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Input On Labs, Please!
Hi there. Hope you all are well. Was wondering what your opinions are on my latest set of labs.
2 1/2 years post TT. Hashimoto's, nodules that couldn't be ruled out as cancerous.
Labs from 7/5/11
Free T3 2.71 (1.76-3.78)
Free T4 1.49 (0.7-1.9)
TSH 1.730 (0.400-4.000)
Vit D 29.4
B12 590
CURRENT LABS 4/16/12
Free T3 3.02 ***Same ranges as above
Free T4 1.63
TSH 0.239 .....Why so low?
Vit D 39.7
B12 649
Question..I kind of thought I'd need a raise in Synthroid. Currently on 125mcg. Previous labs, I was on 112mcg. Feel better than I did, but still get periods of awful fatigue..not regularly. Sore legs at times. The only time I could say I have any hyper feelings is just some anxiety and trouble sleeping before my cycle. More times than none, I'm tired. Had cortisol test and 24hr saliva test which came back fine. Just wondered why TSH is so low? At least I was able to get my FT3 up. All in all, I feel ok. Thanks!
2 1/2 years post TT. Hashimoto's, nodules that couldn't be ruled out as cancerous.
Labs from 7/5/11
Free T3 2.71 (1.76-3.78)
Free T4 1.49 (0.7-1.9)
TSH 1.730 (0.400-4.000)
Vit D 29.4
B12 590
CURRENT LABS 4/16/12
Free T3 3.02 ***Same ranges as above
Free T4 1.63
TSH 0.239 .....Why so low?
Vit D 39.7
B12 649
Question..I kind of thought I'd need a raise in Synthroid. Currently on 125mcg. Previous labs, I was on 112mcg. Feel better than I did, but still get periods of awful fatigue..not regularly. Sore legs at times. The only time I could say I have any hyper feelings is just some anxiety and trouble sleeping before my cycle. More times than none, I'm tired. Had cortisol test and 24hr saliva test which came back fine. Just wondered why TSH is so low? At least I was able to get my FT3 up. All in all, I feel ok. Thanks!
The Dr's mistakenly do not believe that the dosage in NDT is consistent. However they have nothing to base that opinion upon.
In fact the reading that I've done stated that there have been more recalls for the synthetic drugs due to consistency issues in potency than NDT.
NDT has been used successfully for over 100 years. So it actually has more of a track record than synthetics.
The down side is that because it is a two part medicine, it is more difficult to specifically achieve levels separately for T4 and T3 like two separate synthetic medicines can. But many people don't seem to need this level of precision. For those that do, the synthetic component can be added to the NDT. So in reality again there is no reason for a Dr to not wan to prescribe NDT as they still have options available to them.
NDT is man manipulated by the manufacturer and the use of fillers and binders can be used in part in order to help level out the potency of the drugs so that the product is more consistent.
NDT still has more T4 in it than T3. T4 takes six or more weeks to stabilize in the blood. So slight variation in T4 makes little difference when averaged over the 6 weeks. T3 is a little more sensitive. But again NDT has been successfully used for 100 years.
I guess Dr's are scientists and they believe that scientifically produced materials are superior. And they have the ability to adjust each hormone separately which is an advantage.
It seems to me that before all these "superior" tests such as TSH, and "superior" synthetic drugs, the Dr's used to diagnose patients and prescribe NDT based upon symptoms and adjusted the medication based upon symptom relief. And all was pretty well with the world.
Since the advent of TSH, many Dr.s ignore symptoms if the TSH level comes out with a certain number and will medicate only with T4 in order to get a certain number. They don't care if the person is feeling like crap even when they hit that magic number. The Dr's "rule out" thyroid as being a cause, prescribe 16 different medications to cover up the 16 remaining symptoms because some test shows a certain number and therefore there is "no way" that the thyroid could be causing the symptoms. Sometimes they even diagnose fibromyliga or chronic fatigue syndrome when they can't figure out what is going on.
I find it particularly interesting that chronic fatigue syndrome and fibromalygia both seem to become prevalent conditions in the population only AFTER the advent of the TSH test.
Humm, could it be that TSH is erroneously giving the Dr's false information? And thus the Dr's "rule out" low thyroid as being a cause for the symptoms because the TSH is normal? therefore no way could be thyroid related.
Also interestingly "they" are now finding out that people with fibromalygia are now being miraculously helped when given of all things.....Thyroid medicine.
What a coincidence don't you think?
Sometimes too much of a good thing is not good. In some ways having all these additional information and tests and fancy drugs has resulted in poorer care. This might be one of those situations. 60 years ago you would have gone in to the Dr with a list of symptoms. he would have likely prescribed NDT and over time adjusted your dosage until you felt well. They would never have done any blood tests and you would have felt great.
Today we have thousands of people complaining they feel like crap but are told it is all in their head because the TSH is 1.5 or whatever. You tell me which situation resulted in better care?
Just my opinions mind you. Take them for what you paid for them!
In fact the reading that I've done stated that there have been more recalls for the synthetic drugs due to consistency issues in potency than NDT.
NDT has been used successfully for over 100 years. So it actually has more of a track record than synthetics.
The down side is that because it is a two part medicine, it is more difficult to specifically achieve levels separately for T4 and T3 like two separate synthetic medicines can. But many people don't seem to need this level of precision. For those that do, the synthetic component can be added to the NDT. So in reality again there is no reason for a Dr to not wan to prescribe NDT as they still have options available to them.
NDT is man manipulated by the manufacturer and the use of fillers and binders can be used in part in order to help level out the potency of the drugs so that the product is more consistent.
NDT still has more T4 in it than T3. T4 takes six or more weeks to stabilize in the blood. So slight variation in T4 makes little difference when averaged over the 6 weeks. T3 is a little more sensitive. But again NDT has been successfully used for 100 years.
I guess Dr's are scientists and they believe that scientifically produced materials are superior. And they have the ability to adjust each hormone separately which is an advantage.
It seems to me that before all these "superior" tests such as TSH, and "superior" synthetic drugs, the Dr's used to diagnose patients and prescribe NDT based upon symptoms and adjusted the medication based upon symptom relief. And all was pretty well with the world.
Since the advent of TSH, many Dr.s ignore symptoms if the TSH level comes out with a certain number and will medicate only with T4 in order to get a certain number. They don't care if the person is feeling like crap even when they hit that magic number. The Dr's "rule out" thyroid as being a cause, prescribe 16 different medications to cover up the 16 remaining symptoms because some test shows a certain number and therefore there is "no way" that the thyroid could be causing the symptoms. Sometimes they even diagnose fibromyliga or chronic fatigue syndrome when they can't figure out what is going on.
I find it particularly interesting that chronic fatigue syndrome and fibromalygia both seem to become prevalent conditions in the population only AFTER the advent of the TSH test.
Humm, could it be that TSH is erroneously giving the Dr's false information? And thus the Dr's "rule out" low thyroid as being a cause for the symptoms because the TSH is normal? therefore no way could be thyroid related.
Also interestingly "they" are now finding out that people with fibromalygia are now being miraculously helped when given of all things.....Thyroid medicine.
What a coincidence don't you think?
Sometimes too much of a good thing is not good. In some ways having all these additional information and tests and fancy drugs has resulted in poorer care. This might be one of those situations. 60 years ago you would have gone in to the Dr with a list of symptoms. he would have likely prescribed NDT and over time adjusted your dosage until you felt well. They would never have done any blood tests and you would have felt great.
Today we have thousands of people complaining they feel like crap but are told it is all in their head because the TSH is 1.5 or whatever. You tell me which situation resulted in better care?
Just my opinions mind you. Take them for what you paid for them!
Hi there. Yes, I do know that it's real and not synthetic. It's just that when I enquired about it at different Dr's...they do not perscribe it for reasons I've mentioned above.
Of course I don't want to stay at the level that I'm at. I will keep searching if you think that's the answer and I do value your input. In your opinion..what's the big deal with these Dr's prescribing it? I don't get it? I mean, I've gone so far as to pick up my phone book and go down the list and they all say no.
Of course I don't want to stay at the level that I'm at. I will keep searching if you think that's the answer and I do value your input. In your opinion..what's the big deal with these Dr's prescribing it? I don't get it? I mean, I've gone so far as to pick up my phone book and go down the list and they all say no.
If you still have symptoms then NDT is an option you should consider. The T3 component in NDT is real and significant and it is not synthetic. You may find that you can tolerate it in NDT.
The concern of course is what if you can't tolerate it. But nothing ventured nothing gained. Are you really able to settle for where you are now or search to get completely well? Only you can answer that question.
The concern of course is what if you can't tolerate it. But nothing ventured nothing gained. Are you really able to settle for where you are now or search to get completely well? Only you can answer that question.
Iron and sodium are fine. I thought maybe it was my iron, also..but, it came back excellent. Calcium, fine. Everything looked good to me..at least waaaaaay better than any of my other labs.
My TSH is lower that that and I still feel hypo. TSH is useless for me.
Have you had your Iron levels checked? Low Iron can cause hypo symptoms and fatigue.
Have you had your Iron levels checked? Low Iron can cause hypo symptoms and fatigue.
Thank you both for your comments! I should clarify that this Endo is not my Endo. I have an appt with mine on May 1st to go over labs. I have been to different ones, though,,and they do not perscribe anything other than Synthroid. They were all willing to test the Free's..which was hard enough in itself and also willing to perscribe Cytomel. You can't even get alot of Dr's to do that! I'm well aware of the whole pharmaceutical kickback they receive for always writing scripts for Synthroid. I've heard them say that the other meds are to hard to regulate the dosage, different fillers, etc and they will not perscribe them. I'm telling you, as you know, so many of them won't even test the Free's and totally rely on TSH..you guys know that. I don't want to kick my Dr to the curb because he listens to me, that in itself is hard to find.
As far as my Vit D..I take 2,400 units a day and this is the highest it's ever been. They will not let me take much more because I have one kidney? Also, the B12 is the highest it's ever been. Tried shots of B12, sublingual, etc and it didn't give me energy..it made me anxious. I'm a strange case, I guess!
Thanks again for the comments. I'm curious to see how my appt goes on the 1st.
As far as my Vit D..I take 2,400 units a day and this is the highest it's ever been. They will not let me take much more because I have one kidney? Also, the B12 is the highest it's ever been. Tried shots of B12, sublingual, etc and it didn't give me energy..it made me anxious. I'm a strange case, I guess!
Thanks again for the comments. I'm curious to see how my appt goes on the 1st.
COMMUNITY LEADER
I totally agree with gimel that NDT might be an option for you. None of us is the same, so what works for one, may not work for another. I'm doing well on my Tirosint and generic T3, but there are some who just can't do well on synthetics.
If your doctor is willing to prescribe it, it would certainly be worth trying.
Too bad you didn't ask the endo at your hospital about alternatives to see what he'd say... maybe he'd prescribe something else.
I do believe that not all hypothyroid-like symptoms are always thyroid related; for instance, your vitamin D is still very low in the range, which could cause hypo symptoms to be worse. Additionally, your B12, even at mid range, would be way too low for me...... if I don't keep mine way at the top of the range, I get horribly fatigued.
Everything has to work together in order for us to feel our best.
If your doctor is willing to prescribe it, it would certainly be worth trying.
Too bad you didn't ask the endo at your hospital about alternatives to see what he'd say... maybe he'd prescribe something else.
I do believe that not all hypothyroid-like symptoms are always thyroid related; for instance, your vitamin D is still very low in the range, which could cause hypo symptoms to be worse. Additionally, your B12, even at mid range, would be way too low for me...... if I don't keep mine way at the top of the range, I get horribly fatigued.
Everything has to work together in order for us to feel our best.
If you don't tolerate Cytomel, then why not try an NDT type, like Armour Thyroid or Nature-Throid? Since those are a combo of T4 and T3, you would need to adjust your T4 dosage accordingly, but you might find that you can use either to gradually raise your Free T3 enough to relieve symptoms. I may be biased, but I just don't accept that continuing to have hypo symptoms is unavoidable, as the doctor suggested. Perhaps if the doctor is one of those that has the "Immaculate TSH Belief" and uses "Reference Range Endocrinology", that might explain his opinion about the chances for successful treatment.
Until proven otherwise, I continue to believe that clinical treatment with the right thyroid medication, plus the correct dosage, can relieve hypo symptoms and make you feel well again. I think you might get some good info from this letter written by a good thyroid doctor for patients that he sometimes consults with from a distance. The letter is then sent to the PCP of the patient to help guide treatment.
http://hormonerestoration.com/files/ThyroidPMD.pdf
Until proven otherwise, I continue to believe that clinical treatment with the right thyroid medication, plus the correct dosage, can relieve hypo symptoms and make you feel well again. I think you might get some good info from this letter written by a good thyroid doctor for patients that he sometimes consults with from a distance. The letter is then sent to the PCP of the patient to help guide treatment.
http://hormonerestoration.com/files/ThyroidPMD.pdf
Thank you for your reply. I just have never seen it that low. I know it's practically useless, but it still worried me some. Considering how low my FT3 was before..(it was even lower than the earlier lab report I put on this post)..maybe I should leave well enough alone. I'm thinking since my body does not like even the slightest bit of the Cytomel, I don't know another way to get my numbers into a range where they ideally, should be. Lower T4, etc.
The ironic thing is I work in a hospital and I ran into this Endo and we were talking and I told him I had a TT and still don't feel quite right and he said he wasn't surprised! I don't know to many people who have had one and can say they feel 100% without a thyroid. In most cases, we are relying on a synthetic pill to do the job of a major organ that controls practically everything. ...Makes sense to me!
Thank you!
The ironic thing is I work in a hospital and I ran into this Endo and we were talking and I told him I had a TT and still don't feel quite right and he said he wasn't surprised! I don't know to many people who have had one and can say they feel 100% without a thyroid. In most cases, we are relying on a synthetic pill to do the job of a major organ that controls practically everything. ...Makes sense to me!
Thank you!
taking thyroid medication can result in suppression of TSH. This seems especially true when people take medicine with T3 component. However Dr's seem unaware of this possibility.
TSH is virtually useless. If the medical community would stop using it and only go be Free T3 and Free T4 a LOT of people would be better treated and happy.
If you don't really have symptoms, then my thought would be to leave well enough alone. Don't try to fix something that isn't broke.
TSH is so variable that some people feel well with TSH = 20, others need their TSH to be near zero. This is why TSH is so unreliable of a means to adequately treat thyroid issues.
TSH is virtually useless. If the medical community would stop using it and only go be Free T3 and Free T4 a LOT of people would be better treated and happy.
If you don't really have symptoms, then my thought would be to leave well enough alone. Don't try to fix something that isn't broke.
TSH is so variable that some people feel well with TSH = 20, others need their TSH to be near zero. This is why TSH is so unreliable of a means to adequately treat thyroid issues.
Thanks, Barb.
When I was on a lower dose of Synthroid, they did try adding Cytomel..but, I couldn't take it..even in it's smallest form it made my heart pound out of my chest. I was cutting those tiny pills in a splitter, into 4's.
They said there was a BIT of cancer detected and so with the Hashi's and I already have a history with cancer..to get the thyroid removed. I think the Endo will be surprised as to how low the TSH is. I see him May 1st.
Just wondered if I had something else going on, since that's the lowest I've seen it. I'm pretty pleased with the Vit D and B12. I know the numbers could be higher, but I'll take it...considering at one point, they were in the toilet!
When I was on a lower dose of Synthroid, they did try adding Cytomel..but, I couldn't take it..even in it's smallest form it made my heart pound out of my chest. I was cutting those tiny pills in a splitter, into 4's.
They said there was a BIT of cancer detected and so with the Hashi's and I already have a history with cancer..to get the thyroid removed. I think the Endo will be surprised as to how low the TSH is. I see him May 1st.
Just wondered if I had something else going on, since that's the lowest I've seen it. I'm pretty pleased with the Vit D and B12. I know the numbers could be higher, but I'll take it...considering at one point, they were in the toilet!
COMMUNITY LEADER
Your levels are much better than than they were; however, your FT4 is pretty high... 77.5% of the range, when rule of thumb is have FT4 at about mid range. Your FT3 could go up just a bit; it's at 62% and rule of thumb is to have it in the upper 1/3 of the range.
I wonder if you could get your doctor to back down on the synthroid and add a source of T3 med - very small dose. It's generally accepted that when adding a T3 med, the T4 should be cut by 25 mcg for every 5 mcg of T3. For instance, you're at 125 mcg synthroid (T4), so if you were to add 5 mcg T3, you'd back your synthroid down to 100 mcg. Just an example.
It's not unusual to have very low (or undetectable) TSH, when on thyroid medication. Did your nodules turn out to be cancer? Most doctors want suppressed TSH in cancer patients.
Both anxiety and sleep issues can be from either hyper or hypo; if you are having them before you menstruate, they could be unrelated to thyroid and have more to do with reproductive hormones.
I wonder if you could get your doctor to back down on the synthroid and add a source of T3 med - very small dose. It's generally accepted that when adding a T3 med, the T4 should be cut by 25 mcg for every 5 mcg of T3. For instance, you're at 125 mcg synthroid (T4), so if you were to add 5 mcg T3, you'd back your synthroid down to 100 mcg. Just an example.
It's not unusual to have very low (or undetectable) TSH, when on thyroid medication. Did your nodules turn out to be cancer? Most doctors want suppressed TSH in cancer patients.
Both anxiety and sleep issues can be from either hyper or hypo; if you are having them before you menstruate, they could be unrelated to thyroid and have more to do with reproductive hormones.
Ps..There was a point my FT3 was slightly under range and FT4 was in higher range..so, they thought maybe a converstion issue. I guess it seemed to resolve itself?
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