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More lab results
A locum doc called me today from my GP's in absolute panic at my lab results (which are still incomplete). TSH was 0.5 and he panicked and said I was hyper due to the TSH. I explained that Armour suppresses TSH and it is useless on its own as a diagnostic tool. Here in the UK, it is the revered test, they swear by it. I have had TSH of 0.01 and still felt great!!! Anyhow, free T4 was 21 (miu/pl) which he said was much too high and as yet, free T3 results are not available but the lab called him to tell him they are "off the scale." I am currently on 2 and a half grains of Armour and was considering increasing my dose as my hair is more dry and brittle than it has been and my complexion is grey and I'm more tired than usual. Can anyone help me with the free T4 results - is 21 really too high? Should I decrease my Armour? I have read that when patients are hyper, they can also have brittle hair/hair loss. Physically I feel very well, no palpitations, no obvious symptoms of hyperthyroidism but perhaps it is possible I am slightly hyper? If anyone can shed some light, I would be so grateful. Thanks in anticipation. :)
Let me start by explaining a little of the process. When your pituitary senses that your thryoid hormone levels are low, it puts out TSH. The only function of TSH is as a "messenger" from your pituitary to your thyroid that your body needs more thyroid hormone. In the healthy thyroid, in response to the TSH, your thyroid produces T4 and a little bit of T3. T4 is the "storage" form of the thyroid hormones. It basically floats around in your blood until your cells need hormone, and then it must be converted to T3 before your cells can use it. T3 is the "active" form of the thyroid hormones. Our thyroids produce very little T3...most T3 comes from conversion, and conversion happens mostly in the liver, although there are many sites throughout the body where conversion occurs to a lesser extent.
A conversion problem is indcated when FT4 levels are relatively high in their range (50%+) and FT3 levels remain low in their range. I do not see that situation in your German labs, where yur FT4 is above range, but your FT3 is WAY above range. Furthermore, the two labs you posted in the comment immediately above have no FT3, so it's impossible to diagnose a conversion problem from them.
As I explained a couple of paragraphs ago, most conversion takes place in the liver and other peripheral sites throughout the body. By and large, conversion is a metabolic process, not a thyroid process; so an inflamed thyroid does not compromise conversion (an inflamed liver is much more likely to do that).
50 mcg of levo is not a high dose to start with. If you are over 50, have been hypo for more than a few months or have a history of heart arrhythmia, a lower starting dose could be indicated. In the absence of that, however, 50 mcg is a pretty conservative dose.
I'm not saying you don't have a conversion problem, I just want you to understand how this all works.
"Looking at these tests, I notice that FT4 is slightly higher on the second one on 31st March - why would that be if I was taking medication?" Unless I'm reading that wrong, your FT4 on 3-31 was 13, and on 2-17, it was 12, so it had gone up very slightly. I would explain that by saying that you were on quite a low dose at the time (50 mcg?), which was not enough to increase FT4 significantly.
You're absolutely right (your last paragraph). First off, thyroid disease is not seen as debilitating..not like diabetes, for example. Diabetes and thyroid disease are first cousins, but few people see them that way. Finding the correct meds is a PROCESS, sometimes a very long and trying process. Lots of times, we don't feel better until the process is almost totally complete. Don't even get me started on doctors! I got very lucky and found an endo that I love...it takes a lot of luck anda lot of research.
Having any luck with THR research?
.
A conversion problem is indcated when FT4 levels are relatively high in their range (50%+) and FT3 levels remain low in their range. I do not see that situation in your German labs, where yur FT4 is above range, but your FT3 is WAY above range. Furthermore, the two labs you posted in the comment immediately above have no FT3, so it's impossible to diagnose a conversion problem from them.
As I explained a couple of paragraphs ago, most conversion takes place in the liver and other peripheral sites throughout the body. By and large, conversion is a metabolic process, not a thyroid process; so an inflamed thyroid does not compromise conversion (an inflamed liver is much more likely to do that).
50 mcg of levo is not a high dose to start with. If you are over 50, have been hypo for more than a few months or have a history of heart arrhythmia, a lower starting dose could be indicated. In the absence of that, however, 50 mcg is a pretty conservative dose.
I'm not saying you don't have a conversion problem, I just want you to understand how this all works.
"Looking at these tests, I notice that FT4 is slightly higher on the second one on 31st March - why would that be if I was taking medication?" Unless I'm reading that wrong, your FT4 on 3-31 was 13, and on 2-17, it was 12, so it had gone up very slightly. I would explain that by saying that you were on quite a low dose at the time (50 mcg?), which was not enough to increase FT4 significantly.
You're absolutely right (your last paragraph). First off, thyroid disease is not seen as debilitating..not like diabetes, for example. Diabetes and thyroid disease are first cousins, but few people see them that way. Finding the correct meds is a PROCESS, sometimes a very long and trying process. Lots of times, we don't feel better until the process is almost totally complete. Don't even get me started on doctors! I got very lucky and found an endo that I love...it takes a lot of luck anda lot of research.
Having any luck with THR research?
.
The German Dr said that I didn't convert well based on the inflammed state of the thyroid gland on ultrasound, which compromises T4 to T3 conversion. Before I went to him, I had two sets of bloods taken - the first one in February was the start of my hypothyroidism and I was put on Levothyroxine 50 mcg which I was told was a high dose to start on but my symptoms were horrendous. The GP increased me gradually until I was at 200 mcg and I had a brief spurt of feeling great then crashed and had almost all of the side effects of Levo. My husband knew the endo in Germany who, before seeing me, suggested I take Armour and start at half a grain until the consultation. Here are the lab results from February and 6 weeks later after Levo.
Serum free T4 13 pmol/L (9.0-25.0)
Serum TSH 0.63 miu/L (0.30-5.00)
Taken 30.03.2011 10:20 Lab issue 31.03.2011 23:00
Serum free T4 12pmol/L (9.0-25.0)
Serum TSH 12miu/L (0.30-5.00)
-TSH >20 suggests hypothyroidism - Dr **** to discuss with pt)
Taken 14.02.2011 11:30 Lab issue 17.02.2011 17:00
Looking at these tests, I notice that FT4 is slightly higher on the second one on 31st March - why would that be if I was taking medication?
Thyroid disease is at times very debilitating and the presumption that when patients start to take thyroid replacement hormones they feel better, well that couldn't be further from the truth. Then to make it worse, we have too many doctors who know so little about this condition and are arrogant with their limited knowledge. I know there are great doctors out there who treat us properly, but they are definitely the minority.
Serum free T4 13 pmol/L (9.0-25.0)
Serum TSH 0.63 miu/L (0.30-5.00)
Taken 30.03.2011 10:20 Lab issue 31.03.2011 23:00
Serum free T4 12pmol/L (9.0-25.0)
Serum TSH 12miu/L (0.30-5.00)
-TSH >20 suggests hypothyroidism - Dr **** to discuss with pt)
Taken 14.02.2011 11:30 Lab issue 17.02.2011 17:00
Looking at these tests, I notice that FT4 is slightly higher on the second one on 31st March - why would that be if I was taking medication?
Thyroid disease is at times very debilitating and the presumption that when patients start to take thyroid replacement hormones they feel better, well that couldn't be further from the truth. Then to make it worse, we have too many doctors who know so little about this condition and are arrogant with their limited knowledge. I know there are great doctors out there who treat us properly, but they are definitely the minority.
Quite frankly, I don't understand why the doctor in Germany said you didn't convert well. It's impossible to say from the labs that were done in Germany whether you convert well or not since you'd been on Armour prior to them, and Armour contains a fairly high level of T3. I'd have to see labs before you started Armour to know that for sure. Of course, since you did so much better on Armour, that would suggest a conversion problem. Your FT3 and FT4 in the German labs are both over upper limit of the range, so it's impossible to say if you convert well or not (from those particular labs). Did he have previous labs to look at, too?
T3-only meds are seldom used on a long-term basis. However, T3-only is often used to treat THR...IF you are diagnosed with that, but that diagnosis would have to come first.
When your bloods are that high (FT3 and FT4), indicating hypER, and you feel hypo is when you have to start looking at THR. If you can tolerate high levels of FT3 like your current level without feeling hyper, it's a real red flag.
No, I have to agree with you...I don't think the T3 is affecting your heart...we should all have your HR and BP stats!
T3-only meds are seldom used on a long-term basis. However, T3-only is often used to treat THR...IF you are diagnosed with that, but that diagnosis would have to come first.
When your bloods are that high (FT3 and FT4), indicating hypER, and you feel hypo is when you have to start looking at THR. If you can tolerate high levels of FT3 like your current level without feeling hyper, it's a real red flag.
No, I have to agree with you...I don't think the T3 is affecting your heart...we should all have your HR and BP stats!
I just sent you the link to thyroid UK to show that the ranges on your FT3 and FT4 were similar, so that was what I was basing my theory that they actually were frees, rather than totals, on. You've now confirmed that. However, you still have to use the range from your lab. Ranges can vary lab to lab, and the most accurate to use is the one from your very own lab report.
FT3 is very high...it's well above the top of the range.
Yes, your TSH is quite low...remember, the lower it is, the closer you get to hypER, the higher it is to hypO). TSH often becomes totally unreliable once we're on meds. It's often best ignored.
Back to you on the rest later...
FT3 is very high...it's well above the top of the range.
Yes, your TSH is quite low...remember, the lower it is, the closer you get to hypER, the higher it is to hypO). TSH often becomes totally unreliable once we're on meds. It's often best ignored.
Back to you on the rest later...
Me again goolarra. I'm having a look at the first link that you gave me - Thyroid UK and my FT4 and FT3 readings are nothing to be concerned about according to these results, unless of course they use a different range to measure levels. I'm comparing my own levels and have just noticed that my TSH is not 0.5 as I was told on the 'phone but 0.05. I'm baffled, totally lost in the dark. Will I ever get there, will I ever understand?
I can't tell you how grateful I am to you for your consideration in helping me to begin to understand and hopefully gain control over my thyroid condition. Words aren't enough.
Clearly your knowledge is enough to question my results - you thought they were FT4 and FT3 readings and.........you were right!!!! I was so agitated today that I rang the GP again and spoke to the practice manager and she kindly sent me an email with my results and look what we have. I will copy and paste from the lab report:
Sample Result Range
Serum free t4 level 21 (9.0-25.0) pmol/l
Serum TSH level <0.05
Serum free
triiodothyronine level 9.0 (3.5-6.5) - Dr ******* spoke to pt Re Free T3 level being potentially toxic
Taken 12.08.2011 10:12 Lab issue - 12.08.2011 23:00
I will have a look at the articles that you have kindly sent me and do some research into THR. The FT4 is quite high, why is that? At a guess, is it because it builds up in my system with no where to go as it can't convert to T3? The endo in Germany said I couldn't convert T4 to T3. With the T4 being so high, wouldn't it be better for me to be on a T3 only med such as Cytomel or Thybon?
Although my bloods tell one story, my symptoms tell another and although I am not feeling extremely hypo, I don't feel myself. My hair and nails are dry and brittle, I am gaining weight in spite of being careful about what I eat and I walk with my dog for 1 and a half to 2 hours daily. My family are fed up with me being forgetful and say its like living with someone with Alzheimer's.
As for my heart problems, I have no problems there and am completely stable on beta blockers and ACE inhibitors which help to keep my pulse and blood pressure down and regulate the heart rate. I also have a cardioverter defibrillator implanted and my pulse and blood pressure are low because of the medication but that is the whole idea. A typical pulse and BP reading for me is between 60 and 68 with a BP of less than 100/60. Clearly the T3 in Armour does not cause me any problems that are associated with being hypER - at least something is going right for me!
Once again, huge thanks for your support. This and your wealth of knowledge encourage me and help me to try to be optimistic about finding out what is going on. Enjoy the rest of your evening. :)
Clearly your knowledge is enough to question my results - you thought they were FT4 and FT3 readings and.........you were right!!!! I was so agitated today that I rang the GP again and spoke to the practice manager and she kindly sent me an email with my results and look what we have. I will copy and paste from the lab report:
Sample Result Range
Serum free t4 level 21 (9.0-25.0) pmol/l
Serum TSH level <0.05
Serum free
triiodothyronine level 9.0 (3.5-6.5) - Dr ******* spoke to pt Re Free T3 level being potentially toxic
Taken 12.08.2011 10:12 Lab issue - 12.08.2011 23:00
I will have a look at the articles that you have kindly sent me and do some research into THR. The FT4 is quite high, why is that? At a guess, is it because it builds up in my system with no where to go as it can't convert to T3? The endo in Germany said I couldn't convert T4 to T3. With the T4 being so high, wouldn't it be better for me to be on a T3 only med such as Cytomel or Thybon?
Although my bloods tell one story, my symptoms tell another and although I am not feeling extremely hypo, I don't feel myself. My hair and nails are dry and brittle, I am gaining weight in spite of being careful about what I eat and I walk with my dog for 1 and a half to 2 hours daily. My family are fed up with me being forgetful and say its like living with someone with Alzheimer's.
As for my heart problems, I have no problems there and am completely stable on beta blockers and ACE inhibitors which help to keep my pulse and blood pressure down and regulate the heart rate. I also have a cardioverter defibrillator implanted and my pulse and blood pressure are low because of the medication but that is the whole idea. A typical pulse and BP reading for me is between 60 and 68 with a BP of less than 100/60. Clearly the T3 in Armour does not cause me any problems that are associated with being hypER - at least something is going right for me!
Once again, huge thanks for your support. This and your wealth of knowledge encourage me and help me to try to be optimistic about finding out what is going on. Enjoy the rest of your evening. :)
It is confusing...and we even see labs that use the same units using different ranges (it depends on a lot of things, their methods/equipment included), so we always ask for range along with result.
So, when you went to the German doctor, just before the German labs, you were feeling well...no hypER symptoms whatsoever?
Your latest labs: That range on the FT4 really does look like an FT4 range to me. That's fairly typical of some of the ranges we see from UK, Australia, etc. I'm not as sure about whether that's an FT3 or TT3 range. Sometimes, they will run FT4 along with TT3 (don't ask!). If I had to guess, I'd say it's FT3. Your FT4 is still quite high in the range. Your FT3 is clearly above range, and you are feeling hypO, correct?
Here’s a link that gives typical UK ranges. Although they’re not exactly the same as yours, I think the difference has to do with the lab to lab variation mentioned above.
http://www.thyroiduk.org.uk/tuk/pages/diagnosis/blood_tests.html
If I've got all that right, then I still think this shows THR. Anyone who feels well with the labs you posted from Germany and isn't buzzing-off-the-planet hypER almost has to be resistant. Any elevated HR or BP, tachycardia, palpitations, etc. during the time of the German labs? However, you've had heart issues, and higher levels of thyroid hormones, especially T3, often don't mix with heart problems. The way to treat THR is to increase thyroid meds enough to control symptoms without regard to lab values, but your heart issues make me a little nervous about that.
Have you had a chance to research THR at all? Here’s a link to a MH discussion on THR:
http://www.medhelp.org/posts/Thyroid-Disorders/Thyroid-Hormone-Resistance/show/1202364?personal_page_id=287727#post_5499329
Take a look at some articles on THR online and the above thread and let me know what you think. If you agree that this is a possibility, we can delve further into where you go from here, how you go about being diagnosed and what your treatment should be. If you think you might have THR as you’re researching, start printing articles because you’re going to need them to discuss with your doctors, most of whom won’t have a clue what you’re talking about.
So, when you went to the German doctor, just before the German labs, you were feeling well...no hypER symptoms whatsoever?
Your latest labs: That range on the FT4 really does look like an FT4 range to me. That's fairly typical of some of the ranges we see from UK, Australia, etc. I'm not as sure about whether that's an FT3 or TT3 range. Sometimes, they will run FT4 along with TT3 (don't ask!). If I had to guess, I'd say it's FT3. Your FT4 is still quite high in the range. Your FT3 is clearly above range, and you are feeling hypO, correct?
Here’s a link that gives typical UK ranges. Although they’re not exactly the same as yours, I think the difference has to do with the lab to lab variation mentioned above.
http://www.thyroiduk.org.uk/tuk/pages/diagnosis/blood_tests.html
If I've got all that right, then I still think this shows THR. Anyone who feels well with the labs you posted from Germany and isn't buzzing-off-the-planet hypER almost has to be resistant. Any elevated HR or BP, tachycardia, palpitations, etc. during the time of the German labs? However, you've had heart issues, and higher levels of thyroid hormones, especially T3, often don't mix with heart problems. The way to treat THR is to increase thyroid meds enough to control symptoms without regard to lab values, but your heart issues make me a little nervous about that.
Have you had a chance to research THR at all? Here’s a link to a MH discussion on THR:
http://www.medhelp.org/posts/Thyroid-Disorders/Thyroid-Hormone-Resistance/show/1202364?personal_page_id=287727#post_5499329
Take a look at some articles on THR online and the above thread and let me know what you think. If you agree that this is a possibility, we can delve further into where you go from here, how you go about being diagnosed and what your treatment should be. If you think you might have THR as you’re researching, start printing articles because you’re going to need them to discuss with your doctors, most of whom won’t have a clue what you’re talking about.
It is so confusing when different labs use different scales! To answer your question about the German endo's reaction to my levels being so high, he suggested I have a break from thyroid medication (Armour) for 2 weeks and then take Prothyrid - a German synthetic T4 and T3 combination. I refused to go back on Levothyroxine (I didn't realise it was synthetic T4 until later in the day when I collected the prescription from the pharmacy). I lasted for 10 days without medication then started to have hypo symptoms, the most noticeable being intense lack of concentration, confusion, extreme tiredness and I ached from head to toe - it even hurt to swallow. I started back on Armour at a reduced dose initially and felt better within 2 days.
Today I rang my GP and got the results of my tests but I am more confused than ever! I already gave my TSH and FT4 but will include it with the scale they use for measuring the levels. Here goes:
TSH 0.5 ( 0.5 - 5.0)
FT4 21 ( 9 - 25 )
FT3 9.0 ( 3.5 - 6.5)
I looked at past results and noticed that the scale is the same as total T4 and T3, so I rang the hospital lab in the hope of having the matter clarified. I am not more confused and annoyed than ever! The lab told me the results are total and they only test for total and not free T4 and T3. Why not I asked, I saw the nurse at the surgery ask for free T4 and T3 levels after I had a mini-wobbly to get her to do so! I am more in the dark than ever, have no idea what to do. The GP cannot give me any advice as I am on Armour and I am being treated like a traitor.
For now, I have reduced my dosage of Armour to 2 grains spread out 3 times over the day. Brain fog continues, sometimes I can't even finish a sentence as I lose my train of thought! I am lethargic but manage to avoid falling asleep during the day but am sleeping for 11 - 12 hours at night and have to be strict and force myself out of bed compared to a normal 7 - 8 hours night's sleep.
Today I am very tearful and emotional bursting into tears for absolutely no reason. I just feel like hurling my medication to the other end of the world. Thyroid problems stink, it's like a curse and being ignored and treated like an outcast by the GP here doesn't help. I would have thought that any caring GP would work with me and support me in trying to get my levels right since I have dilated cardiomyopathy and suffered congestive heart failure in 2009 - that's when DCM was diagnosed. I have always been a very active person, careful about diet, small frame for my height - 1.68 (5' 6") and UK dress size 8 (US size 4) so heart disease was a real blow. I stabilised and all was going well until Hashimoto's decided to come and put it's dirty feet inside my system and take up residence. I have gained 8kg (more than a stone) and can't shift the weight at all. My husband makes caustic comments about my weight which doesn't help. I don't know what to do.......... Sorry for being so moany everybody. :(
Today I rang my GP and got the results of my tests but I am more confused than ever! I already gave my TSH and FT4 but will include it with the scale they use for measuring the levels. Here goes:
TSH 0.5 ( 0.5 - 5.0)
FT4 21 ( 9 - 25 )
FT3 9.0 ( 3.5 - 6.5)
I looked at past results and noticed that the scale is the same as total T4 and T3, so I rang the hospital lab in the hope of having the matter clarified. I am not more confused and annoyed than ever! The lab told me the results are total and they only test for total and not free T4 and T3. Why not I asked, I saw the nurse at the surgery ask for free T4 and T3 levels after I had a mini-wobbly to get her to do so! I am more in the dark than ever, have no idea what to do. The GP cannot give me any advice as I am on Armour and I am being treated like a traitor.
For now, I have reduced my dosage of Armour to 2 grains spread out 3 times over the day. Brain fog continues, sometimes I can't even finish a sentence as I lose my train of thought! I am lethargic but manage to avoid falling asleep during the day but am sleeping for 11 - 12 hours at night and have to be strict and force myself out of bed compared to a normal 7 - 8 hours night's sleep.
Today I am very tearful and emotional bursting into tears for absolutely no reason. I just feel like hurling my medication to the other end of the world. Thyroid problems stink, it's like a curse and being ignored and treated like an outcast by the GP here doesn't help. I would have thought that any caring GP would work with me and support me in trying to get my levels right since I have dilated cardiomyopathy and suffered congestive heart failure in 2009 - that's when DCM was diagnosed. I have always been a very active person, careful about diet, small frame for my height - 1.68 (5' 6") and UK dress size 8 (US size 4) so heart disease was a real blow. I stabilised and all was going well until Hashimoto's decided to come and put it's dirty feet inside my system and take up residence. I have gained 8kg (more than a stone) and can't shift the weight at all. My husband makes caustic comments about my weight which doesn't help. I don't know what to do.......... Sorry for being so moany everybody. :(
Yes, different countries often use different units to measure, and units change even within countries from one lab to another. However, your German labs do have reference ranges attached. So, you can see that your FT3 at 14 is clearly several times the upper limit of the range (4.4). FT4 of 3.3 with an upper limit of 1.7 is also very high.
Most of us with those numbers would be very hyper. You felt well at those levels, which is what prompted me to ask about THR. When people have THR, their cells are resistant to absorbing T3. FT3 concentrations have to be extremely high before T3 can get into cells. Said another way, blood FT3 levels are very high, but you are still hypo on the cellular level.
Compare those labs with your June labs. Now your FT4 is on the floor of the range, and your FT3 is still quite high, but within range, though barely. Once again, with an FT3 level that high, most of us would be feeling very hypER, and if I interpret correctly, you are starting to have some hypO symptoms creeping back (brain fog returning, etc.)?
That's why I suggested you research THR. Your German doctor didn't say anything about that? What was his reaction to your extremely high FT3 and FT4 levels? Did he change your meds after seeing those levels?
Most of us with those numbers would be very hyper. You felt well at those levels, which is what prompted me to ask about THR. When people have THR, their cells are resistant to absorbing T3. FT3 concentrations have to be extremely high before T3 can get into cells. Said another way, blood FT3 levels are very high, but you are still hypo on the cellular level.
Compare those labs with your June labs. Now your FT4 is on the floor of the range, and your FT3 is still quite high, but within range, though barely. Once again, with an FT3 level that high, most of us would be feeling very hypER, and if I interpret correctly, you are starting to have some hypO symptoms creeping back (brain fog returning, etc.)?
That's why I suggested you research THR. Your German doctor didn't say anything about that? What was his reaction to your extremely high FT3 and FT4 levels? Did he change your meds after seeing those levels?
Hah hah, the 'Almighty TSH' - that's a good one. It's true though for many doctors - it's kind of worshipped by them as the main or only diagnostic aid in thyroid disorders. I had a discussion about TSH and the feedback loop with my doc and he said he's never heard of a feedback loop. Can you believe that? That's high school biology - homeostasis!
The lab results from Germany are copied and pasted from the lab report that is scanned into my laptop. The endo there in Germany is very efficient, seems to know a whole lot more than they could ever learn here in the UK, so no...no decimal points in the wrong place. Could it be that their measuring system/scale is different I wonder? Pardon me, but can I ask you what makes you think that I could be thyroid hormone resistant? Would the hormone levels not be lower rather than higher? I'm new to this - diagnosed at the beginning of this year and I'm still trying to get to grips with it and educate myself as much as possible.
The recent lab results are free T3 and free T4 and not total. I'm still waiting for the free T3 result but apparently I may not have any actual figures. Crazy or what? I am impatiently waiting for Friday to come so that I can get the results on paper for myself.
The lab results from Germany are copied and pasted from the lab report that is scanned into my laptop. The endo there in Germany is very efficient, seems to know a whole lot more than they could ever learn here in the UK, so no...no decimal points in the wrong place. Could it be that their measuring system/scale is different I wonder? Pardon me, but can I ask you what makes you think that I could be thyroid hormone resistant? Would the hormone levels not be lower rather than higher? I'm new to this - diagnosed at the beginning of this year and I'm still trying to get to grips with it and educate myself as much as possible.
The recent lab results are free T3 and free T4 and not total. I'm still waiting for the free T3 result but apparently I may not have any actual figures. Crazy or what? I am impatiently waiting for Friday to come so that I can get the results on paper for myself.
One of our members calls it the "Almighty TSH"...too many doctors here think it's the gold standard as well, but I know it's even worse in the UK. Many of our members have TSH almost undetectable before their hypo symptoms are relieved.
I find your labs from Germany very interesting since they're from when you felt really well. Are they correct? FT4 is 3.3 with a range of 0.93-1.7 and FT3 of 14 with a range of 2.0-4.4? Misplaced decimal points? I don't doubt you, just want to verify because these numbers are quite high and could indicate thyroid hormone resistance (THR).
In the June labs form the UK, are those free T3 and free T4 or total T3 and total T4?
I find your labs from Germany very interesting since they're from when you felt really well. Are they correct? FT4 is 3.3 with a range of 0.93-1.7 and FT3 of 14 with a range of 2.0-4.4? Misplaced decimal points? I don't doubt you, just want to verify because these numbers are quite high and could indicate thyroid hormone resistance (THR).
In the June labs form the UK, are those free T3 and free T4 or total T3 and total T4?
I am so grateful to you getting back to me. As yet, I have no report proper, so don't know the range of FT4. At my GP's practice, this is the first time I have had tests for FT4 and FT3. I had to be really firm, bordering on the obnoxious to have them taken as all they want to test is TSH and T4.
With regard to the FT3 being off the scale, it doesn't make sense at all. Surely they can detect the level even if it is very high as far as they are concerned. The locum doc kept going on about the TSH being low which it isn't. I normally see an endo in Germany as I am not satisfied with treatment for thyroid disorders here in the UK. Levothyroxine is the ONLY med available. Since switching to Armour earlier this year, I feel great, my depression has gone. GP here and my cardiologist wanted to put me on anti-depressants. I told them where they could put their diagnosis. Since starting on Armour, my low mood has gone, I have more energy, hair stopped falling out - it fell out heaps when I was first put on Levo and my reptile skin has gone. Brain fog went but is coming back and my memory is shot - I have to write things down to help me remember.
We all know here that TSH of 0.5 is not low, even with the scale they use here in the UK (0.5 - 5.0) I am still within range, low end but so what. I tried to explain that as I am on Armour, the TSH will be suppressed and this is more or less insignificant. Ouch. I hit a nerve - a big one. TSH by docs here is revered like a God.
To answer your question about what my FT3 and FT4 levels were when my TSH was 0.01, I'll give you part of the lab report here. The endo I attend is in Germany (Munich), did extensive tests and ultrasound then diagnosed Hashimotos and told me I couldn't convert T4 to T3. Results from his lab are as follows: (April 27th this year)
Thyreotropin=0,01 μlU/ml; Norm. NW 0,27-4,2;
freies T3=14 pg/ml Norm. NW 2,0-4,4;
freies T4=3,3 ng/dl; Norm. NW 0,93-1,7
Cortisol=19 μg/dl; Norm. NW 5-25;
Anti TG=576 U/ml Norm. NW 0-40;
Anti TPO=16 U/ml; Norm. NW 0-35
Back in June, I had bloods taken at my GP here in UK and results are:
TSH 0.55
T4 - 9.0 (normal range 9.0 - 25.0)
T3 - 6.3 (normal range 3.5 - 6.5)
Since I am taking Armour, my GP is very hostile towards me as I refuse conventional treatment but the simple fact of the matter is that Levothyroxine does nothing for me, other than make my symptoms worse. I would never go back to that med, not ever.
The lab report will be at the practice on Friday and I'm hoping I'll have some figures for the FT3 and if not, I want to know why and will call the hospital or visit the lab on my own if I have to. The only help I have is here on thyroid forums with patients like me, who appear to know much more than any doc in the UK could ever know when it comes to thyroid disorders. They develop tunnel vision in med school when it comes to thyroid I fear.
Again, a huge thanks and sorry for this message being so long winded........ :)
With regard to the FT3 being off the scale, it doesn't make sense at all. Surely they can detect the level even if it is very high as far as they are concerned. The locum doc kept going on about the TSH being low which it isn't. I normally see an endo in Germany as I am not satisfied with treatment for thyroid disorders here in the UK. Levothyroxine is the ONLY med available. Since switching to Armour earlier this year, I feel great, my depression has gone. GP here and my cardiologist wanted to put me on anti-depressants. I told them where they could put their diagnosis. Since starting on Armour, my low mood has gone, I have more energy, hair stopped falling out - it fell out heaps when I was first put on Levo and my reptile skin has gone. Brain fog went but is coming back and my memory is shot - I have to write things down to help me remember.
We all know here that TSH of 0.5 is not low, even with the scale they use here in the UK (0.5 - 5.0) I am still within range, low end but so what. I tried to explain that as I am on Armour, the TSH will be suppressed and this is more or less insignificant. Ouch. I hit a nerve - a big one. TSH by docs here is revered like a God.
To answer your question about what my FT3 and FT4 levels were when my TSH was 0.01, I'll give you part of the lab report here. The endo I attend is in Germany (Munich), did extensive tests and ultrasound then diagnosed Hashimotos and told me I couldn't convert T4 to T3. Results from his lab are as follows: (April 27th this year)
Thyreotropin=0,01 μlU/ml; Norm. NW 0,27-4,2;
freies T3=14 pg/ml Norm. NW 2,0-4,4;
freies T4=3,3 ng/dl; Norm. NW 0,93-1,7
Cortisol=19 μg/dl; Norm. NW 5-25;
Anti TG=576 U/ml Norm. NW 0-40;
Anti TPO=16 U/ml; Norm. NW 0-35
Back in June, I had bloods taken at my GP here in UK and results are:
TSH 0.55
T4 - 9.0 (normal range 9.0 - 25.0)
T3 - 6.3 (normal range 3.5 - 6.5)
Since I am taking Armour, my GP is very hostile towards me as I refuse conventional treatment but the simple fact of the matter is that Levothyroxine does nothing for me, other than make my symptoms worse. I would never go back to that med, not ever.
The lab report will be at the practice on Friday and I'm hoping I'll have some figures for the FT3 and if not, I want to know why and will call the hospital or visit the lab on my own if I have to. The only help I have is here on thyroid forums with patients like me, who appear to know much more than any doc in the UK could ever know when it comes to thyroid disorders. They develop tunnel vision in med school when it comes to thyroid I fear.
Again, a huge thanks and sorry for this message being so long winded........ :)
Thanks so much for your feedback. I understand that it's difficult for me to obtain a concise opinion without the FT3 results. I'm afraid that they may not have any results for the FT3 as the locum doc said the lab said the FT3 was off the scale. He said a report will come through on Friday (one week after tests were done). I asked if figures would be available for FT3 and he said probably not. WHAT??? So what is their cut off point at least? He didn't know. I will wait until Friday for the full results and if there are no figures for FT3, I will ring the hospital lab myself and try to get some answers. In the UK, docs are very anxious when dealing with patients who are on Armour. I've been told it's illegal. No doc, class A,B,C drugs are available but Armour thyroid is not illegal. It's illegal for them to prescribe it or any T3 med such as Cytomel but it's not illegal for me to take it. The doc's experience is very limited and I think that is very true of all docs here in the UK, or at least 99% of them.
I'm following your advice and have reduced my dose as of today. I've had more concentration problems, brain fog is returning, hair is falling out as though I am hypo but as I said before, I have read that some symptoms of being hyper are like that. Hmmmmmm. Like you say, I can always increase the dose if the hypo symptoms come back.
I'm following your advice and have reduced my dose as of today. I've had more concentration problems, brain fog is returning, hair is falling out as though I am hypo but as I said before, I have read that some symptoms of being hyper are like that. Hmmmmmm. Like you say, I can always increase the dose if the hypo symptoms come back.
What's the range on your FT4? Ranges vary lab to lab and have to come from your own lab report...perhaps you have the range from an old report if you just got a verbal on this one?
I guess I don't know how results on FT3 could be "not available" but the lab could know they are "off the scale". It doesn't make sense to me. Does it to you?
0.5 is not terribly low for TSH...certainly not low enough to send anyone into panic mode.
When your TSH was 0.01, and you felt great, what was your FT3 and FT4?
I guess I don't know how results on FT3 could be "not available" but the lab could know they are "off the scale". It doesn't make sense to me. Does it to you?
0.5 is not terribly low for TSH...certainly not low enough to send anyone into panic mode.
When your TSH was 0.01, and you felt great, what was your FT3 and FT4?
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