will resist it must be in the Endo engagement rule book resist all blood test beyond TF4 &TSH.
Any idea why my TSH would go up vs. down? Does this indicate Im Hypo? How is that possible with 2/test on same 125mcg.
Any idea why my TSH would go up vs. down? Does this indicate Im Hypo? How is that possible with 2/test on same 125mcg.
Hypothyroid patients taking thyroid med adequate to relieve symptoms frequently have a suppressed level of TSH. That does not mean hyperthyroidism, unless there are hyper symptoms due to excessive levels of Free T4 and Free T3. Free T3 is the thyroid hormone used by all the cells of the body, so it is important to know. You have not even been tested for Free T3, so you do not know if your body was/is adequately converting the T4 to T3.
A good thyroid doctor will treat a hypothyroid patient clinically, by testing and adjusting Free T4 and Free T3 as needed to relieve symptoms, without being influenced by resultant TSH levels. Symptom relief should be all important, not just test results, and especially not TSH results when taking thyroid med. You can read about this in the following link. I highly recommend reading at least the first two pages, and more, if you want to get into the discussion and scientific evidence for all that is recommended.
http://www.thyroiduk.org.uk/tuk/TUK_PDFs/diagnosis_and_treatment_of_hypothyroidism_issue_1.pdf
In the paper on page 13, note rec. 10. "It should be noted that when taking adequate thyroid medication, the TSH level in an L-T4 treated patient is frequently suppressed below the reference range 79 - 81 . A suppressed TSH level means that the patient has become hyperthyroid only if there are hyper symptoms due to excessive levels of FT4 and FT3."
So I would definitely say you are hypothyroid, not hyperthyroid. You also need to get the doctor to test for both Free T4 and Free T3 every time you go in for tests. Since hypothyroid patients are so frequently deficient in Vitamin D, B12 and ferritin, you need to get those tested and then supplement as needed to optimize. D should be at least 50 ng/mL, B12 in the upper end of its range, and ferritin should be at least 100.
If you doctor resists doing these tests and is unwilling to treat you clinically as described, then you will need to find a good thyroid doctor that will do so.
A good thyroid doctor will treat a hypothyroid patient clinically, by testing and adjusting Free T4 and Free T3 as needed to relieve symptoms, without being influenced by resultant TSH levels. Symptom relief should be all important, not just test results, and especially not TSH results when taking thyroid med. You can read about this in the following link. I highly recommend reading at least the first two pages, and more, if you want to get into the discussion and scientific evidence for all that is recommended.
http://www.thyroiduk.org.uk/tuk/TUK_PDFs/diagnosis_and_treatment_of_hypothyroidism_issue_1.pdf
In the paper on page 13, note rec. 10. "It should be noted that when taking adequate thyroid medication, the TSH level in an L-T4 treated patient is frequently suppressed below the reference range 79 - 81 . A suppressed TSH level means that the patient has become hyperthyroid only if there are hyper symptoms due to excessive levels of FT4 and FT3."
So I would definitely say you are hypothyroid, not hyperthyroid. You also need to get the doctor to test for both Free T4 and Free T3 every time you go in for tests. Since hypothyroid patients are so frequently deficient in Vitamin D, B12 and ferritin, you need to get those tested and then supplement as needed to optimize. D should be at least 50 ng/mL, B12 in the upper end of its range, and ferritin should be at least 100.
If you doctor resists doing these tests and is unwilling to treat you clinically as described, then you will need to find a good thyroid doctor that will do so.
2 Comments
Thank You Gimel. I gave my 1st Endo the boot after he blew me off on my request for the T3 test and dismissed all my on going body issues saying its not thyroid related. Anyway he did my Vitamin D and that was 42.90 (12-80 range) and as I stated I see a new Endo this Friday and will request the T3 test and hope this person can accomplish this if not I might have to file a formal complaint (military medicine)is a nightmare awful care at best. I will certainly read the info on link you provided.
P.s. My cholestrol levels have hit all time high and Im a crazy workout person (not related)to thyroid my endo says.
P.s. My cholestrol levels have hit all time high and Im a crazy workout person (not related)to thyroid my endo says.
I do take B-complex,Selenium,zinc and magnesium (about 6 hours after synthroid)
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