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My new test results..any info would help

Had my blood tests done after being on synthroid since april..1 1/2 pill od synthriod..here they are..free t4 0.72 raange =0.77-1.61  TSH 0.42 range=0.34-4.82  this lab says my f4 is low,free t3=2.9 range=2.3-4.2 pg/ml these were done by quest i think last time they were done by labcorp these were done on july 8th back in dec my t4 was 1.12 range =0.82-1.77 tsh-1.280 range=0.450-4.500 no free t3 was done then and tese were befor going on synthroid in april..dr added cytomel 1/2 of a 5mcg pill dailey yesterday.hope it helps as i need energy and hoping will help sex drive  are these levels pretty good/Any input would help Thanks
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Avatar universal
Its me again!! called drs offive Monday ,nurse told me to go back on what drr orginally prescibed so i did...i think i might feel better on 2 25 mcg. of synthryoid and 1/2 cytomel..gonna see still today on the 1 1/2 synthroid and the 1/2 cytomel will call dr tommorow.so sleepy im on pain pillls as i had a  root canel yesterday..seems all i do is take pills an they interact against each other but drs all know what i take.i worry about the xanac and pain pill.
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649848 tn?1534633700
COMMUNITY LEADER
I think the most important thing to do is get that FT3 tested.  Some of the T4 and T3 in our bodies is bound by protein, therefore, unusable.  Total T3 tests both bound and free, so you have no way of knowing how much is actually free for use (i.e unbound and available to enter the cells).  It's very possible that her FT3 could be low, also, even though the total is relatively high.  That's why we always tell members to test FREE, not total.

I'm not real up on Reverse T3, but I'd be more inclined to think that isn't her problem, at this point, but again, without an FT3, you can't know.  

The single, most important thing you need right now is an FT3; without it, your wife is not going to get well. I would never recommend taking a med with T3 in it, without keeping track of FT3 levels.  
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Avatar universal
The last blood labs taken for my wife were just completed in I think mid July.  And as a result the dosage was increased from the 112 to 125 mcg of Levo.  I think she started taking the increased dose starting the last few days in July.

I know it takes a while for T4 to get a response. But like I said over the last 2+ weeks if anything it seems like she is more tired than even before she took the increased dose.

Thinking back, I think the first signs of her starting to slip further Hypo was irregular menstrual cycles both in timing and flow.  She didn't think too much about it at the time.  But looking back it seems like that symptom preceded the fatigue.  Now she is putting on sweaters when I'm hot in a T-shirt and she can't stand the AC on in the car or in the house without being covered up.  Plus the fatigue and irritability and of course no libido etc.

If you say her TT3 is high which it is over the upper 1/3, and she is well below range in T4 what could be up with that?  

Why would her T4 be below range, yet her total T3 be higher in the range?  Is it possible that she has a problem with reverse T3?

I am starting to wonder if she should change to Armour to get a straight T3 component?  But again without a FT3 it is hard to know isn't it?

Maybe we need both the FT3 and Reverse T3 and get the ratio.
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649848 tn?1534633700
COMMUNITY LEADER
Yes, I understood that carol upped her cytomel as well as the T4 med; the thing is, the cytomel would wear off relatively quickly, so by now would not be an  issue.

When were those labs of your wife's done?  While it's best to work up slowly, if your wife is still hypo, it would be worth getting her retested and ask for another increase.  But most of all, I really think you need to get online and order a thyroid panel that includes FT3.  Her TT3 is relatively high in the range, so you need to know what the free is.  

I don't know a lot about DHEA either; it's an adrenal hormone and decreases with age.  It's harmful to take too large doses of it; therefore, is best take only under a doctor's supervision.
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Avatar universal
Please check your inbox.  I thought I'd ask a few questions off line that may be a little more off topic than this thread.
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Avatar universal
barb.  she not only upped her T4 med.  

She ALSO upped her T3 Cytomel dosage.  So that would have an immediate effect.  ANd based on her stopping and her symptoms returning almost immediately that would make some sense that it was in fact the T3 self increased dosage.

Camorocarol:  I do not know anything about DHEA.  But if it could have an increase in my wife's energy level, fatigue and libido I'd be interested in learning more about this.

I do know that my wifes labs her free T4 was BELOW range She tested

TSH 3.67  range Can't remember range but not over 3
FT4 0.68 (.75 - 1.54)
TOTAL T3 1.46 (0.7 - 1.7)

They raised her Levo from 112 mcg to 125 mcg.  What I feel is meager increase.  It has been over 4 weeks and we/I have seen absolutely zero improvement.  In fact if anything I think her fatigue and cold sensitivity has gotten worse.  We have been unable at all requests to get a Free T3 test.  So we are also about to go to the online blood lab testing to actually get what the hell we ask for!  

My wife never really has had a sex drive.  But then again, I'm about 100% sure she also has been Hypo our whole relationship.  I'm not convinced she has ever been properly medicated.  I think she has always been medicated at about 75% to 80% of optimum.  She finds it impossible to lose weight. Which does no magic wonders to her self esteem, body image and thus sexuality either.  I've heard that women with Hypo can't lose weight unless they really get to optimum medication.  And this would explain her inability regardless of diet and exercise program she has undertaken.  And I'm talking STRICT guidance to weight watchers, LA weight loss programs etc in concert with walking up to 7 miles a day.

Anyhow, Tell me more about DHEA.

I'm thinking it is still primarily her continuing to remain hypo, but after 21+ years of a spouse with no libido I'm willing to look into any avenue.  not to mention helping her in her feeling well in daily life and all that comes along with that.

When you feel and are treated to be #2 to everything in life, including her sleep.  It feels like an anchor around the neck of a marriage.  At least that's how one husband feels!  I understand it is medical issue.  But when seemingly impossible to solve, (while simultaneously knowing it CAN be solved, at least most of it)  it becomes extremely frustrating.  This is non ending.  It is not like she has a cold or the flu or the occasional too tired tonight, or even this week.  But 21+ years.  It is getting really, really heavy monkey on this husband's back.
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649848 tn?1534633700
COMMUNITY LEADER
Check on www.drugs.com.  Type in the names of your medications and see if there is interaction between them.   I take my blood pressure med shortly after my thyroid med, so you might just have to experiment and see if they make a difference.  Most likely, the most they would do is inhibit absorption of your thyroid med, which would cause you to need a higher dose.  Since you already seem to need an increase, you want to make sure you get maximum absorption.  
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Avatar universal
can i take my hormones pills and other pills like wellbutrin like an hour after synthroid and cytomel?
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649848 tn?1534633700
COMMUNITY LEADER
It sounds like you probably do need an increase in med, but you need to let your doctor determine the dose, then stay on it.  The way you felt at the beginning of last week, would have more to do with whatever dosage you were on a few weeks ago, than what you've just done, since it takes a while for synthyroid to have much effect.  

You need to separate your vitamins/minerals/supplements from your thyroid medication by at least 4 hrs; therefore, if you take your thyroid med at 7:00 am, take your supplements at noon or in the evening.

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Avatar universal
i know u r right but i have been on 1 1/2 synthroid pills since april..seems thats quite awhile.3 months on it..And my t4 in july was low than the range..and on the posts here everyone all my others are low...i have no energy at all today..im calling dr tommorw and telling her what i have done..i did take 2 synthroids this am but only 1/2 cytomel..felt so good beginning of the week with uppinh meds andd now like crap..i have been taking 2 dhea the last 2 days so 10 mgs. a day..today only 5 mgs,maybe its making me tired i dont know much about it.im taking the l lysine too.was taking l carnitine and l tryrosine,,but niot today,,i take vitamin d,and a multi,,i got a new femring on the 8th they are suppose to last 3 months but mine dont ..maybe the new one was strong and that made me have energy and sexual desire..this is all so wied to me...and i get cold and i never got so cold before..are supplements ok with thyroid meds..i need so much info  Thanks
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649848 tn?1534633700
COMMUNITY LEADER
Yes, generally speaking, if TSH is high, you're hypo, but TSH is not a good indicator of thyroid function, or lack of.  TSH is a pituitary hormone and its only function is to signal the thyroid to produce hormones.  

Free T3 and Free T4 are the actual thyroid hormones, and they are the ones that best determine whether or not you are hypo, along with symptoms.

It seems to me that you just need to get back on the dosage(s) your doctor told you to take and let things stabilized.  This can take several weeks, or even months, but do make sure you always let your medication have a chance to become stabilized and do the proper testing before making changes.

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Avatar universal
So I was reading..if yout TSH is high u are hypo..when mine was first test it was
1.280 range=0.450-4.500
So i guess i must not be to hypo since i read if its high..seems im more to the low end..but when dr put me on synthroid she was going mainly by symtoms not results....the last 2 days sex drive dropped a bit..i find this odd after 4 days of energy and wanting sex...what have i done?
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Avatar universal
she checked it and out on between 5 mg and 10 mgs..im trying 2 ,but think i will go back to one..had 2 last tow days
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649848 tn?1534633700
COMMUNITY LEADER
Have you checked into any of the online lab services?  I think we talked about this in other threads, as an option for your wife.  You can get a TSH, FT3 and FT4 for about $85; it's a cheap way to figure out what's going on.  

camarocarol -- did your doctor actually test your DHEA or just put you on it?  At what dosage?
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Avatar universal
thanks for responding..i will go back to the orginal dose as dr had perscribed(she is out of her office today i tried to call and tell her what i was doing)i guess if in a few days im back to feeling run down abd biting everones heads off i will see if i can get ahold of her,im not due to see her till in sept,thats when she will retest my blood.Maybe my adding the DHEA as my dr said helped my sex drive..we did it agin last night 4 nights in a row!!And im taking l lysine and l carnitine and l tryosine(but i read it could screw up thyroids meds so im not taking it) but i started the DHEA and the about 2 weeks ago I had read a article ion a magizine about low lcanitine levels and this lady had been tired for years ,no sex drive and stuff.she saidafter a month and years of suffering she feels great!! I know me and hubby used to me sex every night,last two years down to once a month..it sucked so I hope this will help u and your wife.
so if I go back to dr for blood work after i go back down on the meds and things r the same as before levels and stufff and feeling crappy is that how she will tell? If i took taking the 2 synthroid and the 1/2 of cytomel would that be a bad idea? i dont want to feel bad again.
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Avatar universal
Wow you have had a heck of a ride for years.

Well T3 is available immediately for your body to use.  And this likely explains your recent burst of energy.  Some people say that T3 is a lot like "speed" (the barbiturate) because it does get you all revved up.  

I would love to have my wife get a T3 addition.  But the Drs absolutely REFUSES to do a Free T3 test so we have no idea what level it is at.  Only Total T3.  Really pissing us off to no end.  Her Dr just raised my wifes dose up a measly 13 mcg from 112 to 125 mcg of Levo (T4).  I'm sure it will help but we still don't know if she has a conversion issue or not. Based on the total T3 it appears not and her Free T4 is still lower in the range so we know she needs an increase in T4.

For you  I would suggest/recommend that you go back to what the Dr prescribed, wait a few weeks and get blood labs again to see what the results are.  I think you may want to fess up with your Dr and say that when you increased the dosages you felt much better. Then I would think that would support your Dr increasing your dosage.  Would she increase both like you did or just add more  T4 and leave the Cytomel alone? I don't know.  If I was the Dr. I may try just the upping of the T4 and again test in 6 weeks to see the results.  The key thing to watch is the Free T3 result.  Did upping the T4 med have a corresponding appropriate increase in free T3?  If so that may be the ticket to continue to increase and adjust the T4 med.  On the other hand if no boost to the FT3  then that would call for a switch in strategy to up the Cytomel (T3).

Understand I'm not a Dr. and I'm only applying what I learned here and some common sense.

You should be thanking your lucky starts that you have found a Dr. that is BOTH treating you by symptoms AND open to testing and treating with a T3 meds.  Many people are not that lucky.  I know my wife & I are not that lucky.

In about a month my wife goes back to get labs done.  If no FT3 test we are going to go and pay out of pocket to an online lab order and lab to get it done ourselves.  We may further have to go find a Dr. out of our insurance HMO system in order to actually get treated properly.  We believe that her current Dr. is on the right track, it is just that the Dr. is only able I think to get her to 80 or 90% of being truly feeling as good as she deserves and ought to feel.

I can say that it is very hurtful to a husband to know when you go to bed that your wife is more interested in sleep than you.  Last night I just tried talking to her and she about bit my head off!  Not conducive to intimacy.  Neither verbal nor physical.  Which over time if not corrected can take a toll on a marriage.
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Avatar universal
ok baackground history in 1990 i became servely anxious and went to tons of drs all who checked my thyroid just tsh and said it was normal and i was having anxiety put me on xanax.in 1995 i had a hysterectomy and was put on premarin which i took for 8 years and then could no longer afford it,things got worse,in 2007 i tried to get off xanax and the beer i was drinking,i ended up in a mental hospital,thyroid was checked there and still was told it was normal..put on more antidepessants and crap meds.I had to check my self in to mental hospital 2 more time during 2008 due to dr changing meds so often..finally in march 2010 i went to utah to a shrink there,he started getting me on right track of getting off those meds,,but not the xanax...he retired 2 months after i found him,so then i found a dr in idaho(i live in nevada)he told me no way was it my hormones..It might have been 2009 but i think more 2010....so he ut me on addderal as i wa so tired,it did nothing for me,Finally my hubby(new) that i married said ENOUGH it must be your hormones or thyroid..so last july i found the nurse practioner im seeing who specilizes in hormones.Right away she took all kinds of blood tests,all were so low its taking since last july till now of trying differnt kinds of hormones to get me halfway better,in april she ran all the tests for thyroid(i had some done in dec) and those results werent to good,so in april she put me on the 25 mcg odf synthyroid then upped it to the 37.5.it was me at my july visit that asked about the cytomel..she is very open to symtoms and said there was room to play around,,after about 1 weeek on cytomel bad headaches,so she had me stop it for 3 days,still had headaches,so guess they were from my sinus surgery back in may,so she said go back on cytomel.the ones i had the compounding pharmist make made me very dizzzy and ill so i got the pills and had them split them. now the last 4 days i have taking the 2 synthyroids and 1 cytomel and as i said im up more doing more and sex 4 nights in a row,Im also on the dhea.I talked to ,my pharmist that has been thru all this with me and he says stay on higher dose till i can talk to dr..he said it wont hurt me.I thought i might stop the cytomel for the weekend but he said wait till i talk to her she might want me to have blood tested.but i understand what u r saying about knowing which med did what,so im in a pickle there. So u see i guess i  am a desparate person who has been thru hell since 1990,lost my hubby of 21 years in 2002 and im not willing to lose this one,he goes to dr with me and supports me 100 percent...he has been thru hell with me too,most guys would have left me.I only noticed yesterday im having itching..dont know what that is all about and chills,pharmist sais if i was getting to much meds i would be sweating and heart racing..so i dont know. i still apprecirte all your info and flying fool it was u who gave me the idea of upping th synthroid,i know u didnt mean on my own but my dr is 70 miles away and her stupid receptionest must not have gave her my messae so i will try again to day,,at least im not biting everyone heads off like i was 4 days ago !!
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Avatar universal
Woiw i didnt know ,i have been on 1 1/2 pills of synthryoid since march or april..and the cytomel just since july....are u saying i should go back to 1 1/2 of synthyroid and 1/2 cytomel? Must be the DHEA iom a horndog the last few days
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Avatar universal
T4 meds take up to 6 weeks to become stabilized.  So even re-testing in a month is really too quick to know what the dose result was in your bloodstream.

T3 meds to mess with on your own is more of a concern as T3 is available immediately.  You may feel OK now but it is possible for the T4 meds to start "kicking in" over time and then it is possible you can send yourself too far and go Hyper.  And hyper has really nasty and possibly more health concerns.

And because as Barb said you made two changes and did it in between labs, you have no idea necessarily which one did what.

So I agree that self medicating is definitely a big no-no.  Especially with T3 (Cytomel).  If I were you I would be very happy that you have a Dr. that will even consider adding a T3 med at all at this point.

Sounds as if low libido is a concern.  That is a concern for my wife was well.  And so far we've been unable to yet get to a medicated level to achieve the sweet spot for medicine.  Part of that is our trouble finding a good Dr. within our HMO.  And the fact that every time I think we get close to optimum dosage, I think Hashi's takes its toll and she slides back towards Hypo.  I think we're always just a little bit behind and short of the curve and thus never really get to achieve the sweet spot.  It also makes it difficult when I see the need her symptoms before my wife. So then it is the traditional husband wife stubbornness that gets going.  Have you ever tried to tell your spouse that they should go to the Dr?  The first thing they normally do is ignore you or tell you that you don't know what your talking about and resist going.  At least that has been generally the response I get.  of course she thinks its only because of the libido that I want her to go.  And I have to admit.   There is some truth to that. But I also don't like seeing her grouchy and tired all the time.

Some people have had to resort to changing up their meds on their own.  But this is usually after agonizingly long periods of time and uncooperative Dr's.  And many have had roller coaster rides of hell from series of Dr's who mess with their dosage etc.  So those people are truly at their wits end and feel that it is a last resort.  And you have to remember that you are using strong prescription medicines without Dr' permission, knowledge or prescription.  Which is I believe illegal in most if not all states.  So this method should be used knowing that there could be very dire consequences.  I do not get the sense you are anywhere near that state of desperation.  I understand as Barb said that you want relief, and sooner is always better than later.  But I strongly encourage you to be patient at this time.

You may want to fess up to your Dr. what you did and what the result was.  They may take that into consideration when contemplating the next dosage change.  On the other hand, the Dr. may be VERY skeptical to increase things as he may fear you will start self medicating yourself again.  The closer the Dr think he is getting you to an even keel, the higher the risk that if you were to self medicate by you unilaterally increasing dosage could send you over the edge and into Hyper land.
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649848 tn?1534633700
COMMUNITY LEADER
The worst thing in the world you can do is adjust your own medications or adjust them too often.  You aren't giving yourself enough time for your body to adjust to the dosages.

Did your doctor tell you to increase the cytomel from 2.5 mcg to 5 mcg/day?  

You should only ever make one change at a time and give ample time for that change to stabilize, then retest before making more changes; the way you're doing it (self-medicating), you aren't going to know whether the cytomel helps or not because you didn't wait to be retested, like your doctor wanted.  

I understand that you want to feel better quickly, but dealing with thyroid issues doesn't work that way.  Because it takes several weeks for changes to take effect, you have go slowly.
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Avatar universal
Hi,,I upped my generic synthroid a few days ago from  37.5 (1 and 1/2 pills) to 2 pills so im taking 50 mcgs...i tried to call dr no answer so im doing this on my own...i feel better i also upped the cytomel from 1/2 of a 5 mcg pil to a whole one.1/2 in morning and 1/2 in afternoon,have had sex last two nights..i know my dr didnt want me to up the synthroid untill blood test in a month from cytomel..the only thing i have is headache and seems like fingers are swelling..do you thnk im crazy to try this on my own?Am i in any danger i wonder..dr also has me on dhea..5 mg.I tried armour and was a nervous wreck. i stopped prozac in July after being on it for a year and have been very gripey..pharmist feels its more hormones than stopping the prozac..Im also on wellbutrin sr and hope to get off it to in time...one thing i still get is cold spells..Odd?? thanks for all the info and more is always welcome..I just dont want to cause heart damage.
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Avatar universal
I still go back to the fact that if symptom relief generally occurs in people when the Free T4 is mid range and Free T3 in upper 1/3 of the range.

the fact that you are still low in the range for T4 would indicate that you could increase the T4 med.  Then re-test and see what response you have both in symptoms and lab results.  If the conversion process is working, you should see a jump in BOTH the Free T4 and Free T3. And I would hope improvement in your symptoms.   If on the other hand your Free T4 do go up but there is no increase in the Free T3 then you may have a conversion problem.

the actual dosage for everybody is all over the board.  It all depends upon how out of whack their blood levels are and individually what each person feels in order to get symptom relief.  I do know that 25 mcg of Synthroid is a common starting dose.  And increases in 12.5 or at most 25 mcg are the most common.  I don't know too much about Cytomel other than that it is pretty expensive and that it is a T3 med and it is quite common T3 med to add when it is called for.

Another option that works out well for some people is to go on natural Thyroid.  I think two common names for this are "Armour" and "Nature" .  This has both a T4 and T3 components.  Again the dosage is different but it does work well for some people.  They usually do the natural thyroid doses in "grains", not micro or mili grams.
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Avatar universal
Thanks..I forgot to mention i had labs done in dec, and then in may dr put me on synthroid in april and then my recent labs in July and thats when she added cytomel.Are tese low doses i was thinking of upping to 2 synthroids instead of 1 and a half pill 25 mcg.Thanks
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