Update: thanks again, I haven't forgotten this helpful post, I'm just waiting for the medication to level-off and then I'm going to get re-tested in about two or three weeks.
Another typo "Drat"
"medication based on TSH alone, which does help the patient,"
the above line should read: prescribe medication based on TSH alone does "not" help the patient. Sorry about that, a statement around here like that will get me lynched lol
First of all I made an error above, the test for Graves is TSI, not TPI,
I need to know how long you were off medication when you had your last lab, and so you understand your test results, I have to give you the whole story, Your thyroid produces and secretes the T4 hormone, part of it is lost to protein, what is left is Free T4, this free T4 is converted mostly by the liver into T3, then again some is lost to protein, the remainder of that is Free T3, so Free T4 is a storage like hormone that builds up a little, the Free T3 is used and absorbed by your cells and body right away. (if all production stopped, Free T3 would be exhasted pretty quick, but the Free T4 would last longer.) When your T3 is low, the Pituitary Gland located in the brain, senses this low level and sends its own hormone Thyroid Stimulating Hormone (TSH) to bump or stimulate the thyroid into producing and secreting more T4, so when the TSH is high, the Free T3 is low, and when the Free T3 is high the TSH is low. Many MD's just prescribe medication based on TSH alone, which does help the patient, number one, most of the TSH ranges are outdated and should be 0.2-2.0, the older ones are still 0.5-5.0 or .04-4.5, these ranges are obsolete, So medication should be based on the patients symptoms and Free T3/Free T4, To answer your question regarding your Free T4 being at 28.8% at the time of your last labs, if you were unmedicated for a long period of time, then it would not take anytime at all to get your Free T3 up, because you were taking a combo T3/T4 medication, but even so, you would have to give your Free T4 a chance to catch up, since it takes a little longer for storage, or if you want a cache.
In order to determine a range percentage, you take the larger number of range, deduct the lower number of range, write down the result, Then take your level and deduct the lower range number, divide by the number you wrote down then multiply the answer by 100. Do this with Free T3, then repeat with your Free T4, This is how to figure percentage in range, and also this will tell you if you have a conversion issue, this happens when your Free T4 is higher than your Free T3, when you compare the percentages with each other. Feel free to ask if you have any more questions. Good Luck FTB4
Also good advice. And hey, while I've got your attention: I got tested soon after dropping the med when it was probably about half-active in my body, forgot about that, and indeed my T3 was at about 66% - but my T4 was still way low (about 20% of the range at that point). So it seems like the T4 level is my real problem, was the original problem, and even with a high dose of dessicated thyroid I had an elevated T3 and suppressed TSH levels but still a dragging T4. Is there another medicine that targets that specific hormone, or is it not as big a deal?
You can interview the niurse when you call MD's just ask if they treat thyroid by symptoms and Free T3 or does the Doc more or less follow TSH, if they say TSH, run away. lol Best Regards FTB4
Thank you so much! Yes, that's what I suspect as well - I think I was *slightly* over-medicated (at 90mg or 1.5 grains) but I certainly shouldn't have been pulled all the way off. You asked what sort of MDs I've been seeing, so: the first was an ND, the second an internist. Neither of them was an endocrinologist.
So yes, I'm going to bring this advice to a NEW thyroid doctor and see about 1 grain (60mg) of thyroid and retesting in six weeks. Now if only I can find a good thyroid-savvy doctor in my area...
Thanks again!
I agree with FTB4. You need a good thyroid doctor. By that I mean one that will treat you clinically, for symptoms, by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels. Symptom relief should be all important, not just test results, and especially not TSH results.
You can get some good insight into clinical treatment from this letter written by a good thyroid doctor for patients that he sometimes consults with after initial tests and evaluation. The letter is then sent to the participating doctor of the patient to help guide treatment. In the letter, please note the statement, "the ultimate criterion for dose adjustment must always be the clinical response of the patient."
http://hormonerestoration.com/files/ThyroidPMD.pdf
Oh right, sorry.
Pre-medication:
T4 Free - 0.6 (0.8-1.7)
T3 Total - 92 (80-200)
TSH - 1.10 (0.45-4.50)
Post-medication:
T4 Free - 1.06 (0.8-1.7)
T3 Free - 4.1 (2.0-4.4)
TSH - 0.4 (0.45-4.50)
Thanks for looking, and I hope that clears things up!
We would need the ranges provided for each lab level provided with your results in order to respond to your questions. ranges vary from lab to lab Thank You FTB4
Best Regards FTB4