T4 low, T3 high, TSH high

[Alyson928]

I've been underwhelmed by my doctor's lack of explanation, and testing.  The initial test of my thyroid basics showed my free T4 = .64 (normal .58 - 1.64) kind of low, my free T3 = 4.36 (normal 2.5 - 3.9) high, and my TSH 7.62 (normal .34 - 5.60) high, he said that it was probably a lab error.  I was put on 50 mcg Levoxothyrene.  Testing a month later showed normal ranges were achieved, with free T3 right at the boarder of 3.9, but I was changed to 75 mcg Synthroid, I think because some ranges weren't in the middle.  However, in the most recent testing, free T3 was omitted.  What's that all about?  Maybe I'm just paranoid, but when he said the numbers should both be high or low, I believed him, and mine aren't.

Thanks for any insights you have!
Alyson

[stella5349]

We'll either way - your opt level is NOT where you need to be to feel better.

It may take time - but push the doctor to tweek your meds.  You may want to suggest an increase of .88 to see if the TSH drops below the 1.45

Some have a better result when they are at a .5 to a 1.5 so you may need to be lower.

TSH is just that "a reading" it may not be normal for you - so beaware that if you doctors says on paper your fine - let him know your not and want to be twweked.

Tell him - YOU will let him know when you feel better and not judge you on a piece of lab paperwork.

[Alyson928]

Sorry, this is Alyson again.  I can see the table got hosed up, so here's the info:

June 6
TSH = 7.62

June 17
Free T4 = .64
Free T3 = 4.36

July 29
TSH = 2.59
Free T4 = .82
Free T3 = 3.9

September 2
TSH = 1.45
Free T4 = 1.01

[Alyson928]

I really appreciate your comments, because all the doctor talks about is the numbers ... other than when I initially said I'm exhausted.  The problem is, the doctor said my levels are fine, but I don't feel fine.  I don't feel as exhausted now that I'm on 75 mcg Synthroid (well, the last few days at least), but I don't feel normal.  I'm still really tired, have no problems sleeping 10 hours a day, and at work I have a hard time focusing for the normal 8 hours.  (On the days I work from home, I lay down over my lunch break, and that gets me through the afternoon.)

Ref Low Ref High 6/6/08 6/17/08 7/29/08 9/2/08
Medicine (4 wk min) 50 mcg 75 mcg
TSH 0.34 5.60 7.62 2.59 1.45
Free T4 0.58 1.64 0.64 0.82 1.01
Free T3 2.50 3.90 4.36 3.90

Above are all the test results they've run so far.  (I hope the columns line up the way it pasted.)  In June I was exhausted (and before, but I thought it was the allergy problems I was having).  In June I was feeling worse, and when they took the test 9/2 I felt as bad as I did in July.  In the last few days I've been feeling a little better, but have been taking iron pills some too (because I heard that could help with low energy).

Is it possible that my levels are going up and down all the time?  Sometimes, I get hot for no good reason - and I'm only 33, so not accepting hot flashes yet : )
Are there other tests (beyond blood tests) that would be appropriate at this time?

Thanks a bunch!

[stella5349]

When you were bumped to the .75 Synthroid

What was the TSH on the last test?

Oddly Free T3 is not always ran - it should be - but if you don't push sometimes they ignore the testing.

Prior to your increase - your labs indicate hypothyroidism. That is why Levo was Rx.

Did you feel better when your FT3 was 4.36 or are you better with 3.9?

Symptom wise--- tell us how you feel.

Testing and being in the "middle" ranges will not necessarily mean you are fine. Everyone is different - We all have different lab numbers when we feel well. Don't just think being in the middle will make this Ok for you.

God knows. I am no where near being in a  middle baseline number in my labs --- and I feel terrific.