Thyroid Results - can you help?

[llovell67]

I just got back my labs and the numbers are way different from the labs I took just 10 days before. I have Graves and have just started taking Toprol XL and Tapazole 30mg/day. Can you tell me if this is severe hyperthyroid and if you think the drugs are going to have any help?

Free T3 3.4 Range is 0.9-1.8
TSH <0.02 Range is 0.30-4.50
T-3 uptake 39.0 Range is 25-35
T3 Total 441 Range is 86-200

What do these mean?

Thank you!

[mkgbrook]

Well you are still hyperthyroid and it looks like you need an increase in your anti-thyroid dosage.
They also didn't perform a FT4 on you. You need a Ft4 and FT3 done. The T3 was a waste of blood and ink.

T-3 uptake 39.0 Range is 25-35 - This is an indicator of how well you are converting and using your T4. In your case you are an over converter of T4 to T3. This is very common in hyperthyroid patients. We burn off T3 quicker.

Free T3 3.4 Range is 0.9-1.8 How hyperT? Well you do not have a Ft4 test so I can only tell you how hyperT you are in comparison to optimal given active T3 in your system.. You are at 277% of the normal range. Optimal upper limit is 80% of the normal range so.. you are roughly 3x the maximum normal T3 limit. On the upside.. I have seen worse. I maxed out at 390% once when my Graves was more active than my Hashimoto's.

TSH <0.02 Range is 0.30-4.50 Well this is your pituitary gland telling the thyroid to STOP making T4 we have enough thyroid hormone already floating about.. i.e. you are still hyperT.

So IMO you need an increase in meds and you need to get that Ft4 run to see where you stand in comparison and balance.

MG

[llovell67]

Thanks MG -

I'm sorry, I labeled the results wrong.
Free T4 is 3.4

[accessn12]

It's almost impossible to tell how hyper you are from the numbers. Every hyper reacts differently to the amount of circulating hormones. Some people are very hyper at just a little bit of extra hormone and some hardly feel a large excess at all. Everybody's body is different.

Sorry mg, I'm going to contradict you. A raise in medication is NOT indicated at this time. 30mg is the maximum safe dose of Tapazole except in emergency situations. For most it is enough to totally suppress the thyroid and given enough time, more than enough to turn a hyper into a hypo. If it was just started, it will take a minimum of 4 to 6 weeks before you will see a real steady state reduction in circulating thyroid hormones.

Also the T3 uptake is not an indication of how well you are converting. It's an indirect measurement of thyroid hormone binding proteins. It used to be the only cost-effective method of estimating the free t4 level cause the higher the level of binding proteins, the less free hormone is circulating. In hypers, the level is usually high and in hypos, it is usually low. If there is a paradox in that number, it's very likely you're looking at a thyroid binding protein anomaly.

The topral is given to control some of the symptoms until the anti-thyroid meds have enough time to have an effect in reducing the amount of thyroid hormone being produced. It also takes a while for the thyroid hormone that is already circulating to clear your system.

Give it some more time llovell and I think you will feel much better. It's kind of a waste of money to have labs done so close together. 4 to 6 weeks apart will give a much better picture as to when the dose of Tapazole should be reduced.

I wish you the best of luck and hope you get to feeling better real soon.

[mkgbrook]

No problem. I like it when people disagree. Especially in areas I am not as familiar with. My Aunt with Graves flops about a bit on her doses. She has orders to increase meds by 10 mg when still hyper in the levels that the labs indicate. She also has had to take 25 mcg of T4 on occasion as well. Graves can be a flightly critter to manage.

Being 277% of normal range in T4 can be hard on you if your body is not made to run there. At 190% I felt like I was going to pop and break apart at the hips and knees. If these labs hold in the next round of blood work then an increase in meds may be needed.

Access is right 100%. I misread the post a bit initially and was under the impression that you were on the suppressants a while, not just 10 days. You do have to give your medication and body time to adjust as needed. Most cases you want a 4 week minimum before increasin meds if you are hypoT. I am not sure how this shifts about for hyperTs and suppressent medication. I will need to dig into the pharmokinetics of the drugs some more.

MG