New lab results

[artfemme]

I just got labs back that the new (doubting Thomas) endo ordered, and saw my PCP about them today. This is my new endo, who told me I was probably gaining weight because  had a steroid shot in my foot, that by increasing my meds to raise my FREEs, I will give myself a heart attack and am destroying my bones. My PCP just shakes her head, but says she is at the limit of her knowledge about thyroid. She has tested my heart, and it's fine. Bone density started falling before they put me on thyroid meds. I have a multi-nodular goiter that has shrunk with medication.

I am currently taking 100 mcg generic levothyroxine and 15 mcg Cytomel. My hair is falling out in bunches and I've gained 30 lbs. since this time last year, when my meds were lowered and the ratio changed because I had some hyper symptoms that seemed to come out of the blue. I was told it couldn't have possibly been an episode of thyroiditis, since tests for Hashi's have been negative. I have gained 4 lbs. since March 1st, and I eat very lightly but well. I have changed nothing in my diet or exercise regimes that would explain the weight gain.  I have edema that my PCP says is not from sodium, and that I do not need a diuretic, as the endo suggested. My blood pressure is normal.

TSH          .06   (.40 - 4.50 ) Quest labs, seems to be old range. TSH is always low, it was around 1 before meds.
FREE T3   2.7   ( 2.3 - 4.2 )
FREE T4   1.6   ( .8 - 2.7 )

Hemoglobin A1c   5.6   (<5.7 + decreased risk of diabetes ) glucose levels are fine. They were elevated before I
                                   was on thyroid meds. Cholesterol is fine, also elevated before medication.

ACTH   8   ( 5 - 27 ) Then it says this reference range applies only to specimens collected between 7am - 10 am.
                              The doctor made no specifications. I called the lab before I went for the draw, and they said it  
                               didn't matter what time I came, or whether I ate or not, that the endo had ordered a non-specific
                               test. When the tech did the draw, I asked him what this test could tell me, and he said, "not
                               much". My PCP doesn't know why the endo ordered it, or why he didn't do a stimulation test.
                               She said that I might as well go back, if only just to ask him to interpret the tests, and so I
                                can ask him why he ordered them this way.

Cortisol, total     3.2   again, no specified draw time, tech and PCP had the same comments as above. Since it was a
                                general draw, it's hard to make conclusions
                                for 8 a.m.  ( 7 - 9 a.m.)     (4.0 -22,0 )
                                for 4 p.m.  (3 - 5 p.m. )     (3.0 - 17.0 )
                                 blood was drawn at 2 p.m., fasting

Estradiol    64             post-menopausal < or = 27

Progesterone   .5         post-menopausal < or = .2
I am on bioidentical HRT, which I cycle, so I have no idea how to interpret these tests. I was on day 20 of a 30 day cycle, 10 days estrogen only, then add progestrone until day 25, then no hormones for 5 days. When I didn't cycle the hormones, I felt terrible. Again, my PCP doesn't know how to interpret these tests in terms of my thyroid, possible hormone binding.

I asked to have DHEA and testosterone tested as well, but he wouldn't add it. I asked to have VIT D levels tested, since my PCP had added 1000 units since the last test. He said if she wanted that, she could test it !

I'm very tired. My PCP said it's ok to up the Cytomel to 25, since I was on that dose before. I'll be getting a new ultrasound of my thyroid and a new bone density test, since it's been a year. 5 endocrinologists have said I should
stop taking all thyroid medication. Again, my PCP shakes her head. She said today that maybe I should go to Houston and consult with a doctor there, at Dr. Ridya Arem's clinic, since I can't seem to find a reasonable doctor in Los Angeles.  How can that be possible ?

Any thoughts on my medication ? My FREEs seem quite low to me, which goes along with how I'm feeling. The endo will fight with me about the TSH, I'm sure.

Thanks for your help.
                                                                                                                                                        

[artfemme]

Very strange formatting...I didn't write it that way. Anybody know why that would happen?

[gimel]

Check your email.