Please Help Me Understand My TSH Levels and Why I Feel Bad All The Time

[DD2992]

My levels were:
TSH: 1.94
T3: 2.5
T4: 1.2

Well 3 months ago I went to my Endocrinologist and told him that im not feeling much better I have been on Synthroid (100 MCG) for about the past 3 years and have not really felt “good”. I am a 26 year old female who is very healthy. I run 3 miles a day and eat very healthy. I have lost 45 lbs since beginning running 4 years ago. I now weigh 160 lbs. My weight fluctuates so horrible. I can easily gain 10 lbs in a week as well as lose 10 lbs in a week! I used to have beautiful healthy hair, nails until being on Synthroid. I have lost a lot of my hair and it is very thin now.  During my visit in November 2010 (3  months ago) my Endocrinologist did lab work.

He said since they were level and I was still feeling bad, that we would try “Levoxyl 100 MCG”
Well I have been on it for 3 months. At first I didnt feel much difference. I suddenly saw my anxiety pretty much go away and did not have chest pains or high heart rate after eating meals. I also noticed I could tolerate alcohol a lot better and would barely have hangovers. I also noticed that I did not have an increase in heart rate after eating meals. I did not have much of a dry mouth on levoxyl. The only bad side effects I had were that I began to have sharp pains in my lower abdomen because I became very constipated. I felt very bloated on this medicine. I gained 10 lbs in 3 months on Levoxyl. Even with me dieting and running 3 miles a day, I still felt bloated and horrible about myself. I then began to feel moody. I never am moody and it seemed like the littlest things would upset me and was never like that before.

[DD2992]

I am confused. The FT3/4 is not listed on my lab report. The numbers I posted earlier is the only numbers on the report? What is FT3/4?

This is exactly how the report reads:
TSH, 3RD GENERATION: 1.94 REFERENCE RANGE: .40-4.5
T4, FREE: 1.2  REFERENCE RANGE: 0.8-1.8
T3, FREE: 2.5 REFERENCE RANGE: 2.3-4.2

*Looks like my T3 is Low, I hope with the Cytomel added tomorrow I will feel better

[DD2992]

Thank you Goolarra for your help. The Endo sent me a prescription for Cytomel I will begin taking those tomorrow along with my Levoxyl. I feel so much better on Levoxyl than Synthroid. Synthroid made me feel HORRIBLE. I have not heard of Tirosint. Thats for the great advice. If I am not sucessful adding Cytomel, I will recoment Tirosint.

Seems like there is so much more for me to learn about this disorder. I am anxious to learn all there is.

Thanks again all!

[yvih]

thanks again for clearing that up for me!

[goolarra]

Right, and in fact, there are times when a lab will assay it's methodology and change it's reference range.  So, even if you keep going to the same lab, things can change.  In fact, the FT4 range my lab uses has been adjusted the last two times I had labs.

So, yes, we never type "normal" without the quotes; we don't really consider anything in the bottom half of the range as "normal", and what's "normal" for me, isn't for you!  Makes you wonder how it ever got to be called "normal", doesn't it?  BUT, the ranges do still have their uses.  Unfortunately, very, very few of us have baseline levels from when our thyoids were healthy.  So, we are forced to use the population range until we establish our own.  Once we know where we feel our best, we can adjust meds and shoot for those levels, using them as a guide to symptom relief.

[yvih]

i guess the fact that there are "normal" ranges posted for general use led me to believe we could all compare - even though the "normal" isn't really normal.  so bascially my labs would have been different if i'd had another lab do them?  got it........
thank you!!!!  

[goolarra]

No, you can't compare results from different labs, unless the ranges are the same (or at least quite similar).  Yes, the ranges are flawed, in fact the whole bottom half of the range probably shouldn't be there.  That's because the "normal" population that made up the ranges contained people with Hashi's and people with hypo symptoms who were not yet being treated.  This is part of the reason that we always add the caution that just being "in" range is seldom sufficient to relieve symptoms and that midrange or above is where most of us want to be.  However, we DO need the range to see where the midpoint is.  Although the ranges are not exact to say the least, they do give us some framework within which to work.  

I'll PM you something I wrote a while back about the proper use of reference ranges.  It goes into more detail.

Once we establish our own personal comfort range within the reference range, we can compare ourselves to ourselves, and use the levels where WE felt good individually instead of the population range.  (Sometime that can be a rather drawn-out process.)