lab results have come in--different lab, trouble deciphering-can someone help?

[nancib]

Now that I'm "doctorless," I've had to take it upon myself to try and medicate in the most reasonable fashion I know, and to see that my labs are done in a timely fashion.  To wit, I had myself tested 2 days ago, Sept.1st at 8:00 A.M., sans morning meds, at Lab Corp.  (The doctors always sent me to Quest Labs.)

My Lab Corp results arrived today.  It was difficult enough to decipher the lab results when I went to Quest, but Lab Corp has additional difficulties for me.  
For example,

FT3:
My test from Quest, done on June 5 2009 showed my FT3 to be 217 in a reference range of 230-420 pg/dL; my test from Lab Corp on 9/1/2009 has my FT3 at 1.9 in a reference range of 2.0-4.4.  

I'm aware that these FT3 levels are both VERY bad, as in lower than low.  But, due to the whole numbers versus the decimal numbers, I don't know exactly which test shows the lowest FT3--maybe they're just the same for all I know.  

I need to learn about this stuff, and learn fast, as I just keep sinking lower and LOWER.  :\

TSH:  
The Quest test-6/5/2009, has my TSH at 5.17 (ref. 0.40-4.50 mIU/L); and the Lab Corp test-9/1/2009, has my TSH at 7.78 (ref. 0.450-4.500).  This one is a no-brainer...don't even need to ask about it...just thought it would be helpful for you to know.  :((

T4:
The Quest test-6/5/2009, has my FT4 at 0.9 (ref. 0.8-1.8 ng/dL); and the Lab Corp test-9/2/2009, has my FT4 at 0.8 (ref. 0.93-1.71 ng/dL).  This one confuses me.  Although I can clearly see that my FT4 is still at rock bottom, how do the two FT4 tests actually compare?  Was there any improvement whatsoever?  Pul-EEZE say yes! :o

By now, I'm sure you have all guessed my dirty little secret.  I am 'MEGA' mathematically challenged--similar to having dyslexia, only MUCH worse in my opinion.  :((  

Anyway, as you can see by these two lab results, I am not doing well AT ALL...a raging hypothyroid lunatic...just calls 'em as I sees 'em.  :\  

There is only one thing in the world that I am 100% certain of.  I feel absolutely AWFUL!!!

STELLA!!!!  SOMEBODY!!!  HELP!!!

(P.S.  For the past month I have been on 1/4 grain Naturethroid and 25 mcg Synthroid.)

[gimel]

Sorry, I misunderstood and thought you were also adding 6.25 mcg of T4.  Will be sending you a PM later.  Having trouble doing so right now.

[jena64]

Hi Nanci,  I'm sorry you are feeling so terrible.  I was just wondering how do you get you medication if you don't see a doctor anymore?  

[nancib]

Hi, Gimel.

I so appreciate your advice, but I need to run something by you.  My thinking regarding  increase of the 2 meds (Synthroid & Naturethroid) has to do with the total amounts of T3 and T4 I WAS taking, versus the total T3 & T4 I WILL be getting.

(Please be mindful that when discussing Naturethroid I refer to an "equivalent" dose.)

For the past month, on 25 mcg Synthroid and 1/4 grain Naturethroid, my total T4 was
43.5 and my total T3 was 2.25.

I would like to increase my total T4 by 25%, but this isn't possible due to the difficulty of  cutting the pills in my arsenal.  :)

Anyhow, if I DO decrease this next month's dose of Synthroid to 6.25 mcg and raise Naturethroid by 3/8 grain, it will put my total T4 at 52.50 and my total T3 at 5.625.

Since I have more confidence increasing my meds than I have in the past, this change doesn't seem too drastic to me.  BUT, I could be wrong....I was wrong once before.  ;) (sorry.)  :))    

The reason I have more confidence now is because, not having to answer to any doctor, I've been able to raise my hydrocortisone dosages to what I consider a more reasonable level.  More than anything else, I believe my past extreme sensitivity to raising meds had to do with my adrenals objecting to being pummeled into action.

Do you still think I should drop the extra 3/8 Naturethroid?

Nanci



  

[gimel]

You have lots of experience with the effect of changes in your dosage, so with your sensitivity to meds, I would just suggest that you may be increasing the Naturethroid a bit too much by adding a total of 3/8 grain.   I really have no personal experience to rely on.  I just want to make sure you go slowly enough to succeed with this.  So, how about increasing only 1/4 grain, and split the total of 1/2  grain into 2 or 4 splits, whatever you think is best for you.  If this goes well for you then you could consider increasing again in 3-4 weeks.  As far as the Synthroid increase, that amount seems plenty conservative enough.

Please let us know how it works out.

[Smilerdeb]

Gimel is brilliant with levels and worth taking the advice.

[nancib]

Hi, Gimel.

I agree with your theory that the range of 'Frees' is too broad...probably little question.

As I said, for the past month I've been on 1/4 grain Naturethroid and 25 mcg Synthroid. This has clearly done squat.  :\  

So, yes, I'm slowly increasin my meds--slowly enough, I hope.  

My plan for the next month is to take Naturethroid and Synthroid in the following manner.  (Please tell me what you think :)

  6:00    1/4 grain Naturethroid & 6.25 mcg Synthroid
10:00    1/8 grain Naturethroid
  2:00    1/8 grain Naturethroid
  6:00    1/8 grain Naturethroid  

[gimel]

Your new lab results basically show the same thing.  You are hypo.  The latest FT3 result was 1.9, with a reference range of 2.0-4.4 pg/ml.  The basic difference from the other test is the measurement units, pg/ml versus pg/dl.  I think they do that just to help confuse us.  LOL
Your FT4 is still at the very low end of its ref. range.  

All these results are even stronger evidence when you consider my theory that since the reference ranges for the "Frees" have never been adjusted to exclude suspect hypo and hyper patients from the data bases,  as was done for the new TSH range, both of the ranges for the "Frees" are too broad.  If they were adjusted like TSH, I think the ranges would be more like 3.2-4.3pg/ml for FT3 and 1.0-1.55 ng/dl for FT4.

Looks like it is time for you to SLOWLY increase your meds.