Aa
Help with labs...
Hi everyone...started today on generic synthroid. Dr said I could try the treatment though I am su clinical hypo? She has me on .25 mg. the question I have is if I should even be on this medicine? I do have fatigue, overall unwell feeling, leg tiredness, headaches, rashes, dizzy/faint, but they believe I have undifferentiated connective tissue disease, pre-lupus. Following are my labs- any insight would be much appreciated.
Tpo =229 range 0-35
Tsh 5.02 range .27-4.2
Free t4 .983 range .7-1.7
B12 382 range 211-946
Vit d 34.3 range 30-100
Ana 1:1280
Didn't have any t3 testing.
I take vit d 2000 per day and a b-12 vit daily. Again appreciate any thoughts!
Tpo =229 range 0-35
Tsh 5.02 range .27-4.2
Free t4 .983 range .7-1.7
B12 382 range 211-946
Vit d 34.3 range 30-100
Ana 1:1280
Didn't have any t3 testing.
I take vit d 2000 per day and a b-12 vit daily. Again appreciate any thoughts!
COMMUNITY LEADER
You still have a bit to go to get your FT4 to the mid range point, that's typically recommended and where most of need to be to feel best, but without FT3, we can't know if you're converting adequately or not.
Your doctor must be ordering TSH w/reflex? That's an order to the lab to analyze TSH and if it's in range, they should stop there, but if TSH is out of range, they should analyze FT4. If your doctor continues to order TSH w/reflex, as soon as your TSH returns to normal, the lab will stop analyzing anything but TSH. Your doctor needs to start ordering TSH, Free T4 and Free T3, individually, so the lab runs them all, no matter what.
You don't necessarily need an endo, but you do need a doctor who will test properly and it doesn't look like this doctor will fill that bill, so you might want to think about finding a different one.
That said, anxiety can be a symptom of hypo, as can the facial breakouts. If you aren't converting the FT4 to FT3, which is what the body actually uses, you'll stay hypo and as I noted before, since we don't have an FT3 result, we don't know if that process is working right or not. Apparently, your doctor is merely "assuming" it is.
Your doctor must be ordering TSH w/reflex? That's an order to the lab to analyze TSH and if it's in range, they should stop there, but if TSH is out of range, they should analyze FT4. If your doctor continues to order TSH w/reflex, as soon as your TSH returns to normal, the lab will stop analyzing anything but TSH. Your doctor needs to start ordering TSH, Free T4 and Free T3, individually, so the lab runs them all, no matter what.
You don't necessarily need an endo, but you do need a doctor who will test properly and it doesn't look like this doctor will fill that bill, so you might want to think about finding a different one.
That said, anxiety can be a symptom of hypo, as can the facial breakouts. If you aren't converting the FT4 to FT3, which is what the body actually uses, you'll stay hypo and as I noted before, since we don't have an FT3 result, we don't know if that process is working right or not. Apparently, your doctor is merely "assuming" it is.
T4 range is ..7-1.7. I definitely have more energy, have been feeling a bit anxious at times even. My face has broken out a bit as well which isn't any fun for a woman in her mid 30s. Lol. Overall still adjusting to meds but feel a slight difference. I asked md for next labs to include ft3 so we will see what she says. She still doesn't think I need to see an endocrinologist.
COMMUNITY LEADER
What's the reference range for the FT4? It's "better", but your TSH is actually higher...
No Free T3?
What about symptoms?
No Free T3?
What about symptoms?
Well I had my 1st testing since 4 weeks on med. free t4 reflexive is 1.1 and my tsh is 6.21. Any thought? I believe the t4 is better right?
No Prob with the tmi! It made me laugh :) the urine does have a metal smell as well. I will try the water. You've been a wealth of info and help. Truly-thank you for all your advice
COMMUNITY LEADER
It could. It made my poo smell like metal... yeah, sorry for TMI... lol
Make sure you drink plenty of water every day... You don't have to abide by the standard 8 glasses, but do drink enough to just give your urine a light yellow color; that should help keep odor at bay.
Make sure you drink plenty of water every day... You don't have to abide by the standard 8 glasses, but do drink enough to just give your urine a light yellow color; that should help keep odor at bay.
One other question...could the new medicine cause an odor to urine? Sorry for too much info but it's definitely different since I started the Levo 3 days ago.
COMMUNITY LEADER
Be sure you specify FREE T3, not just T3 or you'll get Total T3, which is obsolete and of almost no value. If she balks, as many doctors do, it may be time for a new doctor.
As I noted, just being "in range" isn't good enough, because the ranges are way too broad. I'm not sure why they don't just knock off the bottom halves of the ranges on a lot of things.
In Japan, anything below 500 is deficient for Vitamin B-12 and even my lab puts a note on the report that states any level below 500 can present symptoms.
As long as your Vitamin D levels are that low, you can take a higher dose, but you need to have them tested again in a month or so. Once levels get up to around 50, you can drop back to the 2000 IU/day and you'll probably be okay. Vitamin D deficiency can cause a lot of hypo-like symptoms.
Keep in touch and let us know how you do on the 25 mcg levothyroxine (generic Synthroid). I don't know if your doctor told you, but it's quite common for symptoms to worsen or for new ones to appear when first starting a med or when changing doses. It's also important to note that it takes 4-6 weeks for the med to reach full potential in your blood, then it takes time for your body to get well, so it could take that long or longer for symptoms to be alleviated. In addition, the 25 mcg might not be a high enough dosage, so that will have to be considered when you have your blood tests in 4 weeks. Just make sure your doctor does not go more by TSH than by the actual thyroid hormone (FT3 and FT4) levels, as those are most important.
As I noted, just being "in range" isn't good enough, because the ranges are way too broad. I'm not sure why they don't just knock off the bottom halves of the ranges on a lot of things.
In Japan, anything below 500 is deficient for Vitamin B-12 and even my lab puts a note on the report that states any level below 500 can present symptoms.
As long as your Vitamin D levels are that low, you can take a higher dose, but you need to have them tested again in a month or so. Once levels get up to around 50, you can drop back to the 2000 IU/day and you'll probably be okay. Vitamin D deficiency can cause a lot of hypo-like symptoms.
Keep in touch and let us know how you do on the 25 mcg levothyroxine (generic Synthroid). I don't know if your doctor told you, but it's quite common for symptoms to worsen or for new ones to appear when first starting a med or when changing doses. It's also important to note that it takes 4-6 weeks for the med to reach full potential in your blood, then it takes time for your body to get well, so it could take that long or longer for symptoms to be alleviated. In addition, the 25 mcg might not be a high enough dosage, so that will have to be considered when you have your blood tests in 4 weeks. Just make sure your doctor does not go more by TSH than by the actual thyroid hormone (FT3 and FT4) levels, as those are most important.
Thank you for your reply...I am going to have labs done after 4 weeks on the medicine, I will ask her for t3. Also maybe I should be taking a higher d supplement? I have 5000mg pills I was taking about a month ago, I thought it may have been too much since last 2 labs were showing a little over 30. I will try and find a b12 spray, thanks again. You've been a big help
COMMUNITY LEADER
I don't see anything "subclinical" about your results. ANA can be positive with Hashimoto's. Your TPOab, clearly, indicates Hashimoto's Thyroiditis. Your TSH is too high in the range and your FT4 is too low in the range, indicating primary hypothyroidism.
You should always insist on Free T3 test every time you have TSH and Free T4, since Free T3 is the hormone used by the individual cells and symptoms correlate best with Free T3.
Just because levels are "in range" doesn't mean they are adequate. That holds true for the FT4, as well as the B-12 and Vitamin D.
Add to that vitamin B-12 that is way too low in its range, in spite of taking a B-12 supplement. This indicated Pernicious Anemia, which is inability to absorb B-12. If you aren't take a sublingual B-12 or using a spray, you should try that and see if it helps bring your levels up. If those fail, ask your doctor for injectible B-12. Most of us have to have vitamin B-12 near the top or over range (the range my lab uses is 200-1100 and I keep my level right at the top) in order to alleviate symptoms.
Your vitamin D is also way too low. Vitamin D levels should be at least 50 and preferably 60-80. Vitamin D is necessary for the metabolism of thyroid hormones.
In my opinion, you do need to be on the thyroid medication and will probably need to increase your dosage as the Hashimoto's progresses and you thyroid makes less and less of its hormones.
All of that said, since Hashimoto's is an autoimmune disease, the chances, of getting another are that much greater, since you already have one.
You should always insist on Free T3 test every time you have TSH and Free T4, since Free T3 is the hormone used by the individual cells and symptoms correlate best with Free T3.
Just because levels are "in range" doesn't mean they are adequate. That holds true for the FT4, as well as the B-12 and Vitamin D.
Add to that vitamin B-12 that is way too low in its range, in spite of taking a B-12 supplement. This indicated Pernicious Anemia, which is inability to absorb B-12. If you aren't take a sublingual B-12 or using a spray, you should try that and see if it helps bring your levels up. If those fail, ask your doctor for injectible B-12. Most of us have to have vitamin B-12 near the top or over range (the range my lab uses is 200-1100 and I keep my level right at the top) in order to alleviate symptoms.
Your vitamin D is also way too low. Vitamin D levels should be at least 50 and preferably 60-80. Vitamin D is necessary for the metabolism of thyroid hormones.
In my opinion, you do need to be on the thyroid medication and will probably need to increase your dosage as the Hashimoto's progresses and you thyroid makes less and less of its hormones.
All of that said, since Hashimoto's is an autoimmune disease, the chances, of getting another are that much greater, since you already have one.
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