I'm getting new labs done tomorrow at 9:00 to see if my dose is too low. I've read different things about not taking your meds before labs because it will affect the tsh. Is that true? Should I not take it?
I kind of wish someone would answer this for you. I don't know the answer either. My labs came back so screwy that I think that taking my synthroid an hour and a half before the test gave a bad result with a tsh of .10(.50-5.0 normal range). But I dont know for sure.
Meds don't immeditely alter your TSH. If your MD tests only the TSH, take your meds and don't worry about it.
If he/she tests T4, either total or free, do NOT take your med before the blood draw. It will cause a spike in T4 that can look like overmedication and make your MD want to decrease your dose when it isn't warranted.
If you take a T3 med, either Cytomel or Armour, and your MD tests T3, either total or free, do NOT take your med before the blood draw for the same reason as above.
I didn't see this post in time, so I already took my meds this morning. She does test for T4, but it seems she's only looking at the TSH right now, which keeps getting lower despite dose decreases. Oh well. Hopefully she'll also go by symptoms. There's no way she can lower my dose even more since I'm basically taking 50mcg, and I feel bad at that dose.
How long before getting your blood drawn did you take your thyroid medication? It takes an hour for most of the T4 to get in the blood. This will cause a spike in blood T4 levels for 3 - 4 hours after absorption. Then about 2 hours after taking your meds your get a secondary conversion spike where a lot of the excess T4 running about is grabbed and sent into T3 conversion. You tend to have higher than normal T3 levels 3-5 hours after taking your meds. Rule of thumb for taking your thyroid meds on the day of a blood draw:
1) If your blood draw is early morning, wait until after your blood is drawn.
2) If your blood draw is in the afternoon, take your T4 supplement at least six hours prior to your blood draw.
Tigger is she monitoring your Ft3 levels as well? Having a spiraling lower TSH with decreasing dosage points to one of two things. Your T4 to T3 conversion may be in over drive or your pituitary gland is not functioning as it should. Has your MD checked your adrenals (these affect the rate of T4 to T3 conversion) and your pituitary gland (This gland tells the thyroid when to make more meds as well as the adrenal glands when to make more hormones as well. I like to imagine the pituitary gland as the hormonal over seerer.)? Both are important to keep an eye on if you have been hypothyroid for a long time. Long term untreated hypothyroidism has been known to cause the adrenals to become fatigued or shut down. In the case of Hashimoto's and Graves, AI attack can be polyglandular. All in all just watching the TSH and Ft4 and tweeking your T4 dosage may not be enough if you are a complex case.
Just my non-MD opinion. But my first IM and Endo put me off long enough on treatment that my adrenals shut down and my pituitary gland just doesn't work like it is supposed too. I have lazy glands. I wish I could take a vacation like they did. Early retirement.. sounds good, huh?
If we learn by our mistakes, I am working on one hell of an education.
I guess I'm screwed then because I took my meds at 6:00 and had my blood drawn at 9:30. Maybe if I've always taken my meds before my bloodwork, it will at least be consistant. My doctor has never told me to not take my meds before. I'm sure she'd say it doesn't make a difference.
No, she's never tested my adrenals, but I did have an MRI for my pituitary and they found nothing.
I don't think she's really looking at FT3 since I have to ask for that one every time I have labs done. Seems she's only looking at TSH and FT4.
YOUR DOCTOR SHOULD HAVE ADVISED YOU WHAT TO DO. Sometimes YOU DO NEED TO TAKE ALL YOUR NORMAL MEDS SO THEY CAN MEASURE IF YOU'RE ON THE CORRECT AMOUNT. If they want to find out more info about TSH or your dis-ease, then the Doc may suggest NOT TO TAKE THEM. Always, Always, ask your Doc - the lab tech will have no idea. And as for fasting - that too you need to ask your doc. I'm having alot of blood/urine tests done and this time I'm taking my meds and DO NOT HAVE TO FAST. So just ask - you don't want to do it all over again. And if you don't advise Doc, he/she could misread the results - if you took the Synthroid and didn't tell her -he/she may think you HYPERTHYROID. But when you tell your Doc, then they can "guestimate" the overabundance of T3/T4 - especially if you take in the a.m. and then are tested soon therafter. Docs should always write directions on the top of form - with Hashi's or hypothyroid, we're lucky if we can remember what day it is before checking a calendar! Best wishes!