Lab results

[sfox79]

Ok, it was suggested that I post my most recent lab results to get an opinion from everyone on how I'm sitting.  One thing I noticed immediately was that my doctor only draws T4 Free and TSH.  Isn't that odd considering she knows I'm hypothyroid and I am now diagnosed with Hashimoto's? Anyways, here are my results:

Thyroid Peroxidase Antibodies   >1000
TSH        2.3     (obviously this lab has not adopted new guidelines as the ok range listed is .4- 4.5)
T4 Free   1.05

I am on Synthroid 88mcg to achieve these labs.  I have been on this dose for a year and a half.  I want to start taking Selenium to try to help with the TPO level.  I do still have symptoms of hypothyroid though like high cholesterol, constant coldness, lack of energy, and it is incredibly difficult for me to lose weight.  Before Christmas it was discovered that I had massive gallstones and I could not eat for almost 4 weeks with the exception of plain baked chicken breast, rice, and plain potatoes.  I lost 25 lbs in 2 weeks initially and then gained back 10 without adding in any more food.  It just seemed kinda odd and I chalked it up to my thyroid issue.  I guess my question is, if my thyroid were controlled properly with the Synthroid, shouldn't these symptoms go away?

[goolarra]

Your FT4 is low.  It's just at the top of the bottom quarter of the range.  Many of us don't feel comfortable until FT4 is around midrange, and FT3 is in the upper half to third of its range.

A lot of doctors are unbelievably stubborn about FT3.  Why is beyond me...it's a cheap test that rounds out the thyroid picture nicely.  Lots of them were taught in med school that if FT4 is okay, so is FT3.  Spend any time on the forum, and you'll know how accurate that statement is.

Is your doctor amenable to an increase?  It might be a good time to try 100 mcg, or if you think that might be too big a jump at once, alternate 100/88 to get 94 per day.  I'd ask for an increase, then recheck bloodwork in four to five weeks after the increase (and ask him to add FT3 to the order so you're sure you're converting properly).

[sfox79]

The lab range for FT4 is .8 - 1.8

[goolarra]

What's the reference range on your FT4?  Ranges are specific to each lab and have to come from your own lab report.

Yes, the definition of a properly controlled thyroid (according to me anyway!) is a symptom-free patient.  If your doctor is not treating your symptoms, then you are not being treated properly.

Your FT4 looks pretty low, but I'd like to see the range before commenting further.

[laura1967]

My endo told me that anyone with Hashimoto's needs to have their TSH supressed to between a .50-1.0, when on a T4 med only.  This will help to control the hypo symptoms. It seems you are only in the beginning stages yet of the Hashimoto destruction of the thyroid. It would also greatly help to have a Free T3 done with your next labs so you can see if you are converting properly. You can have perfect T4 levels and have hypo symptoms due to your T3 level being too low. :)