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thyroid blood work

I 'll appreciate if someone says some words after have a look on the figures.

3months ago my TSH was 2.3-2.5 (I dont remember the exact figure). since 1month I have beeen very lethargy and drowsy....sometimes I do feel mental slowness, when I walk...my muscles ache too.....kinda weird tiredness that seems to staying with me forever.
my cholesterol levels are deranged....

Total Cholesterol 5.49 (cut off is 5.2)
LDL 3..28 (should be 1.30)
Triglycerides 2.06 (requires attention/treatment)

Prolactic 18.9( cut off 18.6)
total proten 83( range is 63-82)
TSH 3.64 (normal is 0.46-4.6)

Havent received free T3 yet.

I am hoping the symptoms I have been experiencing is due to the change in the dose my family doc made 3months ago....I was on 150MCG of Synthyroid earlier and then 3months ago my doc changed it to 112MCG.......
I am concerned about "myxedema".....since I have been feeling very tired and my face is puffy too. my endocrinologist has increased my dose to 125MCG ......and he's gonna see if I have same symptoms after 1 month of use.

any kind of advise/suggestion regarding the symptoms'll be appreciated.

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1097839 tn?1344579942
wow, what a fascinating article Gimel. thank you so much for posting the link.

it's so incredibly complex, after 6 months with this illness and having learned so much my head is still spinning with trying to understand it all. I am starting to get to a point where I hope I will be able to have an informed discussion with my doctor about getting FT3 tested when my next bloods are due, in about 4 wks. I have more homework to do to completely get it but it's starting to fall in to place a bit for me and your postings are helping that process so thank you.

clearly there is a raging controversy within the medical community and that makes it extra difficult for us patients to navigate this complex condition. it's so good to have a forum like this where more experienced patients can share their knowledge and insight to those of us new to the whole thing.

Helpful - 0
Avatar universal
When I said that  "In my opinion the very best way to treat a thyroid patient is to test and adjust FT3 and FT4 with whatever type of medication is necessary to alleviate symptoms, without being constrained by resultant TSH levels", I should have added that frequently we hear from members with FT3 and FT4 within the lower part of their reference ranges, yet they have lingering hypo symptoms.  To alleviate symptoms often requires that FT3 is adjusted into the upper part of its range and FT4 is adjusted to at least the midpoint of its range.  If your body is not converting T4 to T3 adequately, then that is when it is advisable to add a source of T3 meds in order to raise FT3 level and alleviate symptoms.

Here is a good article that I think you might benefit from reading and discussing with your doctor as well.

http://www.hormonerestoration.com/Thyroid.html
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Avatar universal
hi gimel,

thanx for helpful advise. I actually spoke to my endocrinolgist for checking free t3 and free t4. he was not very happy but he had made a requisition. so far I have not received my free T3 measurements as yet....since in this small town of canada, they dont usually perform a freeT3 test in their labs....so its referred out and 'll take a few more days for the test to be back at my doc's office.
I am not sure what happens to FreeT3 level if you are hypothyroid??it must be low I guess. and if the results come out "low"....'ll my endo start treating me with other medication.....I doubt it since most ofthese endocrinolgists they follow a "bookish management".....I spke to the end a few days ago for prescribing me cytomel(t3) but he thought I shouldnt be thinking in this direction, rather I should forget about T3 meds.
I was not forcing him to prescribe me t3.....I just asked him and he got upset.I actually wanna to know some other lines of treatment but he didnt understand my question. I dont know, but may be they need to learn how to listen to the patients views and querries. recently I have found a "surgeon" and a naturopath in a city away from my town and I 'll be seeing him soon.....just wanna to get a second opinion.so I think your suggestion about "finding a new doc" is reasonable.

the answer to your suggestion regarding "be more demanding"....I'll try it once I get my freeT3 results.thankyou so very much.
Helpful - 0
Avatar universal
TSH is a pituitary hormone that is affected by so many variables that it is inadequate as a diagnostic, by which to determine medication.  At best it is only an indicator to be considered along with more important indicators, which are symptoms and also the levels of the actual, biologically active thyroid hormones, free T3 and free T4 (FT3 and FT4, not to be confused with total T3 and total T4).  Free T3 is the most important because it is about 4 times as active as free T4.  FT3 also correlates best with hypo symptoms.  TSH correlates very poorly with hypo symptoms.

In my opinion the very best way to treat a thyroid patient is to test and adjust FT3 and FT4 with whatever type of medication is necessary to alleviate symptoms, without being constrained by resultant TSH levels.  I suggest that insist on being tested for FT3 and FT4 and also find out if the doctor is willing to treat you as I described above, rather than by TSH level.  If your doctor does not agree with this approach, then you will either have to be more demanding of what you need, or find a good thyroid doctor.
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1097839 tn?1344579942
it does sound like you've had too much of a reduction in your dose. I don't know why your family doc would cut you down from 150 all the way to 112, it sounds like too big a jump and very likely to have caused your symptoms. I'd question him on why he made that decision and let him know the effect it has had on you so he is more cautious with the next hypothryoid patient he deals with.

Glad to see you have an endo and he has increased your dose by a sensible sounding amount. if you aren't better after a month he has the option of increasing it again and if you felt fine on 150 mcg then you should expect to feel fine again when they've got the dosage correct again. I hope you're not going to be in for months of slow adjustments as that's what I'm going through at the moment.

Re your TSH result, there is some disagreement around what the normal band should be. You probably want to be less than 3, I think that's the official upper limit for normal in the US, it was revised a few years ago but the range your family doc has given you is what the range used to be and apparently quite a few doctors still work to the old range for some reason. I'd ask your endo whether he uses the same range or the newer one.

Your dose should be based on a combination of what your readings say and how you feel. if you have a good doctor who understands your illness hopefully you will soon be right as rain again, either on the 125 you are on now or on a slightly higher dose further down the line if it turns out that's what you need. It sounds like your endo is on the case.

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