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Old 09-11-2003, 02:53 PM   #1
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Red face Lab results- Help! Now what?!

My labs in July:

TSH 5.59 (0.3-5.5)
Free T4 1.2 (don't remember range)
No diagnosis or treatment given.

Labs today 9/11/03

TSH 3.85
Free T4 0.94

I got these from the nurse. She didn't give me ranges or any of my other results. She said those were normal and I could talk to the doctor about it when he calls me tomorrow.

HELP!!- My TSH went down w/o meds but I feel WORSE than I did at the first labs!!! What do I say when he calls tomorrow?!?!? And what does the change in Free T4 mean? I'm scared he's going to tell me I'm fine, and just either deal with the symptoms or put me on "psyco-drugs." What am I going to do? I need some help and explaination of results guys, PLEASE!!!

 
Old 09-11-2003, 03:18 PM   #2
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BUMP!!! I need some help guys! Also see my other post about food causing a change in #'s.

 
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Old 09-11-2003, 04:48 PM   #3
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Bump!

 
Old 09-11-2003, 04:51 PM   #4
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TSH can vary by up to 3 units in the course of 24 hours, so the cahnge there is not really statistically significant. Your T4 DID drop significantly, though.

Probable lab ranges for your results are:

Free T4 0.8-1.8
TSH .3-3.0 (per the American Association of Clinical Endocrinoloists though your lab's range may have something as high as 6 at the top end.)


You feel worse, because your T4 is lower, if my guess is correct. I believe tat with your TSH as high as it is, you should seek the opinion of another doctor. If you are on insurance, tis may mean going outside your insurance for a diagnosis, and it will be worth it if you have to.
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Old 09-11-2003, 04:57 PM   #5
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Meep-

Thank you for replying!!!

The doctor I saw today is new for me. I found him on the Armour thyroid website. I intentionally did not mention my previous test results, because I didn't want him to think I was a "doctor-hopper" if I didn't get my way. Do you think I should bring this up to him when I talk to him as well as my previous results? Good news...he does seem like a doctor willing to listen.

BTW- What is the relationship between the two tests? What I mean is how will a change in one affect the results of the other and vice versa?


[This message has been edited by imsotired (edited 09-11-2003).]

 
Old 09-11-2003, 05:55 PM   #6
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Please give me any advice you may have!!! See my other thread too, please!!!

 
Old 09-11-2003, 06:41 PM   #7
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My test were within normal limits too. Ask your dr. to let you try Armour. I am really surprised that he didn't do your FT3 since he is considered an Armour doc. I basically told my dr. that I knew "my lab tests felt fine, but I didn't." Ususally you can talk them into humoring you if you are non-confrontational. I really think if you got a tsh every week it would vary, just depends on whether your pituitary is on another project. I would tell him about the other test and tell him he was recommended on the Armour site. If he's like my dr., he will give you a low dose with a couple of refills(he knew I was going to raise the dose gradually, just not as much as I did). I experimented and then went in after I ran out of 3 months worth of drugs in six weeks and told him how much better I felt and about upping my dose. He was okay with it since I was so improved. Worth a try. LOL IWL

 
Old 09-11-2003, 06:46 PM   #8
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Thank you for the advice. He did run many different thyroid tests including a urine test (I didn't even know there was a thyroid urine test), but the nurse wouldn't give them all to me without talking to him first.

I'll ask him about starting meds regardless of test results.

 
Old 09-12-2003, 12:09 PM   #9
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Quote:
Originally posted by imsotired:
Do you think I should bring this up to him when I talk to him as well as my previous results? Good news...he does seem like a doctor willing to listen.

BTW- What is the relationship between the two tests? What I mean is how will a change in one affect the results of the other and vice versa?
If you bring up past doctor experiences to him at all, bring up to him that other doctors haven't listened and that you are glad he seems to listen, care and understand, and leave it at that. Compliment and encourage, but dont' talk bad about the other doctors other than stating that they didn't seem to listen. Keep it factual and leave your emotions out of it.

We men are notorious for preferring facts over emotions, and we can't help it, darn the luck. As much as that confounds and confuses women, men communicate and think differently. Women are equally as confused about women and the way they express their emotions. (can you tell I have been reading Mars and Venus books? )

Speaking of relationships, you asked about the relationship between T4 and TSH levels. OK, here's how it works:

TSH stimulates the thyroid gland to produce thyroid hormones including T4. The Higher the TSH, the more your thyroid gland is poked and prodded and told to produce more T4 and T3. Lower TSH Tells the thyroid gland to slow down.

On the flip-side of that, T4 and T3 are measured in the blood by the hypothalamus which tells the Pituitary how much TSH to make. More T3 and or T4 means that it will tell the pituitary to make less TSH. If the hypothalamus thinks you have enough thyroid hormones, it keeps TSH steady (usually around 1-1.5 or so in a healthy adult with no thyroid problems or risks). If it thinks you have too much T3 and T4, it lowers TSH so the thyroid gland will slow down. If it thinks you have too little, it speeds up the thyroid gland by cranking up the TSH.

So, T4 lowers TSH and TSH raises T4. Supposedly, they should find a balance point, but in some people that doesn't happen. That's where we are as hypothyroid patients. In most of us, the thyroid gland doesn't respond well enough to TSH and so TSH continues to rise in order to kick the thyroid into action, instead of finding balance.
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Old 09-12-2003, 01:58 PM   #10
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Hey Meep, Even though "men prefer facts over emotions" you pretty much suggested that she butter him up a little just like I did. The things we do to make men/drs. feel cooperative. Hey, whatever works. LOL, IWL

 
Old 09-12-2003, 04:54 PM   #11
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Well, my doctor FINALLY called at around 5:15 pm. He said all my labs look fine to him. He really wasn't interested in my previous lab work since it was not done in the lab he uses and he couldn't "vouch for it's accuracy." He said by the symptoms I described, it still sounds like thyroid to him and he was really surprised that my results weren't higher.

He told me I could come back in a month and do it all over again if I wanted. If I didn't have a significant change or if he couldn't see a trend or pattern, he'd be happy to give me copies of my labs and refer me to an endo. I quote, "There's not any around here though, heh, heh, heh." GRRRRRRRR! I kinda liked him up til he acted like that. As if I'm just stuck with him and there's nothing I can do about it.

I am going to wait a month and have my labs redone though. Not because I "sooooo impressed" with him, but because I want to have lab work done consecutively in the same lab and to give him ONE more chance them I'm outta there if he still acts like I'm some sort of idiot with no other options. I'm NOT excited about the idea of having to put on the miles to go to an endo, but I've finally come to the realization that I gotta do what I gotta do if I really want to feel better.

OH YEA- and he doesn't prescribe meds based on symptoms, just labs. He shot that idea down before I even had the chance to suggest it.


Found out my ranges (kinda):

TSH- high end was 4.5 (mine was 3.85)
free T4- low end was 0.71 (mine was 0.94)

[This message has been edited by imsotired (edited 09-12-2003).]

 
Old 09-13-2003, 12:22 AM   #12
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Augh! If he only goes by tests, then your tsh is hypo according to new guidelines. Print out the AACE new tsh guidelines and mail it to him with a note asking AGAIN for a trial dose. You're gonna have to fight. There's no guarantee that the endo doc will be any different. Double AUGH! So much for buttering him up. Hugs, IWL

 
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