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Good news- wife FINALLY getting FT3 test
After a long and bumpy road where my wife's Dr refuses to test for Free T3 (they will do FT4), and my wife resisting me on the importance of FT3 testing. My wife finally decided to go to HealthcheckUSA and ordered the test on-line. We have to pay for this out of pocket but we'll FINALLY know where she stands.
She will go to have blood drawn Monday. Hopefully the results will follow soon after.
her last test in Mid July was
FT4 0.68 ( 0.75 - 1.54)
TOTAL T3 1.46 ( 0.7 - 1.7)
TSH 3.67
Since that test her Levo was increased a measly amount. From 112 to 120 mcg. Dr. said TSH should be between 1 and 2. So it is clear her Dr has immaculate TSH theory. But since she was BELOW the bottom of the range on FT4 it was clear she needed an increase in her dose.
I have guessed that this latest increase will result in the following. It will be interesting to see how close my guess is.
I believe that she will now be slightly below mid range on FT4 and she MAY be mid range in FT3.
My Guess:
TSH 2.2
FT4 0.85
FT3 maybe to mid range or very slightly above mid range. certainly below the upper 1/3
We all know that symptom relief is a target around mid range FT4 and UPPER 1/3 range FT3.
After never having an FT3 test performed it is a complete and utter guess. But in the past she has seemed to respond to T4 dosage increase reasonably, So I don't think she has a conversion problem. But we maybe now will have a chance to be able to determine is she does or does not have a conversion problem.
She will go to have blood drawn Monday. Hopefully the results will follow soon after.
her last test in Mid July was
FT4 0.68 ( 0.75 - 1.54)
TOTAL T3 1.46 ( 0.7 - 1.7)
TSH 3.67
Since that test her Levo was increased a measly amount. From 112 to 120 mcg. Dr. said TSH should be between 1 and 2. So it is clear her Dr has immaculate TSH theory. But since she was BELOW the bottom of the range on FT4 it was clear she needed an increase in her dose.
I have guessed that this latest increase will result in the following. It will be interesting to see how close my guess is.
I believe that she will now be slightly below mid range on FT4 and she MAY be mid range in FT3.
My Guess:
TSH 2.2
FT4 0.85
FT3 maybe to mid range or very slightly above mid range. certainly below the upper 1/3
We all know that symptom relief is a target around mid range FT4 and UPPER 1/3 range FT3.
After never having an FT3 test performed it is a complete and utter guess. But in the past she has seemed to respond to T4 dosage increase reasonably, So I don't think she has a conversion problem. But we maybe now will have a chance to be able to determine is she does or does not have a conversion problem.
My wife does NOT take Selenium. She takes a high quality multi vitamin. She also takes 6,000 IU of Vit D3. She recently ran out of Magnesium supplement. But no selenium.
She does not feel horrible. Just not 100%. More like maybe 85%. So she has been in this situation before. Where she feels just good enough to do nothing more. And the Dr is perfectly happy with that and my wife is not motivated enough to be proactive. Although this time may be different.
I just do not know whether to push for another bump in the Levo to get the FT4 at or above mid range before we ask for Cytomel. OR if we should push for some Cytomel now.
her symptoms are still fatigue although it is not nearly as bad as it was. hair loss, dry skin, acid reflux medicine, trouble sleeping, periods were irregular both in timing and flow,can't lose weight no matter what.
I will try to get a history of TSH, FT4 and other labs as well if I can the dosage of Levo she was on during that time. Like I said this is the first time we've ever gotten an FT3 test.
My wife has a high threshold for pain and she generally is not a complainer in that way. So if she can function she just plows through. But I don't think she even remembers what "normal" is like. So when she gets to this point, she feels so much better than she has for such a long time that she thinks that she is "normal" or maybe better word would be "well". But in fact she still has a ways to go to truly feel well. She just has never felt truly well to even know what that feels like.
When her Dr raised her meds the last time, She (the Dr. stated that she'd like to see the TSH between 1 and 2. Well my wife is not below 1 so I suspect that her Dr will do NOTHING. with TSH that low and both FT$ & FT3 in "normal range". In fact, I'm a bit concerned that the Dr will want her to lower the dosage!!!!!!
She does not feel horrible. Just not 100%. More like maybe 85%. So she has been in this situation before. Where she feels just good enough to do nothing more. And the Dr is perfectly happy with that and my wife is not motivated enough to be proactive. Although this time may be different.
I just do not know whether to push for another bump in the Levo to get the FT4 at or above mid range before we ask for Cytomel. OR if we should push for some Cytomel now.
her symptoms are still fatigue although it is not nearly as bad as it was. hair loss, dry skin, acid reflux medicine, trouble sleeping, periods were irregular both in timing and flow,can't lose weight no matter what.
I will try to get a history of TSH, FT4 and other labs as well if I can the dosage of Levo she was on during that time. Like I said this is the first time we've ever gotten an FT3 test.
My wife has a high threshold for pain and she generally is not a complainer in that way. So if she can function she just plows through. But I don't think she even remembers what "normal" is like. So when she gets to this point, she feels so much better than she has for such a long time that she thinks that she is "normal" or maybe better word would be "well". But in fact she still has a ways to go to truly feel well. She just has never felt truly well to even know what that feels like.
When her Dr raised her meds the last time, She (the Dr. stated that she'd like to see the TSH between 1 and 2. Well my wife is not below 1 so I suspect that her Dr will do NOTHING. with TSH that low and both FT$ & FT3 in "normal range". In fact, I'm a bit concerned that the Dr will want her to lower the dosage!!!!!!
I think it's a bit of a tough call at this point. I know your wife has been on meds for quite a while, but is this the first time her FT4 has even been close to midrange? If so, be aware that it can take conversion a while to ramp back up after a long period of low FT4 levels. We often see FT3 lagging, then starting to climb as the body begins to recognize the higher FT4 levels. So, some arguement can be made for giving it a little time (and probably a slight increase in T4 meds). Her FT3 is not abyssmal...has a ways to go, but not horrible.
Does your wife supplement selenium?
On the other hand, a little T3 could be added. If/when conversion kicks back in, it can always be discontinued. Of course, this means monitoring FT3 levels regularly. Does adding T3 meds in at this point have the potential to inhibit the natural conversion process? I don't know.
Just a couple of things to think about and discuss with your doctor...
Does your wife supplement selenium?
On the other hand, a little T3 could be added. If/when conversion kicks back in, it can always be discontinued. Of course, this means monitoring FT3 levels regularly. Does adding T3 meds in at this point have the potential to inhibit the natural conversion process? I don't know.
Just a couple of things to think about and discuss with your doctor...
Well my guess was not far off.
My guess was:
TSH 2.2
FT4 below mid range 0.85
and FT3 about mid range.
The labs came back and my wife's ACTUAL numbers are:
TSH 0.789 (0.45-4.5)
FT4 1.24 (0.82-1.77) mid range = 1.295
FT3 (Trilodothyronine, free, serum) = 2.9 (2.0-4.4) upper 1/3 range = 3.6
So she is slightly BELOW mid range FT4 and BELOW even mif range FT3.
This after raising her Levo dose up to 125 mcg from 112 mcg
Her previous lab at 112 mcg levo was (different lab)
TSH 3.67
FT4 0.68 (0.75-1.54)
TOTAL T3 1.46 (0.7-1.7)
What is your guys take on this?
Seems to me she is responding to increase in Levo but not quite enough. My question is since she is still below mid range on FT4, would it make sense to up the dosage of Levo to at least get mid range, or is there enough indication of slow or poor conversion that would make adding in Cytomel to the mix?
I'm leaning to wanting to go with a split 0.5 mcg cytomel half in the morning and half in the early afternoon, say 1 PM or so.
What say you?
My guess was:
TSH 2.2
FT4 below mid range 0.85
and FT3 about mid range.
The labs came back and my wife's ACTUAL numbers are:
TSH 0.789 (0.45-4.5)
FT4 1.24 (0.82-1.77) mid range = 1.295
FT3 (Trilodothyronine, free, serum) = 2.9 (2.0-4.4) upper 1/3 range = 3.6
So she is slightly BELOW mid range FT4 and BELOW even mif range FT3.
This after raising her Levo dose up to 125 mcg from 112 mcg
Her previous lab at 112 mcg levo was (different lab)
TSH 3.67
FT4 0.68 (0.75-1.54)
TOTAL T3 1.46 (0.7-1.7)
What is your guys take on this?
Seems to me she is responding to increase in Levo but not quite enough. My question is since she is still below mid range on FT4, would it make sense to up the dosage of Levo to at least get mid range, or is there enough indication of slow or poor conversion that would make adding in Cytomel to the mix?
I'm leaning to wanting to go with a split 0.5 mcg cytomel half in the morning and half in the early afternoon, say 1 PM or so.
What say you?
Yes the $85 package included TSH, FT4 & FT3. I think totals as well.
The next package deal to get the antibody tests was over $200. So at this point we didn't go that far.
with her current Dr. My biggest hope is that she has a TSH over 2. otherwise I think it may be difficult to get her to up her dosage. We will see.
The next package deal to get the antibody tests was over $200. So at this point we didn't go that far.
with her current Dr. My biggest hope is that she has a TSH over 2. otherwise I think it may be difficult to get her to up her dosage. We will see.
COMMUNITY LEADER
I'm so glad your wife decided to go ahead and do this. I hope her FT4 goes up as much as you are guessing it will. Even at that, with the TSH at your guess of 2.2, she may still be somewhat hypo, and could need another increase in med.
Did you get another FT4 and TSH to go along with the FT3? It's always best to get all three together.
If the blood is drawn on Mon, you should have results e-mailed on Tues or Wed. Will be anxious to see them. I did healthcheckUSA some time ago, and it took about a day and 1/2 before the results were e-mailed to me. Yes, it's out of pocket, but well worth the money.
Did you get another FT4 and TSH to go along with the FT3? It's always best to get all three together.
If the blood is drawn on Mon, you should have results e-mailed on Tues or Wed. Will be anxious to see them. I did healthcheckUSA some time ago, and it took about a day and 1/2 before the results were e-mailed to me. Yes, it's out of pocket, but well worth the money.
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