New Labs

[Prism45]

Hi everyone!  Any insight you might have on these labs would be most welcome.

I started the end of Dec on 100 mg levothhroxine and after 2 weeks of hyper went to 50 mg.  I started back up at the end of Jan to 62 and then first week of Feb 75 mg.  I am currently on 75 mg  Synthroid.  I do not seem to be having any major hyper symptoms from the 75 mg.  New Dr. said to not use the generic that I am sensitive.

I take 4000 d3 and a multi with b12, and just started 65 mg of Iron after seeing the ferritin result.  Been looking up information on the Iron but so far just not sure about it.  Is anyone taking iron?

triiodothyronine (T3), serum          135 ng/dL 87-178                         T3 SerPl-mCnc
thyroxine, serum, free                  0.9 ng/dL 0.6-1.5                         T4 Free SerPl-mCnc
thyroid stimulating hormone, serum 2.749 microintl units/mL 0.400-5.000 TSH SerPl-aCnc

thyroid peroxidase antibody, serum, Immulite method 562.7 IU/mL             0.0-9.0
thyroglobulin antibody                                         145.7 intl units/mL 0.0-4.0

ferritin, serum                              19 ng/mL   11-310                         Ferritin SerPl-mCnc
hemoglobin, blood                      13.2 g/dL           11.0-15.1                 Hgb Bld-mCnc
Vitamin D, 25 Hydroxy D2             <10 ng/mL ng/mL   
vitamin D 25- hydroxy, serum      49 ng/mL   30-80
vitamin b12, serum                     726 pg/mL 180-914


Previous test - prior to any medication
TSH  11.74   -- just told was to be below 2.5
Free T4     .9   (.8-1.7)

Vit d  33   (30-80) (4000 supplement)

I don't know if anyone can answer these questions based on the above info but can't hurt to ask :) -- Can you tell if that is free T3?  It does not say so but that is what I asked if they tested for.  Also, in one of the reference papers that I was reading on thyroid it said  that the old test was to 5 and the new test was .3-3 -- Is this the old testing or is it just a difference in the labs?  Do the labs even do the old testing anymore?  Might be I just need to call the Dr. office but after having just asked one question regarding the results and being told to just retest in 6 mos.  I am thinking I might not get far. Or maybe I just need to figure out the best way to ask them the questions to get a good response.
Thanks

[Barb135]

AACE is the American Association of Clinical Endocrinologists.  Many/most labs have ignored the recommendation to change the range for TSH to 0.3-3.0.  Since doctors only look at the ranges provided by the lab, they simply go by the old ranges, as well.  You can mention it to your doctor, but most likely it will fall on deaf ears.

19 IS too low for the ferritin; I'm not sure what your doctor was thinking, when he said your labs were "fine".  You should still discuss iron usage with your doctor.

The idea that you need TSH to be below 2.5 shows that even the doctor who did your surgery is putting too much stock in TSH and not enough in the FT3 and FT4 levels.

If you only started the 75 mcg levo, the first week of Feb, it's way too soon to be increasing to 88 mcg, since it takes, at least, 4-6 weeks for a dosage change to take full effect.  By increasing so quickly, you run the risk of over medication.

I don't agree that synthroid is any better than the generics.  I actually did better on generic levo than I did on synthroid.  The only thing the insistence on Synthroid does, is help out the manufacturer.  

I personally, have not done the temperature test for hypo.  Some say it's fool proof for determining hypo, others say it has no bearing.  My thoughts fall in between, in that it may be helpful as far as a diagnosis is concerned, however, I don't think it's going to help you track how your med doing.  There are other things that can cause your temperature to rise/fall.

Alleviation of other symptoms will tell you better, how the med is doing.  If you develop sudden, unexplained weight loss, diarrhea, etc you're most likely over medicated.

Are you scheduled to retest in 6 weeks?  That's the norm, when actively adjusting meds and since you've had 2 adjustments in < a month, you need to be particularly careful to retest in a timely manner.

[Prism45]

Hi Barb,

Hope you are doing well.

I just got done with some surgery yesterday so please bear with my semi drug state along with the funkey keyboard.  I was hoping that I was wrong about the lab tests since I not only researched the Dr. but called the office and asked what tests were used for hypo.

Who is AACE?  This dr. has an email system for labs.  I think I would like to make a reference to this old lab usage.  

As far as the Dr. is concerned my labs look good and I don't need to change anything.  I decided that that 19 was too low.  The 65mg Iron is the only stand alone tablet that I saw at cvs.  it is equivalent to 325 ferrus sulfate which I read "somewhere" (lots and lots of reading lately) was a normal dose.  need to find out more about it.  But since I am still feeling the tired/muscle weakness and I knew I was going into surgery I wanted to get started.

I just gave a copy of the lab results to the dr. that did surgery friday and She told me that I needed to get to below 2.5 and gave me a script for .88 synthroid.  She said the generic versions can be +- 30  -- I did not know it could be that much variation I thought it was just 5 or 10.

Have you ever done the temp test for Hypo?  I just started that to see if I can track how well the medicine is taking effect. I have found it interesting that my temp does not go above 97 so far.  I think that might be an improvement though.  One time I was 96 (but that was before I was officially Hypo LOL and did not realize that it was an indicator)  

[Barb135]

Any time "Free" T3 is not specified on the lab report, the result is not Free T3, it's Total T3, which is considered to be an obsolete test.

If you're referring to TSH with a range of 5 vs 3.3... your lab is using the old range.  Over 10 yrs ago, AACE recommended that the reference range for TSH be changed to 0.3-3.0.  Many labs, therefore doctors, have been very slow/reluctant to change their ranges. Staying with the old ranges, prevents a lot of people from being diagnosed.

It looks like your vitamin D levels are coming up nicely.

Ferritin is definitely too low.  Is that 65 mg iron, doctor recommended?  If not, how did you arrive at that dosage?  A lot of our members take iron, I just don't happen to be one of them, since my ferritin level was, actually, above range.

Your vitamin B-12 doesn't look bad, but supplementing certainly can't hurt.