New lab results are in....

[gizmoesgirl]

Below are my labs from October 2012 through June 11, 2013.  I am still having extreme exhaustion, tired muscles, moodiness, and weight gain among other things.  My endo states that I am now hyper however, i dont seem to have hyper symptoms.  He did not make any changes to my meds which are as follows: Levothyroxin 25mcg 2 pills 4 days a week and 1 pill 3 days a week and Liothyronine 5mcg 1 pill two times a day (this was adjusted after my 5/24/13 labs came in. Does anyone know what causes low Alkaline Phosphate? Any suggestion regarding my most recent lad results would be greatly appreciated.  

10/2012:
TSH 1.48 (.45-4.50)
T4 free 1.2 (0.8-1.7)
T3 free 3.0 (2.0-4.8)
Vitamin D 42.1 (30.1-100)
Thyroglobulin antibodies 109 (<41)

1/3/2013
TSH 3.13 (0.45-4.50)
T3 total 119 (80-200)
T4 free 1.1 (0.8-1.7)
Vitamin D 44.4 (30.1-100)

2/21/2013
TSH 2.52 (0.45-4.50)
T3 total 113 (80-200)
T4 free 1.2 (0.8-1.7)
4/16/2013
TSH 1.17 (0.45-4.50)
Total T3 207(H) (80-200)
T4 0.8 (0.8 -1.7)
Vitamin D 43(30.1-100.0)

5/24/2013
TSH 0.14 (0.45-4.50)
T3 Total 193 (80-200)
T4 Free1 1.0 (0.8-1.7)
Vitamin D 37.4 (30.1-100.0)
Alkaline Phosphate 36 (37-137)

6/11/2013
TSH 0.32 (0.45-4.50)
T3 Total 173 (80-200)
T4 Free1 1.1 (0.8-1.7)
Vitamin D 35.1 (30.1-100.0)
Vitamin B12 562 (248-894)

[gimel]

Hypo patients taking thyroid meds often find that their TSH becomes suppressed.  Unfortunately, most doctors don't recognize that a low TSH does not automatically mean you are hyperthyroid.  You are hyperthyroid only when having hyper symptoms due to excessive levels of the biologically active thyroid hormones, Free T3 and Free T4, neither of which seems to be the case.  In fact you still have what appears to be some hypo symptoms.

I am surprised that your doctor tested for Total T3, rather than Free T3.  Free T3 largely regulates metabolism and many other body functions.  Scientific studies have also shown that Free T3 correlated best with hypo symptoms, while Free T4 and TSH did not correlate at all.  The only test you had for Free T3 was too low in the range.  Many members say that symptom relief required Free T3 in the upper third of its range and Free T4 around the middle of its range.


A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  You can get some good insight into clinical treatment from this letter written by a good thyroid doctor for patients that he sometimes consults with after initial tests and evaluation.  The letter is then sent to the participating doctor of the patient to help guide treatment.  In the letter, please note the statement, "the ultimate
criterion for dose adjustment must always be the clinical response of the patient."

http://hormonerestoration.com/files/ThyroidPMD.pdf

So, you really need to be tested for Free T3, along with Free T4 each time you go in for tests.  TSH is a waste of money to test, when already taking thyroid meds.  Also, your Vitamin D is too low.  Should be around the middle of the range.  Even your B12 can be increased a bit, into the upper part of its range.   Also, if you haven't been tested for ferritin, that should be done.  Ferritin is very important to assure proper thyroid hormone function.  Low ferritin can also cause some symptoms that mimic hypo symptoms.

So you need to talk with your doctor about these issues and make sure you get the Free T3 tested each time.  If you want I can give you some links for your doctor about how TSH suppression frequently occurs when taking thyroid med, and doesn't mean hyperthyroidism.  You are going to need to persuade him differently than his current beliefs, or find a new thyroid doctor.  

[Red_Star]

Low alkaline phosphatase less than 30IU can be due to:

Zinc deficiency
Magnesium deficiency
Hypophosphatasia
Cardiac surgery and cardiopulmonary bypass
Artifacts associated with collection of blood in EDTA or oxalate anticoagulant
Hypothyroidism
Severe anaemia
Pernicious anaemia
Protein/calorie deficiency
Oestrogen replacement therapy in postmenopausal women
End-stage osteopaenia of chronic renal osteodystrophy
Wilson's disease
Achondroplasia and hypothyroidism in children
Vitamin C deficiency

Other suggested possible causes of a low ALP include:

Milk-alkali syndrome
Excess ingestion of vitamin D
Coeliac disease
Hypoparathyroidism
Intake of radioactive heavy metal
Drugs such as clofibrate
Recent massive blood transfusions
Posthepatic resection and transplantation