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Lab Results Question

Hi there everyone, happy new year.  One of my resolutions this year was to become more proactive about my Hashimoto's, thus this post.  I have been taking levoxthyrine for about 5 years (a progression of 75mcg, to 100 and I am currently on 112mcg).  I still have hypo symptoms like dry skin, weight gain and fatigue.  I am being treated by a traditional endocrinologist whom I like personally but she is hard to get appointments with and I find it fairly difficult to get follow up information from her.  Here's my issue - I need to know if my lab results are optimal rather than just within the normal range. Can anyone help out?  The most recent results are

Test:                         My Result    Reference Range
TSH                           4.92            (0.40-4.50 mtU/L)  Result - above high normal
T4, Free                      1.0             (0.8-1.8 ng/dl
T3, Free                       2.5            (2.3-4.2 pg/ml)

In reading some of the other information available online, it seems to me that my medicine is only working okay. Am I correct in concluding that my TSH levels are high because my t4 and t3 results are not optimal and while within normal, ideally should be more towards the mid to higher end of those ranges?  

Any advice would be much appreciated!   Also, any good endocrinologists in the NY metro area (NYC, Long Island?) that you can recommend?  

Thank you and In good health!


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Avatar universal
Just sent info by PM.  To access, just click on your name and then from your personal page, click on messages.
Helpful - 1
Avatar universal
Hi there Gimel - thanks for your help.  I live in Nassau County but I work in Brooklyn during the week so I can see doctors in Brooklyn or NYC on my lunch break.  I can also schedule out on Long Island too (Nassau preferred to Suffolk).  Do you have any recommendations in those areas?  Your help is so appreciated!
Helpful - 0
Avatar universal
Thank you for your quick reply.  My endo is so difficult to see. For example, I wanted to make an appointment today and was told the next available was 8 months away.  These lab results are from blood work my GP ordered so I am going to get a referral from her for a new endo.   Thanks again!
Helpful - 0
Avatar universal
You pretty much hit the nail on the head!  FT4 should be about 50% of range, and yours is only 20%.  FT3 should be 50+%, and yours is 11%.  That's why your TSH is not only above range, but far from optimal.

My advice would be to increase your meds until FT4 is closer to 50% of range.  While you're doing that, you can see if FT3 is tracking FT4 up.  If it's not, after a reasonable period of time for everything to rebalance, it would be time to consider adding some T3 to your meds.  

Considering your TSH is above range, your endo doesn't want to increase your meds?
Helpful - 0
1 Comments
You don't necessarily need an Endo, just a good thyroid doctor.  By that I mean one that will treat clinically by testing and adjusting Free T4 and Free T3 as needed to relieve symptoms, without being constrained by resultant TSH levels.  Many Endos have the "Immaculate TSH Belief" and only pay attention to TSH.  That doesn't work.  If they go beyond TSH they will test for Free T4 and tell you that any test that falls within the so-called "normal" range is adequate.  That is also wrong.  

NYC and Long Island is a very large area, so if you will narrow it down a bit perhaps I can better suggest a doctor that has been recommended by other thyroid patients.  
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