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FINALLY Got FREE T3 Results..HELP!!
Please help me understand results! I still have been feeling like crap and here are the results of my bloodwork from 9/1/10. The results of the Free T4 did not come back from lab yet. Quick refresher of me..TT Dec 09. History of Renal cell carcinoma (kidney removed). Hashimoto's with nodules (TT), Psoriasis, Had Mono a few years ago (I'm almost 40 yrs old)...pretty crappy Autoimmune system, I guess. Tried Cytomel 2.5mg..had chest pain until I stopped it. Have been on 125mcg Synthroid for 3 to 4 months now.
Total T3 - 91 (Range 104-260)
T Uptake 0.87 (Range 0.66-1.27)
Total T4 - 9.1 (Range 4.5-12.0)
TSH - 0.470 (Range 0.400-4.000)
FREE T3 - 2.89 (Range 1.76-3.78)
Any advice you may have, I would appreciate it. I see a new Endo at the end of October. My current one dismisses me and my symptoms and I can't even get a return call out of them..well, barely. I feel tired, depressed, yet anxious. Terrible PMS, also.
Thank you!!!
Total T3 - 91 (Range 104-260)
T Uptake 0.87 (Range 0.66-1.27)
Total T4 - 9.1 (Range 4.5-12.0)
TSH - 0.470 (Range 0.400-4.000)
FREE T3 - 2.89 (Range 1.76-3.78)
Any advice you may have, I would appreciate it. I see a new Endo at the end of October. My current one dismisses me and my symptoms and I can't even get a return call out of them..well, barely. I feel tired, depressed, yet anxious. Terrible PMS, also.
Thank you!!!
FREE T3 - 2.89 (Range 1.76-3.78)
Well your just under the upper third of the range. Many that were hypo try to get FT3 in the upper third. You really need to compare this to FT4 - sounds like you are waiting on this.
Well your just under the upper third of the range. Many that were hypo try to get FT3 in the upper third. You really need to compare this to FT4 - sounds like you are waiting on this.
Yes, am still waiting for the FT4 results. Everything came back except for that. The blood lab told me the results are pending. They must send it out to another facility? I thought it would be back by now. Strange.
Do I not have more comments because I don't have the FREE T4 results? I will try to obtain it this week. Thank you!!
Hey Stranger!....I know that the TSH doesn't mean too much around here, but it seems as if that number is dropping...and if it goes below average range, does that mean the patient will become hyper vs hypo even if the other labs are ok??? Jus Curious...for whoever can answer that ??
TSH is a pituitary hormone. Its only function is as "messenger" from your pituitary to your thyroid to tell your thyroid (or try to) to produce more T4 and T3. TSH is not active metabolically and causes NO symptoms, hypo or hyper.
That's why FT3 and FT4 are so important. They (especially FT3) are responsible for your symptoms. FT3 and FT4 levels must be adjusted until they are optimum for YOU (i.e. you are symptom free) and resultant TSH levels should be ignored. The one exception to this is those who have had thyroid cancer. If you've had thyca, your doctor will most likely want to keep your TSH very low to avoid the possibility of regrowth of thyroid tissue.
In a perfect world (the one full of textbook thyroid patients), TSH accurately reflects FT3 and FT4 levels, going down when levels are too high and rising when levels are too low. However, many other factors can influence TSH levels, including, but not limited to pituitary issues and medications, making TSH unreliable as an indicator.
However, bear in mind also that a person can be hypo or hyper with FT3 and FT4 "in range" We all have our own individual comfort range within the population ranges, and just staying within the population range will not guarantee that you will remain asymptomatic. It's all-important to treat symptoms.
Froggy, it's the weekend when the forum is often pretty quiet, but, you're right, I'd like to see your FT4 before commenting further. As LazyMoose said, your FT3 is still lower than many people are comfortable with. It's at 56% of range, and many find that the level has to be above 67% to feel good. However, I'd still be interested in seeing your FT4.
How long ago did you d/c the Cytomel? Did you have thyca?
That's why FT3 and FT4 are so important. They (especially FT3) are responsible for your symptoms. FT3 and FT4 levels must be adjusted until they are optimum for YOU (i.e. you are symptom free) and resultant TSH levels should be ignored. The one exception to this is those who have had thyroid cancer. If you've had thyca, your doctor will most likely want to keep your TSH very low to avoid the possibility of regrowth of thyroid tissue.
In a perfect world (the one full of textbook thyroid patients), TSH accurately reflects FT3 and FT4 levels, going down when levels are too high and rising when levels are too low. However, many other factors can influence TSH levels, including, but not limited to pituitary issues and medications, making TSH unreliable as an indicator.
However, bear in mind also that a person can be hypo or hyper with FT3 and FT4 "in range" We all have our own individual comfort range within the population ranges, and just staying within the population range will not guarantee that you will remain asymptomatic. It's all-important to treat symptoms.
Froggy, it's the weekend when the forum is often pretty quiet, but, you're right, I'd like to see your FT4 before commenting further. As LazyMoose said, your FT3 is still lower than many people are comfortable with. It's at 56% of range, and many find that the level has to be above 67% to feel good. However, I'd still be interested in seeing your FT4.
How long ago did you d/c the Cytomel? Did you have thyca?
Hi there! Well, I tried the Cytomel about a month ago and had chest pain for 3 days on that small 2.5 dose. I originally thought maybe it was just heartburn or something..but for 3 days? Ha. So, I decided not to take it the next day and guess what?? No chest pain!
What frustrated me is that I told the Endo about it and he never even got back to me as to what to do or if that was ok! I'm seeing a new Endo, but not until end of Oct. He is just not listening to me about my symptoms and they hardly ever return a call. I've had enough! At first, I took it personal..but I work in the hospital where his practice is and many others have said the same.
Well, when they removed the thyroid, they said there was a tiny bit of cancer in the 1 small nodule I had..but it didn't warrant the RAI...which, I know sounds stupid, but I saw how horrible it was when my sister went through it..at least for her. I've been through so much medically, that I wasn't pushing the issue to be more miserable. He said my thyroid was lumpy and out it came.
I was thinking today that maybe I'll try breaking the 2.5 in half though, because no matter how much sleep I get..I have such lethargy during the day. To the point where I saw all these people excited to go to the home opener of the football game today and I thought..if I had tickets, I wouldn't even go because I have NO energy. It's all I can do to go to work and even that is a struggle..but I don't have a choice.
It's funny...mornings are definately my worst and then I seem to perk up about 4 or 5pm. I can even stay up til 1am! I'll get my 8 hours of sleep..good sleep! Then when morning comes and mostly all day, I feel like I had 2 hours of sleep!!! For someone so tired..how can I stay up til 1am some evenings? Weird. The only way I can explain it is lethargic on the outside and anxious on the inside.
I'll post the Free T4 when I get it...hopefully tomorrow! Thank you much! Be Well!
What frustrated me is that I told the Endo about it and he never even got back to me as to what to do or if that was ok! I'm seeing a new Endo, but not until end of Oct. He is just not listening to me about my symptoms and they hardly ever return a call. I've had enough! At first, I took it personal..but I work in the hospital where his practice is and many others have said the same.
Well, when they removed the thyroid, they said there was a tiny bit of cancer in the 1 small nodule I had..but it didn't warrant the RAI...which, I know sounds stupid, but I saw how horrible it was when my sister went through it..at least for her. I've been through so much medically, that I wasn't pushing the issue to be more miserable. He said my thyroid was lumpy and out it came.
I was thinking today that maybe I'll try breaking the 2.5 in half though, because no matter how much sleep I get..I have such lethargy during the day. To the point where I saw all these people excited to go to the home opener of the football game today and I thought..if I had tickets, I wouldn't even go because I have NO energy. It's all I can do to go to work and even that is a struggle..but I don't have a choice.
It's funny...mornings are definately my worst and then I seem to perk up about 4 or 5pm. I can even stay up til 1am! I'll get my 8 hours of sleep..good sleep! Then when morning comes and mostly all day, I feel like I had 2 hours of sleep!!! For someone so tired..how can I stay up til 1am some evenings? Weird. The only way I can explain it is lethargic on the outside and anxious on the inside.
I'll post the Free T4 when I get it...hopefully tomorrow! Thank you much! Be Well!
That doesn't suprised me at all that you didn't do well on the Cytomel with all the other things you had happen that shot your immune system down/
T3 meds ( or hormone) is very hard to regulate and if the body is - let's say - "sick" then it can backfire on you adding it in at the wrong time.
T3 meds ( or hormone) is very hard to regulate and if the body is - let's say - "sick" then it can backfire on you adding it in at the wrong time.
I was hoping you would chime in :-) ...what do you think I can do to feel better? This is ridiculous! I'm off to work and I'm my usual tired, shaky mess. Blah. I just keep saying, at least if something happens..I'm already in a hospital. That's pretty sad :-(
Hope things are well in your world! xo
Hope things are well in your world! xo
Got the results of my FREE T4....
1.6 ...and it says reference range for Pubertal children and Adults is 0.8 to 1.7.
Any ideas what's going on??? Thank you!!
1.6 ...and it says reference range for Pubertal children and Adults is 0.8 to 1.7.
Any ideas what's going on??? Thank you!!
Your FT4 is quite high...89% of range. FT3 is at 56%, which many people find a bit low for comfort. Also, most of us find that FT3 should be higher in its range than FT4 is in its. So, your profile is a little upside-down. You are not converting well.
I think you do need to add the Cytomel, but I understand that it did not work well for you. You might try breaking the 2.5 in half and taking half in the morning with your levo and the other half in the afternoon. I also think that you probably need to lower your levo a little to compensate for the Cytomel. If you drop your levo a little, there is going to be an adjustment period because the T3 will affect you almost immediately, but it will take a while for your FT4 level to drop, So, you might want to start with a small dose of Cytomel (half of a 2.5 total) and increase as your FT4 level drops. If you have angina (chest pain) again, I'd back off the Cytomel for a few days and try it again after your FT4 level has had time to drop a bit.
The rule of thumb is that you decrease the levo 20-25 mcg for every 5 mcg Cytomel you add in (if you want to keep overall levels the same). However, with your FT4 level so high, I'd consider asking your doctor about decreasing to 100 mcg levo before adding in the Cytomel. If all goes well with the initial dose of Cytomel, you can then think about increasing it a little more to get your profile back into line.
This, of course, is just my opinion...something to think about. I hope your new endo will have some constructive input. Let us know how your appointment goes.
I think you do need to add the Cytomel, but I understand that it did not work well for you. You might try breaking the 2.5 in half and taking half in the morning with your levo and the other half in the afternoon. I also think that you probably need to lower your levo a little to compensate for the Cytomel. If you drop your levo a little, there is going to be an adjustment period because the T3 will affect you almost immediately, but it will take a while for your FT4 level to drop, So, you might want to start with a small dose of Cytomel (half of a 2.5 total) and increase as your FT4 level drops. If you have angina (chest pain) again, I'd back off the Cytomel for a few days and try it again after your FT4 level has had time to drop a bit.
The rule of thumb is that you decrease the levo 20-25 mcg for every 5 mcg Cytomel you add in (if you want to keep overall levels the same). However, with your FT4 level so high, I'd consider asking your doctor about decreasing to 100 mcg levo before adding in the Cytomel. If all goes well with the initial dose of Cytomel, you can then think about increasing it a little more to get your profile back into line.
This, of course, is just my opinion...something to think about. I hope your new endo will have some constructive input. Let us know how your appointment goes.
You're hypo. Need to upper your dose a little. BTW, TSH IS a reliable test unless you have pituitary problems. But it should be used together with FT3 and FT4.
Sorry to disagree, but TSH is inadequate as a diagnostic, even if pituitary function is okay. I say that because studies have shown that the best correlation with hypo symptoms is with FT3. TSH did not correlate at all with symptoms. I can't even find any valid studies that show that TSH correlates adequately with T4 or T3. At best TSH is an indicator to be considered along with more important indicators such as symptoms and also the levels of the actual, biologically active thyroid hormones, free T3 and free T4.
I have to disagree with you. From my own experience (20 years of hyper/hypo, 2 thyroid surgeries and everything that comes with it) I can say that TSH although not perfect is a very reliable test. Sorry I can't elaborate because I have problems with my computer: keeps turning off. So I just can't write much.
And one more thing.. One simply can't rely on hormone levels 'cause we need different levels at different times. That's why there's a TSH test. Although I agree about symptoms but they too can be confusing.
Well, here is just one study that statistically validates the correlation of FT3 and 8 different symptoms that were objectively rated by patients before and after testing. In consideration of all that the correlation is amazing. Note that TSH had no correlation at all.
http://www.ingentaconnect.com/content/routledg/cjne/2000/00000010/00000002/art00002
In return, rather than anecdotal evidence only, please show me just one statistically valid study that proves that TSH even correlates with FT3 or FT4, much less with symptoms, which are even more important to a patient. I have yet to see a study or report purporting to show such a correlation, that I can't shoot full of holes.
By the way, I have been hypo much longer than 20 years, with no pituitary problem, and my TSH has never at any time reflected how I was really feeling. So another sample of one, with totally different conclusions.
http://www.ingentaconnect.com/content/routledg/cjne/2000/00000010/00000002/art00002
In return, rather than anecdotal evidence only, please show me just one statistically valid study that proves that TSH even correlates with FT3 or FT4, much less with symptoms, which are even more important to a patient. I have yet to see a study or report purporting to show such a correlation, that I can't shoot full of holes.
By the way, I have been hypo much longer than 20 years, with no pituitary problem, and my TSH has never at any time reflected how I was really feeling. So another sample of one, with totally different conclusions.
I've had a completely different experience. As for studies, I only speak for myself.
I'm soooo sorry about my previous post. I meant that you're HYPER. You are overmedicated. Your TSH is low and your FT4 is pretty high + all your symptoms. So, in my opinion, you need to decrease your meds. Sorry once again.
Ok....lol...so am I hypo or hyper? I wonder why this quack of an Endo didn't mention decreasing the Synthroid..even before getting the FT4 results when he wanted me to first try the Cytomel?? UGH. Of course, I've had a message into him since Monday morning and haven't heard a thing.
Also, isn't 125mcg kind of a low dose for someone to be on with no thyroid? Just a question..I know everyone is different. I know many people who take this dose and still have a thyroid and my sister who had her thyroid out 2 months before mine is on 150mcg and having no problems whatsoever.
I'm telling you guys..having my kidney removed was 1,000 times easier than all of this thyroid stuff. It amazes me how much it controls!
I don't want to drag on for another month until I see the new Endo..so naturally, I will bug the Endo everyday until he gets back to me with some mumbo jumbo. Before he got the results of the FT4...he looked at by bloodwork and said "no change"....UGH!
Also, isn't 125mcg kind of a low dose for someone to be on with no thyroid? Just a question..I know everyone is different. I know many people who take this dose and still have a thyroid and my sister who had her thyroid out 2 months before mine is on 150mcg and having no problems whatsoever.
I'm telling you guys..having my kidney removed was 1,000 times easier than all of this thyroid stuff. It amazes me how much it controls!
I don't want to drag on for another month until I see the new Endo..so naturally, I will bug the Endo everyday until he gets back to me with some mumbo jumbo. Before he got the results of the FT4...he looked at by bloodwork and said "no change"....UGH!
You are hypothyroid due to total thyroidectomy but right now you are overmedicated. So you are hyper due to the excess of levothyroxine you're taking, not due to your thyroid. Does it make sense?! There's no correct dose for people without thyroid. Like you said, everybody is different. What you're taking now is clearly too much for you according to your test results and your symptoms. You'll feel better once they decrease your meds.
That's very interesting....I'm curious to see what others have to say before I bring this up to Endo. Does anyone else agree?
Thank you for your reply!!!
Thank you for your reply!!!
You cannot extrapolate from only your personal experience and say in general that " TSH is a reliable test unless you have pituitary problems". That was my point of disagreement. TSH is affected by too many variables, including the time of day when blood is drawn for testing. Studies have shown that due to its Circadian rhythm, TSH varies as much as 70% from 9 a.m. to 9 p.m.
For these reasons, and the lack of correlation with tests for the actual thyroid hormones, or with symptoms, you cannot successfully regulate medication from a TSH result. That's why it has to be considered as only an indicator and used in conjunction with the more important indicators, which are symptoms and also FT3 and FT4.
For these reasons, and the lack of correlation with tests for the actual thyroid hormones, or with symptoms, you cannot successfully regulate medication from a TSH result. That's why it has to be considered as only an indicator and used in conjunction with the more important indicators, which are symptoms and also FT3 and FT4.
It's perfectly clear to me why you're having symptoms (too much meds) BUT... Since you had cancer they would normally try to supress your TSH. Did your endo mention it to you?! Maybe that's where they want to keep you... It would make sense then.
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