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Lab results - Need some help before I go NUTZ
Hi, I recently had blood test done for thyroid after having a reduction in synthyroid 8 weeks ago from 100mcg to 88mcg and I remained on 15mcg Cytomel entire time and with the reductions Im AGAIN sufferring from emotional breakdowns and feeling of doom.
So I go for the thyroid test and find out my endo did not order the FT3 like she has for every test so Im stuck with just TSH and FT4 only (she's on Baby Leave until Sept) got my number back and was told I was perfect and they don't need to see me until spring of 2019 (not a chance) I have questions for these jerks why do my numbers keeps dropping, I was told lower dose would raise my numbers and it's not true. I Had THYROID cancer and Low TSH was taking away from me because of dexa scan that showed I had osteopenia (mild) case and my Endo trying to raise my TSH. Below are 100mcg results and 88mcg results
FEB 8, 2018 (100mcg)
FT4 (0.93-1.7) ......1.32
T3 (80-200) .........108
TSH (0.27-4.20) ......0.052
June 2018 (88mcg)
FT4: 1.00 ng/dL (0.93-1.7)
TSH: 0.533 mcIU/mL (0.27-4.20)
FT3: NOT ORDERED
Any reason why my numbers keep dropping?
So I go for the thyroid test and find out my endo did not order the FT3 like she has for every test so Im stuck with just TSH and FT4 only (she's on Baby Leave until Sept) got my number back and was told I was perfect and they don't need to see me until spring of 2019 (not a chance) I have questions for these jerks why do my numbers keeps dropping, I was told lower dose would raise my numbers and it's not true. I Had THYROID cancer and Low TSH was taking away from me because of dexa scan that showed I had osteopenia (mild) case and my Endo trying to raise my TSH. Below are 100mcg results and 88mcg results
FEB 8, 2018 (100mcg)
FT4 (0.93-1.7) ......1.32
T3 (80-200) .........108
TSH (0.27-4.20) ......0.052
June 2018 (88mcg)
FT4: 1.00 ng/dL (0.93-1.7)
TSH: 0.533 mcIU/mL (0.27-4.20)
FT3: NOT ORDERED
Any reason why my numbers keep dropping?
I am not familiar with psoriatic arthritis. How is it diagnosed?
With regard to the possibility of being under medicated causing those issues, it is difficult to determine. There are many lists of symptoms that are typical of hypothyroidism. Then there is a list compiled by a lady who maintains a site about thyroid. She says she compiled her long list from all other lists and also complaints from people who related their symptoms to being hypothyroid. Anyway, the list is 300 symptoms. On it you can find arthritis and tendonitis. I know I have had joint pain so bad I could not get off a chair without using my arms to help. After increasing my T3 med, in days I could do deep knee bends with no problem. Same with carpal tunnel syndrome one time.
If interested, please tell us your location and perhaps we can suggest a doctor in your area that has been recommended by other thyroid patients.
With regard to the possibility of being under medicated causing those issues, it is difficult to determine. There are many lists of symptoms that are typical of hypothyroidism. Then there is a list compiled by a lady who maintains a site about thyroid. She says she compiled her long list from all other lists and also complaints from people who related their symptoms to being hypothyroid. Anyway, the list is 300 symptoms. On it you can find arthritis and tendonitis. I know I have had joint pain so bad I could not get off a chair without using my arms to help. After increasing my T3 med, in days I could do deep knee bends with no problem. Same with carpal tunnel syndrome one time.
If interested, please tell us your location and perhaps we can suggest a doctor in your area that has been recommended by other thyroid patients.
It is an awful situation that most hypothyroid patients face every day. Most doctors have been trained and believe that TSH is the only test required to diagnose and treat a hypothyroid patient. That is so far from reality that I don't understand why they don't know better. It all started at least 40 years ago when a decent test for TSH was developed. The thought was that since it was the pituitary output from sensing thyroid hormone levels, that TSH was the diagnostic to be used instead of clinical diagnosis for symptoms that occur more frequently with hypothyroidism then otherwise. The use of TSH as the primary diagnostic continues to this day I think because it is quick and easy and minimizes cost of testing.
So even though we now have accurate tests for the actual biologically active thyroid hormones, doctors refuse to accept that even in the untreated state, TSH has only a weak correlation with Free T4 and Free T3, and a negligible correlation with symptoms, which are the patients' concerns and a direct result of the level of Tissue T3 Effect. Even worse is when TSH is used to determine a hypothyroid patient's medication dosage. Our bodies operate with a continuous low flow of thyroid hormone from the thyroid gland. When taking your full daily dosage all at once, the effect is that TSH becomes suppressed. In fact there are several scientific studies showing that hypo patients taking adequate doses of thyroid med usually have their TSH suppressed. So TSH should NEVER be used to determine med dosage. Doctors don't understand/accept this and think a suppressed TSH is an indication of hyperthyroidism. In reality you are hyperthyroid only if having hyper symptoms due to excessive levels of Free T3 and Free T4, which you did not have. In fact you were not even tested for Free T3 and your Free T4 was just above mid-range, and your Total T3 was only at 23% of its range. How is that supposed to make you hyperthyroid?
To start diagnosis and treatment a doctor really needs to know the correct definition of hypothyroidism. It is not, as commonly believed, just inadequate thyroid hormone, correctly sensed by the pituitary which then secretes TSH to stimulate the thyroid gland. The correct definition is "insufficient T3 effect in tissue throughout the body due to inadequate supply of, or response to, thyroid hormone." Since TSH does not meet the criteria for a primary diagnostic, the patient should be given a full medical history, an examination for symptoms that occur more frequently with hypothyroidism than otherwise. and then extended biochemical tests. Since there is no biochemical test that can reliably be used as a pass/fail decision about hypothyroidism, diagnosis is really a probability theory that must be evaluated by a therapeutic trial of thyroid med adequate to raise the FT4 and FT3 into the upper part of their ranges. If symptoms ease, then the trial is confirmed and dosage should be adjusted as needed to relieve symptoms. It is very important to know that a recent, excellent scientific paper concluded that : "Hypothyroid symptom relief was associated with both a T4 dose giving TSH-suppression below the lower reference limit and FT3 elevated further into the upper half of its reference range." Your levels were not to that point even before the dosage was dropped, and now your FT4 is only about 9% of its range. If you want a link to this source, I will be glad to send by PM.
In addition to the inadequacy of thyroid hormones, there are other variables that are important for the response to thyroid hormone mentioned in the definition above. It is always good to test for Reverse T3 along with a Free T3 at least at the beginning to see if there is a RT3 issue. In addition, cortisol should be neither high nor low. Also, Vitamin D, B12 and ferritin are very important so they should be tested and then supplemented 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 lest 100.
If you think there is any possibility to get your doctor to read some information confirming all this and reconsider your treatment, then click on my name and scroll down to my Journal and read at least the one page overview of a full paper that is linked and that has extensive scientific evidence for all that is recommended. If not, then you will need to find a good thyroid doctor that will diagnose and treat clinically, rather than based on TSH.
So even though we now have accurate tests for the actual biologically active thyroid hormones, doctors refuse to accept that even in the untreated state, TSH has only a weak correlation with Free T4 and Free T3, and a negligible correlation with symptoms, which are the patients' concerns and a direct result of the level of Tissue T3 Effect. Even worse is when TSH is used to determine a hypothyroid patient's medication dosage. Our bodies operate with a continuous low flow of thyroid hormone from the thyroid gland. When taking your full daily dosage all at once, the effect is that TSH becomes suppressed. In fact there are several scientific studies showing that hypo patients taking adequate doses of thyroid med usually have their TSH suppressed. So TSH should NEVER be used to determine med dosage. Doctors don't understand/accept this and think a suppressed TSH is an indication of hyperthyroidism. In reality you are hyperthyroid only if having hyper symptoms due to excessive levels of Free T3 and Free T4, which you did not have. In fact you were not even tested for Free T3 and your Free T4 was just above mid-range, and your Total T3 was only at 23% of its range. How is that supposed to make you hyperthyroid?
To start diagnosis and treatment a doctor really needs to know the correct definition of hypothyroidism. It is not, as commonly believed, just inadequate thyroid hormone, correctly sensed by the pituitary which then secretes TSH to stimulate the thyroid gland. The correct definition is "insufficient T3 effect in tissue throughout the body due to inadequate supply of, or response to, thyroid hormone." Since TSH does not meet the criteria for a primary diagnostic, the patient should be given a full medical history, an examination for symptoms that occur more frequently with hypothyroidism than otherwise. and then extended biochemical tests. Since there is no biochemical test that can reliably be used as a pass/fail decision about hypothyroidism, diagnosis is really a probability theory that must be evaluated by a therapeutic trial of thyroid med adequate to raise the FT4 and FT3 into the upper part of their ranges. If symptoms ease, then the trial is confirmed and dosage should be adjusted as needed to relieve symptoms. It is very important to know that a recent, excellent scientific paper concluded that : "Hypothyroid symptom relief was associated with both a T4 dose giving TSH-suppression below the lower reference limit and FT3 elevated further into the upper half of its reference range." Your levels were not to that point even before the dosage was dropped, and now your FT4 is only about 9% of its range. If you want a link to this source, I will be glad to send by PM.
In addition to the inadequacy of thyroid hormones, there are other variables that are important for the response to thyroid hormone mentioned in the definition above. It is always good to test for Reverse T3 along with a Free T3 at least at the beginning to see if there is a RT3 issue. In addition, cortisol should be neither high nor low. Also, Vitamin D, B12 and ferritin are very important so they should be tested and then supplemented 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 lest 100.
If you think there is any possibility to get your doctor to read some information confirming all this and reconsider your treatment, then click on my name and scroll down to my Journal and read at least the one page overview of a full paper that is linked and that has extensive scientific evidence for all that is recommended. If not, then you will need to find a good thyroid doctor that will diagnose and treat clinically, rather than based on TSH.
1 Comments
Gimel,
These people won't even budge an inch to help me when I come into their office in crisis mode. I have Psoriatic Arthritis and currently I'm dealing with a monster flare in my knee and Achilles tendon sadly I've had the Achilles since my thyroidectomy 10/2016 so bad that Ive been house bound. Do you think losing and being improperly medicated could be behind my moster flare and could inflammation cause my crummy numbers?
These people won't even budge an inch to help me when I come into their office in crisis mode. I have Psoriatic Arthritis and currently I'm dealing with a monster flare in my knee and Achilles tendon sadly I've had the Achilles since my thyroidectomy 10/2016 so bad that Ive been house bound. Do you think losing and being improperly medicated could be behind my moster flare and could inflammation cause my crummy numbers?
You may not need an endo at all if you can find a decent doctor who knows how to treat thyroid. I called my doctors office and I terviewd his nurse on his thyroid practices before I ever saw him. No thyroid specialist in his right mind would tell you to come back in a year.
Yes, I think They tricked you. Usually you add thyroid to get a higher number I. The range. TSH is the one that “might” drop as you gain numbers in the others or it might not.
Yes, I think They tricked you. Usually you add thyroid to get a higher number I. The range. TSH is the one that “might” drop as you gain numbers in the others or it might not.
1 Comments
I should if you were feeling terrific for a year, you may Not need to see your dr for a year. But falling apart and having feelings of doom warrants another look.
You’re Ft4 is dropping because your dose dropped. You want it to be above the half way point of the range. Your TSH is higher because your dose dropped. Ft3 should be at the upper part of he range. I don’t know a lot about the math involved but I had an endo who reduced my thyroid because he was ignorant about it. In trying to raise the TSH (against my will) I became extremely ill. You might want to find another doctor.
1 Comments
Thanks, Your right I need new endo for sure. Why would they tell me it would raise everything? Think it was a lie to trick me into reducing meds?
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