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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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649848 tn?1534633700
COMMUNITY LEADER
Synthroid comes in a variety of dosages so saying 1 1/2 pill, doesn't help us.  What is your exact dose?  

Both your FT3 and FT4 are too low.  FT4 is actually below the range and FT3 is barely in range.  
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Avatar universal
Im on 25 mcg synthroid plus half another one it equals out to i think 37.5 mcg.Any suggestions or questions i should ask my dr? thanks
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Avatar universal
If your doctor just added Cytomel, you should be getting labs done again in about 5-6 weeks. Be VERY careful NOT to take your meds , especially the Cytomel, until after your blood is drawn or your tests will be inaccurate. Cytomel is 4X stronger than Synthroid, so all together you are taking just 47.5 mcg of thyroid hormone. This is a VERY conservative dose considering how low your Free (circulating and available for use) levels are. Your TSH is low to begin with....mine was too....so you shouldn't be surprised if it drops below normal. This often happens when someone is taking T3 (Cytomel), but is not a problem as long as your Free levels are in range. FreeT4 and FreeT3 are the most important levels, and people usually feel best when the FreeT4 is mid-range or slightly higher and FreeT3 is in the top 1/3 of the range. Since your TSH wasn't elevated, I assume you are being treated because you had symptoms ? I suggest you have your Vit D and perhaps your B12 levels tested as well, as low levels are often associated with low thyroid.

If I might make a request, it is easier for us to understand your labs if you post them something like this:

July 26, 2011
37 1/2 mcg Synthroid    

TSH          .42       ( 0.34 - 4.82 )
Free T4     .72       ( .77 - 1.61 )
Free T3      2.9      ( 2.3 - 4.2 )      

Can you see how much easier that is to read than all run together ? It also makes it easier to compare a series of labs. And it's best to always have your labs drawn by the same company for consistency. Different labs sometimes have different ranges and it makes it hard to compare.

Good luck to you !  
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Avatar universal
Thank you for reposting my results like you did,my drs office uses quest and that is the ts reading from quest the tsh and free t4 were from labcorp this time,there was a mix up and my dr and her lab are 70 miles from me so i had to go to local hospital for the t4 and tsh.          The local hospital also did them in May and back then the T4 was 8.4(range-4.8-13.9) and Tsh was 1.22 (range -0,34-4.82) oh but i see the one in Mat hust says T4 not free T4...but why would my TSH drop from may to july or is it suppose to when on synthyroid. I dont know how to post the numbers like u did.Sorry           And the lab from local hospital says my free t4 is low now as u can see.i coouldnt split the 5mcg of cytomel so went to a compounding paharmist and he made me up some in capsules.I havent felt the best since switching from generic syntrroid to name brand..im hoping that passes,im also on wellbutrin sr,estratest,and xanax.I take vitamin d as i was defficient but the bs were ok                                                                                                          
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Avatar universal
All you have to do is hit the "enter" key after typing in your result the ranges. Just like starting a new paragraph.  it will start a new line.  And do that each time

example:
TSH 2.5 (0.3 to 3.0) - "Hit enter or return"
next test result - "hit enter"

And do that for each range.

If you are Hypo your TSH is high. So taking thyroid meds will LOWER your TSH.  So you going on thyroid meds makes perfect sense that it be lower than before.  It should be or yourre not getting better.

I have a different take on this.  I don't quite understand why they added in a T3 med at this time. Your Free T4 is so low in the range that there is not enough evidence yet to indicate that you have a conversion problem.  Other than to get immediate relief of symptoms.  I would think it would make sense to up your dosage of Synthorid or whatever straight T4 med would make sense.  Then test again in 6 weeks and see what kind of response it has on both Free T4 AND Free T3.  If the free T3's go up reasonably, I would think it would indicate you do NOT have a conversion problem.  There is A LOT of room to move your Free T4 in the range before I would think about conversion problems and adding a T3 med.  

But this is just one persons OPINION.
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Avatar universal
i totally dont understand any of this thyroid stuff..lol..help..so u r saying i shouldnt be on a t3 med,i read where others add t3 to a t4 med and do so much better..I had a pharmist compound the cytomel cause when i tried to cut it it crumbled..i dont know what he did but i got so dizzy and bad feeling...i got the pills today and had my regular pharmisit cut them.If all my levels are low should i be on higher doses of synthroid? I was told i would get energy and sex drive..well on the synthroid since april and i am better but something is still wrong.Dr  also has me on hormone pills..i feel so gripey..and advicem pharmist thought its odd im on both a t3 and a t4 med...
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Avatar universal
I agree many people can feel better when they combo a T3 with a T4 med.  This could be for a couple of reasons.  One is that the Dr's refuse to test for Free T3 and thus never know that they are having a conversion problem. So when they happen to hit upon adding the T3 med in they are actually getting the results they need.  Another possibility is that they happen to hit upon the sweet spot when they finally add a T3 component.

T3 is almost immediate in its use into the body.  It is also short lived. And many times you have to take the medicine in two doses during the day since the morening dose is used up by the afternoon.  T4 med is a long life in the blood. The body has to take time to convert it. And the body will not I guess "call for" the conversion if it is not needed and thus it stays in the blood awaiting to be used at some later point in time.  And this is the reason that it is only taken once a day and takes up to 6 weeks or more to level off when a med change is made.

T4 meds are easy and relatively cheap.  And they are usually the first choice to do.  And most people don't have a conversion problem. So dosage tweaking to get into the sweet spot can be a bit easier as you can keep increasing the dosage until you get feeling well.  However for those people who have a conversion problem.  No matter how much T4 they take or how high their T4 levels are in the blood.  If the body doesn't convert them to T3 which is what the body actually uses. Then it doesn't matter.  This is when people normally add in a T3 med.

There is really no 100% right or wrong answer.  You have to get the the medication levels in whatever combination that results in YOU feeling better.

My thought on the matter is that if you can isolate one med, and get the both Free T3 and Free T4 labs done and monitor all those in concert with your symptom relief you may then be better able to determine if a T3 med should be added to the mix.  Starting out with two variables makes it a bit more difficult to see which med should be adjusted when.  But that is just my opinion.
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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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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
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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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
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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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
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
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
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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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
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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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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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
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
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
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
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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