Can someone help me discern my Thyroid Panel results?

[terricawley]

I have Hashimotos now for 43 years.....taking Armour Thyroid, 1grain day (have taken more in the past)....just went for labs & Free T4 was a low 7.0 (it was 7.8 in January’18), Total T3 was High (209), Free T3 was was a High Normal (5) & rT3 was Normal 14.5. TSH was 1.6 (I function best at .3), TT4 was 7.4, T3Uptake was 31.0 & TPO Ab was a normal 25. I have never seen this before, what in the world is going on? Help, I am not in an area where we have a doctor that I feel can confidently treat me. Thanks for any help you might offer. I did take my pill the morning of my labs, thought that was ok, not sure now. I still wouldn’t think that would cause this type of lab values.

[gimel]

To confirm what I have posted please click on my name and then scroll down to my Journal and read at least the one page overview of a paper on Diagnosis and Treatment of Hypothyroidism:  A Patient's Perspective.  

You have many symptoms that are frequently associated with hypothyroidism.    Your latest test results (biochemical tests)  are not reliable since you took your med before the blood draw.   I do expect that new tests will identify Free T4 and Free T3 levels that are inadequate to relieve hypo symptoms.    Note that as you will read in my Journal, TSH should not be used to titrate a hypothyroid patient's medication.  In addition to testing for Free T4 and Free T3, I highly recommend testing for Reverse T3, cortisol,  Vitamin D if not current result, B12 and ferritin.  The latter are those that affect the body's response to thyroid hormone, so they need to be optimal also.  

If you are in an area of limited availability of doctors, then we can help by providing information for you to give the doctor in order to persuade him to treat clinically, for symptoms, rather than just based on test results.   Symptom relief has to be all important for you, not just test results.    

[gimel]

LightSeeker is correct, that the morning dose of thyroid med should always be delayed until after the blood draw for thyroid tests, in order to avoid false high results.   This is even recommended in the ATA/AACE Guidelines for Hypothyroidism.  

Even more important for diagnosis of your thyroid status is an evaluation for symptoms that occur more frequently with hypothyroidism.   So please tell us about your symptoms.   After that, biochemical tests are needed to help confirm the symptoms evaluation.  

Hypothyroidism is not just "inadequate thyroid levels".  Instead it is "insufficient T3 effect in tissue throughout the body due to inadequate supply of, or response to, thyroid hormone".  So hypothyroidism can be caused by much more than just low levels of Free T4 and Free T3.  We won't know your real levels of Free T4 and Free T3 until after new tests so when you do go back for those, you should make sure to get tested for Free T4, Free T3, cortisol, Vitamin D, B12 and ferritin.   With all of those and an evaluation for symptoms, you will know much more about your thyroid status and what you need from the doctor.   And we can help interpret all this and advise further. We can also give you lots of scientific data that supports clinical diagnosis and treatment that you can provide to your doctor, in order to help get what you need.  

[terricawley]

Thanks so much bfor your comnents.....yes I have been researching & you are correct....Since I don’t have access to a physician who understands all of this, it is tough. You say you can offer an interpretation & support but I don’t know how to contact you—I mean who are you?

Thanks again!

[terricawley]

Also you asked about symptoms....I’m back to sleeping 10 hours a night and having trouble waking. Brain Fog, Cold to my core when others are not, muscle/joint tenderness &   aches. Drier,Courser Skin & Hair, Digestive Issues, those are the major ones.

I have raken more thyroid dosage in the past—2 grains, but my gp doctor wanted to titrate me down so this is what happened. I just got confused about testing & coukdn’t remember (Brain Fog!) if I was supposed to take my med before the test ir not....ultimately I screwed it up.  Also what are biochemical tests? I did do a Vitamin D—it was 32.9. I will have the other tests you recommend when I understand how to do a “biochemical test”.

Thanks again!

[TheLightSeeker]

Unfortunately your labs would  be  mostly inaccurate, since  you took Armour the morning of the test, which is a T3/T4 combination natural thyroid supplement.
Next time, I recommend you bring your supplement with you and take it right AFTER the test!
My ultimate suggestion is to do your own testing at home. Look up Dr Barne's Basal temperature test, but please pay extreme attention to all the details of the instructions of this simple DIY thyroid test, for accurate dosing and monitoring thyroid function. Start with the smallest incremental adjustment, until you reach  satisfactory symptom  relief and normal basal temperature.
Just my educated opinion.
Best wishes,
Niko.