bumping this up for others to post
The nurse's comments baffle me a bit. If your TSH is 0.6, that's at the lower end of the range (0.3-3.0). Is your doctor testing FT3 and FT4 as well as TSH? He should be basing his meds adjustments on symptoms first, followed by FT3 and FT4. You're right, WE do know when our levels are off, without the numbers. FT3 and FT4 are much more important than TSH because they are the actual thyroid hormones. When meds are adjusted on the basis of TSH alone, there are often huge swings from hypo to hyper and back.
I'd call my doctor and ask for results of all thyroid tests with reference ranges (these are specific to each lab and have to come from your own lab report). I'm sure there's something in your labs that would indicate why you still feel so hypo with a relatively low TSH.
It's very frustrating to deal with an insensitive doctor. When you get your results, post them if you'd like, and members will help you interpret them.
yeah, I will post labs, I must have heard the number wrong, maybe it was 6. but I know she said upper range, not lower ? They always mail a hard copy with T4 and other numbers, so when I get it I will post. Below are results from 8 weeks ago and at that point they had me go from .75 to .1 Synthroid.
I am 20+ years diag Hypothyroid and 2 years ago went severe hyperthyroid, was stable for 6 months now back to way hypo, I just hate the feeling, I have everything from feeling like crap to major foot cramps to weight gain to swallowing difficulty and the pericardial effusion crap. I had a nodule biopsied about a month or so ago and all came back benign on that. I wonder if Estrogen or other hormones can wreak havoc on the thyroid as well ?
TSH- 10.87 Lab Ranges- .450 - 4.50
T4 Free- 1.27 Lab Ranges- 82 - 1.77
TPO ab >600 Lab Ranges- 0 - 34
T3 Free 2.4 Lab ranges- 2.0 - 4.4
Seems like the only time this Dr. will even talk to you is if he is about to jam a needle in your throat, otherwise all questions go to one of his bevy of nurses.
One of his bevy of nurses...the visuals are great! Yeah, you have to pay $200 to talk to "the man" himself.
So, these are old labs, but obviously your TSH was way too high, indicating hypo. Your FT4 was just below midrange, and midrange is the recommendation for FT4. However, some of us feel better with FT4 somewhat higher than midrange. So, the increase from 75 to 100 mcg was a good increase.
However, your FT3 is in the basement...lower quarter of range. The recommendation here is upper half to upper third of range. Also, your FT4 is higher in its range than your FT3 is in its. All this points to slow conversion. Your body cannot use T4. It has to convert it to T3 for use by cells. If this is happening too slowly, your FT4 can be "perfect", and you will still feel hypo. I think you need to add some T3 to your meds.
It will be interesting to see your latest labs. Your FT3 and FT4 will most likely have come up a bit due to the increase from 75 to 100, but I'm betting your FT3 is still way too low.
BTW, if your TSH is 6.0 rather than 0.6, then it is ABOVE range still, not in the upper part of the range. Don't let this rest...your nurse doesn't sound like she knows what she's talking about. I don't think you want her "presenting" your case to the doctor for you.
The endocrine system is all interrelated. Estrogen and other hormones definitely affect thyroid hormones and vice versa. Also, since you have Hashi's, your thyroid hormone production often varies in the early stages, creating hypo and hyper swings. How long ago were you diagnosed?
Post your new labs when you get them...
Wow, thanks for all the insight! I have been blind to my thyroid, have always taken meds for how ever long I was diagnosed 20 years ago and it would get out of whack every 5yrs. or so and would need an adjustment here & there but these last 2 years have been hell from super hyperthyroid to now, this.
After skimming through past 10 years or so of panels, I don't see where anyone ever tested the TPO so not sure on that one except for results 8 weeks ago. I sadly had a GP taking care of my thyroid all these years until I recently moved and was able to see an Endo that was within driving distance, so I had my first ultrasound and TPO test.
They are supposed to call me again tomorrow but once I get the hard copy I will post numbers here.
I believe the TPOab result you've shown indicates you have Hashi's which is why Goolara said that. From what I read, that's likely why every few years things seem to go bonkers for you in terms of your thyroid.
New numbers are in, the "janitor" I talked to yesterday was partially correct. Slackers still have not bothered to call me today- guess they too busy sharpening their needles, haha! Is there anything I can do to naturally boost T3 ?? and should I find another Endo if they refuse to do anything...
TSH - .619 Lab Ranges- .450 - 4.50
T4 - 1.34 Lab Ranges- 82 - 1.77
T3 - 2.2 Lab ranges- 2.0 - 4.4
So, FT3 is falling despite rising FT4 levels. Your FT4 is above midpoint now (good). If they refuse to do anything, you can try to educate them (often a losing battle) or you might have to start looking for a new doctor. There is really nothing you can do about low T3 but add T3 meds.
If you do look for a new doctor, I'd suggest pre-interviewing them over the phone (probably through a nurse) and asking a few pertinent questions, like what thyroid bloodwork they routinely order (to make sure it includes FT3) and what therapies they're open to (T4-only, synthetic T3/T4 combos, dessicated). You can get a pretty good feel for them with just a few minutes on the phone.
Thanks for the info. I will call them tomorrow since they neglected to return the call today. I knew seeing a GP all these years was an excuse for them not get into all the T4 & T3's but an Endorcrinologist should look at all values & listen to the patient, even my old family physician told me one time that a patient will always know they have a thyroid problem before you will see it on a piece of paper just by listening to their symptoms.
This guy came highly recommended but my well being (mentally & physically) is more important to me cause I still am symptomatic and the heart thing scares me, I have another echo scheduled for end of May.
I have been researching about T3 and it's very interesting...thanks again for all your info.
I wouldn't assume that just because a doctor's an endo that he's a good thyroid doctor. Many of them, especially in the larger medical markets, specialize in diabetes and don't really do well with thyroid. You want either a thyroid specialist or, at the very least. a "generalist" (endo), who knows thyroid. Since you need T3, and this can be a sticking point for many doctors, you want to make sure you don't get one who refuses to prescribe it (and they are out there).
Best of luck with the endo and with your echo...keep us posted.
I hope this potential specialist turns out exceptionally well for you. The one doctor I went to from the "top thyroid doc" list said my thyroid was fine. What a surprise to find the T3 was almost bottomed out in the range. T4 was at a better level, but still below an optimal range.
Fast forward to eight months later...and had been gaining weight inappropriate and quickly over a period of several weeks. Went to my friend's doc that treats her thyroid. He recognized things for what they are and immediately put me on dessicated thyroid combo of T3/T4. Did I ever luck out or WHAT! Bottom line...help for you is out there!
Thanks so much for advice, I think this Endo deals with a lot of thyroid but one thing right off the bat I didn't like was he only deals with Men's hormonal issues and not women's. I was hoping that he was going to help with my menopausal & osteopenia issue along with the thyroid since they all interact with each other in the body.
After my phone call tomorrow I may be looking for a new Endo..probably a good thing if it comes to that.