thyroid lab tests!

[renee1980]

Hi!  I am a 29 year old female who was diagnosed 2 years ago with Hashimotos! I went to 3 docs til I found one that I really liked and who listened to my symptoms and actually answered my questions :-) I had a TSH of 5.5, 1000's of antibodies and my free t3 was low normal and my free t4 was low normal. I was first on Armour and I believe I was up to 1.5 grains and still not feeling well. My doc decided to test reverse t3- it came back high (<25)...come to find out that my body didnt like the t3/t4 combo, and i wasnt converting t4 to t3. SO for the last 12 months I have been on a bio-identical compound of T3- gradually been increasing dosages. since january of 2009 i have been on   100mcg and feeling so much better. In the past the docs would take blood work about every 4 to 6 months and then change my meds based on that. Recently, i was on Birth control - my body HATED IT! i finally got off of it since it was hindering my work and i felt like i was quickly becoming hypo all over again!!!! i was very concerned that the 2.5 month stint of pills messed with my thyroid. recently i had a check up on my thyroid.  At my last doc appt 2 weeks ago my reverse t3  was <5  which is optimal and my adrenals really good (cortisol was tested morning and at night), and my TSH is down to 0.5! BUT my free T3 were still not the best: 230-420 range, mine was at 263 and my free t4 was LOW! range 0.3-1.som3thing....mine was 0.2!!! I have been feeling pretty good- with some fatigure here and there but very mild. All my symptoms that I had when I was diagnosed with hypo are 99.9% gone with the exception of moderate PMS which is still present (but not sure if that's thyroid related) and the fatigue that hits me pretty hard about once every couple weeks. this may be due to high stress job- and i just need to relax!

question: Should my dosage be changed with these new past blood work results??!! (they were drawn and calculated through Quest Diagnostics at 8:20 a.m) I worry that my free t4 is low?!!! but i am wondering if b/c i have hashimotos the t4 test isn't the most accurate- as opposed to the TSH test which i have read is the most sensitive of the tests and most accurate to calculate!

[renee1980]

i just did some research on my med- YES it is time released :-)

[renee1980]

i believe that they are time released....will it say on the bottle?? on the bottle it says" T3 triiodoliothyronine SR veg 100mcg

[goolarra]

Are your current meds time-released?  If so that's the same as (better than) splitting the dose.  If not, you might look into it...

[renee1980]

thanks for the imput! the doc mentioned that when i decided to get pregnant in a couple years he would definitely monitor my levels closely and we might be adding t4 to the mix. so we will see what happens....i wish that i could take my t3 meds in 2 doses b/c it is fast acting but i know that would cost more and the compounded meds i get now are kinda pricey....so we will see

[goolarra]

TSH is the test that correlates worst with symptoms.  FT3 is best, followed by FT4.  TSH is a pituitary hormone and can be affected by any number of things in the thyroid/pituitary/hypothalmus circle.  FT3 and FT4 are the actual thyroid hormones and give a much better picture of thyroid status than TSH.  TSH IS accurate these days, but it should never be used alone to evaluate thyroid.

Your symptoms are gone, and you say you are feeling well.  This is a good argument for keeping your meds levels where they are.  However, T3-only meds are seldom given on a permanent basis.  Usually T3 is given alone until RT3 comes back into line, and then some T4 is added.  We need both T4 and T3.  T4 is the "storage" form of the thyroid hormones.  It floats around in your bloodstream until needed, then is converted to T3.  T3 is the "active" form of the hormones.  The problem with T3 is that it is very fast-acting and quickly neutralized by your body if not used promptly.  So, we depend on the "reserved" T4 being there when we need it.

Just something to think about...you might consider adding a bit of T4 back in and reducing your T3 to compensate.