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Avatar universal

Help...got some results and still out of range:(

So I finally convinced my Dr to test a few things other than the TSH.  I managed to slip by the provincial guidelines and they tested the t4.

april09  TSH 1.32
Jan10   TSH 4.12
Mar10   TSH 2.65
Mar10  T4FREE    10 (9-22 pmol/l)

I am awaiting the results of the antibody test but for the life of me I can not remember where you want your T4 to fall?? Am I in the right place? I know according to the ENDO Society I fall within their normal ranges for TSH now. But should your TSH jump around so much like that? seems like quite a fluctuation if a normal range is 1ish.  
Any help would be great:)
thanks in advance for any help you can offer...
21 Responses
Avatar universal
I meant to say...got some results and still IN range...
and the reference range for the TSH is 0.3-5.5 mU/L
Avatar universal
well you want your FREE T3 to be in the upper range and your free t4 to be in the mid to upper range.most feel better when labs are in this range. the tsh doesn t really matter so much because it is a pituitary hormone and the the frees are the actual thyroid hormones.  maybe you could request strongly a free t3 test too.  
Avatar universal
Actually, currently accepted reference range for TSH according to AACE is 0.3-3.0.  So, now, you are high "normal", but in January, you were above "normal".

FT4 is way too low.  The rule of thumb for FT4 is midrange...yours is in the bottom tenth of the range.  Of course, this depends on symptoms and other medical conditions, general health, etc.  We are all somewhat different and comfortable at different levels.  Do you still have hypo symptoms?

TSH is quite volatile and even varies intraday.  You should have labs drawn at the same time of day each time so that you are comparing apples to apples.

Keep pushing for the FT3 ...it can be such a valuable piece of the puzzle, especially when you establish your own personal history.
Avatar universal
Just as I typed the above message I was heading for a nap because I was so tired...I have all the hypo symptoms generally but this week I am feeling a little nervous, jittery, tingling under my skin, heart palps (just a few) but incredible fatigue.  I have almost every hypo symptom I have ever read online (except high cholesterol) but all have them have come and gone at different times....the constants are the fatigue, joint and muscle pain, heavy legs and weekness, difficulty breathing, sore throat, wake up feeling tired, snoring, dry skin and really dry heels, loss of libido, cold all day, night sweats, low body temp, sinus infections...
I am just waiting on the antibodies test.  I am a little frustrated with our medical system.  the only way I get a T3 test is if I can get into a endo and that is not going to happen unless my antibodies come back positive. My numbers are too normal and I will not get a referral without numbers that warrant a specialist.  I am stuck without abnormal numbers. :(
Avatar universal
So, you're not on meds at all yet?  Your low FT4 and symptoms definitely sound hypo.

FT3 is very important, but that aside for a moment, your FT4 still warrants meds. Best of luck (I guess you can term it that!) with the antibodies...hope you can get the referral.  If not, do you think you could talk your PCP into a low trial dose to see if it relieves your symptoms?  Nothing to lose here...you can always d/c if it doesn't help...
Avatar universal
I am not on anything...cause I am so "normal".  I am going to go back this week to ask my family doctor for some kind of med but honestly I am not sure how she is going to deal with it.  I think she might try it but now that my TSH is so "normal" I am more doubtful I will get some kind of treatment. I am pinning my hope on the antibody test.  I think to get into an endo would take about 9 months to a year...and I do not for see getting a referral with my labs.  I live in the wrong province to get treatment for a thyroid problem.  
So if I ask for meds which would be a good one? I am in Canada and I have no idea what is available or appropriate? As my Dr is probably a little out of her area of expertise if I ask for something in particular she might go along with it.  
thank you so much for all the replies, it is so frustrating dealing with this.  
I was actually told at the hospital lab that if my family Dr had requested the Free T3 there would have been problems and all the tests would have been held up.  Are these tests expensive to run? I am thinking of trying to find a private lab and getting the tests run on my own.  I know of one in alberta but have never heard of such a thing in BC.  
thanks again:)
Avatar universal
Most often, doctors start us off on T4-only meds (like Synthroid, Levoxyl, generic levothyroxine, etc.).  I'm not sure which brands are available in Canada.  I believe this is a reasonable approach,  If T4-only meds don't relieve symptoms completely, then you can think about adding some synthetic T3 (like Cytomel) or switching to dessicated, which contains both T3 and T4.  There are other more esoteric options, but these are the basics.

You can also get FT3, FT4 and TSH testing online.  Some send you a kit, and you stick your finger and send it back to them.  Others order the tests through your local lab (don't know about Canada, once again), but you pay for them and they send you the results directly.

I don't know where you are in BC, but are you close enough to us a U.S. lab?  We find that here in the States, the medical market will do about anything you ask for cash (up front, please!).  Sorry to sound jaded, but our system is a wreck...
Avatar universal
I am about 30 minutes from washington state. I am not sure how I would go about getting a lab to test me in the US.  Can you just walk into a lab and request any tests??Is it expensive to test for thyroid?  I have no clue.
Avatar universal
No, you can't just walk in, but you could get one of those online labs to order from a U.S. lab in Washington.  I have a tendency to think that going to a lab and having blood drawn probably yields more accurate results than the kit option.  I believe I've seen an online package (FT3, FT4 and TSH) for around $150, but that was a while ago, so don't quote me.  I actually did my very first TSH test online with a kit.  It told me I was pretty hypo, and it was very right!  So, the online service will send you to a lab with orders for thyroid labs, you go in and have your blood drawn, and then they send you, rather than your doctor, the results.
Avatar universal
from reading this thread i'm starting to wonder....

i was diagnosed with hyperthyroid when iw as pregnant with my 2nd child.  then i was in normal range but on the cusp of hyper in between pregnancies until my 3rd came along and i fell below again.  i've been having my levels tested yearly and they're "normal" but on the cusp.

until recently...i've started gaining weight without much change in the way i eat, i get hotflashes, palpatations, my cycles have become funky....and now my latest labs:

free t4 1.1 (the reference range on the form i got ws .6-2.7)
tsh 3rd generation 2.59 (range on form .40-4.20)

can someone shed some insight?
Avatar universal
Your FT4 is fairly low in the range...bottom quarter.  TSH is in range (currently accepted range according to AACE is 0.3-3.0), but fairly high in the range.  Both of these lean toward hypo.

Have you ever had antibodies tested (TPOab and TGab) to see if you are in the initial stages of an autoimmune thyroid disease?  How long has it been since your third?
Avatar universal
I should have added that that's a bit of an unusual range for FT4???
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