FT4 confused

[jen1957]

Just got test results back from doctor and results were 101.32 for TSH W/Reflex to FT4. What exactly does that mean? They told me that it meant that I had no thyroid being produced in my system. I am 56 years old, usually very active, 144 lbs. and I am 5' 7" I have always been able to keep my weight at around 130 lbs but within the past 8 mths have gained the extra weight, tired, and not as much energy. I have been told that every person has a different thyroid level depending on their body. I was also told that after having a hysterectomy, it would cause your thyroid to stop working. Confused ....please help me understand and what do I do. He gave me a perscription of Levothyroxin 175MCG

jen1957

[jen1957]

Thank you for your answer. I actually have been questioning my doctor. I have been getting tested for my thyroid by him for a 1 1/2 years and can not seem to get it under control. I am going to find a new doctor and try to get this right.

[goolarra]

That is the test he was talking about, and it's very low, below range, confirming your high TSH.  A couple of tenths below range doesn't sound like much, but most of us find we have to be about midrange to feel well (1.3 on your range).  So, it's even lower than it initially appears.  Symptoms also confirm hypo.

I agree with flyingfool that a starting dose of 175 mcg is very high.  If you read the dosing instructions on the Synthroid website, you will see that if you are over 50 or if you have been hypo for more than a few months (think back to onset of symptoms) or you have a history of heart arrhythmia, starting dose should be in the 12.5-25 mcg range.  Typically, about 4 weeks after starting meds, you will be retested and meds will be adjusted accordingly.  I'd question the doctor as well.  

[jen1957]

i went back to test results and found the T-4, FREE is Value 0.6 and reference
range is 0.8-1.8 ng/dL. Is that the test you were talking about.

[flyingfool]

A few things.

#1 TSH with reflex to FT4 means that in the event that the TSH is outside the normal range, then they would test for the Free T4 hormone (FT4).

#2 the TSH is WAY outside the normal range.  So they should have tested for the FT4.  Have you gotten that result back yet?  If so please p ost along with the reference range for it as this varys lab to lab.

#3 while I would agree that it is almost assured that you needed to get thyroid hormone medicine.  a starting dose of 175 mcg is absolutely huge!    Most starting doses are 50 mcg or less.  and you are more than three times that amount!  Most people will not tolerate jumping from zero up to 175 mcg.  This would suggest to me that the Dr may not be all that familiar with treating thyroid issues.

I personally would call the Dr. office and ask them about this starting dose and if you can work your way up to this over the next several weeks.